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By Jordan King
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The mpox virus has been detected in San Francisco's wastewater, amid serious concerns about a different version of the disease plaguing other parts of the world.
The WastewaterSCAN Dashboard, a public health tool used to monitor infectious diseases within communities, shows that mpox, formerly known as monkeypox, was detected in southeast San Francisco on July 26, August 11 and August 12.
It is important to note that it is not clear whether these detections come from human sources. It is also important to note that WastewaterSCAN identified the clade II variant of the virus rather than the clade I variant that the World Health Organization (WHO) has declared a "public health emergency of international concern" over.
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The San Francisco Department of Public Health (SFDPH) told Newsweek that the virus detected was clade II, said "mpox cases in San Francisco remain very low" and added that the department would "continue to monitor developments regarding clade I."
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San Francisco's database on the virus, Mpox data and reports, does not show any data for August yet, but does show one case recorded in July.
In May, the San Francisco Health Department encouraged people to take care of their sexual health as summer approaches by being fully vaccinated for mpox.
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It said: "While there is not currently a rise in mpox cases in San Francisco, the virus continues to circulate in areas in the United States.
"In addition, the Centers for Disease Control and Prevention (CDC) is monitoring an outbreak of a different strain of the mpox virus that is currently spreading in the Democratic Republic of the Congo and that causes more severe disease."
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Neighboring Congo has seen 96 percent of all the 17,000 suspected cases across Africa and 517 confirmed deaths since the start of 2024, according to the CDC. The Central African country is one of 14 that have reported outbreaks so far this year.
Mpox came to the fore during a global outbreak in 2022, affecting the U.S., Europe, Australia and many other countries. The virus comes in two "flavors"—clade I and clade II—and spreads through close contact.
The previous outbreak in the U.S. and Europe was driven by the clade II form of the virus and was mostly spread through sexual and intimate contact, with men who have sex with men being at the highest risk of infection. However, the current surge in Africa is being driven by a new variant of the clade I virus, called clade Ib, which is thought to cause more severe disease than previous variants.
On Thursday, Sweden announced the first case of clade I mpox variant outside of Africa.
Sweden's public health agency said in a statement: "A person who sought care at Region Stockholm has been diagnosed with mpox caused by the clade I variant. It is the first case caused by clade I to be diagnosed outside the African continent.
"In this case, a person has been infected during a stay in the part of Africa where there is a major outbreak of mpox clade I. The person in Sweden who has been confirmed to be infected has received care and rules of conduct."
Just the day before, WHO director-general Tedros Adhanom Ghebreyesus said: "This is something that should concern us all...The potential for further spread within Africa and beyond is very worrying."
SFDPH's full statement to Newsweek reads: "At this time, mpox cases in San Francisco remain very low. The seven-day average for mpox cases is currently zero.
"WastewaterSCAN has detected traces of clade II (2022 outbreak type) mpox in San Francisco's wastewater. Mpox has been monitored in wastewater in San Francisco since 2022, with periodic detections since the 2022 outbreak. At this time, mpox detections in San Francisco's wastewater are significantly below levels seen during the 2022 outbreak. For additional questions about wastewater monitoring, please contact WastewaterSCAN.
"SFDPH continues to monitor developments regarding clade I (the 2023 DRC outbreak) mpox along with our federal and state partners. No cases of clade I mpox have been reported in the United States at this time.
"The two-dose mpox vaccine provides the best protection against mpox, including clade I. While anyone who wants protection from mpox may seek a vaccine, we encourage people to visit sf.gov/mpox to see if the vaccine is recommended for them, and to complete the two-dose series.
"Individuals can receive their second dose of the mpox vaccine if it has been at least 28 days since their first dose. There is no need to restart the two-dose series if it has been over 28 days since the first dose. Booster doses are not recommended at this time for those who have completed the two-dose series. In addition, mpox vaccination is not recommended at this time for those who have previously been infected.
"We will continue to update the community if further actions are needed to protect health."
Update 8/19/24, 11:01 a.m ET This article has been updated with comment from the SFDPH and further details.
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