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Volume 32, Supplement –Summer 2026
SUPPLEMENT ISSUE
Other
Monkeypox Virus Surveillance in Wastewater, North Carolina, USA, October 2023–May 2025
Nicole L. Snyder
, Thomas Clerkin, Sarah H. Koenigsberg, Mara B. Tate, Ty L. Lautenschlager, Justin Albertson, Emma L. Doran, Erica F. Wilson, Rachel T. Noble, Virginia T. Guidry, and Ariel R. Christensen
, Thomas Clerkin, Sarah H. Koenigsberg, Mara B. Tate, Ty L. Lautenschlager, Justin Albertson, Emma L. Doran, Erica F. Wilson, Rachel T. Noble, Virginia T. Guidry, and Ariel R. Christensen
Table 3
Diagnostic characteristics stratified by wastewater treatment plant/sewershed in study of mpox surveillance in wastewater, North Carolina, USA, October 2023–May 2025
| Sewershed | TP | FP | TN | FN | Sensitivity, % (95% CI) | Specificity, % (95% CI) | PPV, % (95% CI) | NPV, % (95% CI) |
|---|---|---|---|---|---|---|---|---|
| Cary 1 | 0 | 2 | 5 | 0 | – | 71.4 (35.9–91.8) | <1 (0–65.8) | 100 (56.6–100) |
| Cary 2 | 0 | 0 | 7 | 0 | – | 100 (64.6–100) | – | 100 (64.6–100) |
| Cary 3 |
0 |
1 |
2 |
4 |
<1 (0–49.0) |
66.7 (20.8–93.9) |
<1 (0–79.3) |
33.3 (9.7–70.0) |
| Chapel Hill |
0 |
0 |
2 |
0 |
– |
100 (34.2–100) |
– |
100 (34.3–100) |
| Charlotte 1 | 0 | 4 | 78 | 0 | – | 95.1 (88.1–98.1) | <1 (0–49.0) | 100 (95.3–100) |
| Charlotte 2 | 6 | 0 | 60 | 18 | 25 (12.0–45.0) | 100 (93.8–100) | 100 (61.0–100) | 77.0 (66.4–84.9) |
| Charlotte 3 | 3 | 0 | 52 | 23 | 11.5 (3.5–29.0) | 100 (93.1–100) | 100 (43.9–100) | 69.3 (58.2–78.6) |
| Charlotte 4 |
3 |
6 |
44 |
27 |
10.0 (0.03–25.6) |
88.0 (76.2–94.4) |
33.3 (12.1–64.6) |
62.0 (50.3–72.3) |
| Greensboro |
0 |
3 |
67 |
0 |
– |
95.7 (88.1–98.5) |
<1 (0–56.2) |
100 (94.6–100) |
| Greenville |
0 |
2 |
71 |
0 |
– |
97.3 (90.6–99.1) |
<1 (0–65.8) |
100 (94.9–100) |
| MSD Buncombe (Asheville) |
0 |
2 |
42 |
17 |
<1 (0–18.4) |
95.4 (84.9–98.7) |
<1 (0–79.3) |
71.2 (58.6–81.1) |
| North Durham |
0 |
1 |
6 |
0 |
– |
85.7 (48.7–97.4) |
<1 (0–79.3) |
100 (61.0–100) |
| Raleigh | 3 | 2 | 40 | 38 | 7.3 (2.5–19.4) | 95.2 (84.2–98.7) | 60.0 (23.1–88.2) | 51.3 (40.4–62.1) |
| Raleigh 2 | 0 | 4 | 71 | 0 | – | 94.7 (87.1–97.9) | <1 (0–49.0) | 100 (94.9–100) |
| Raleigh 3 |
0 |
3 |
75 |
0 |
– |
96.2 (89.3–98.7) |
<1 (0–56.2) |
100 (95.1–100) |
| South Durham | 0 | 2 | 5 | 0 | – | 71.4 (35.9–91.8) | <1 (0–65.8) | 100 (56.6–100) |
*Dashes indicate that sensitivity cannot be evaluated in sewersheds with no clinical cases (TP+FN) and PPV cannot be evaluated in sewersheds with no detections (TP+FP). FN, false negative; FP, false positive; MSD, Metropolitan Sewerage District, NPV, negative predictive value; PPV, positive predictive value; TN, true negative; TP, true positive.
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Page updated: August 27, 2026
Page reviewed: August 27, 2026
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