Waste Management from Patients Being Treated for Mpox Virus

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Situation Update: 2022 Mpox Outbreak

In 2022, an outbreak of mpox spread across several countries that don’t normally report mpox, including the United States. Mpox contaminated waste management practices can differ depending on the strain of mpox virus. For how to handle waste for the West African clade of mpox viruses, read the latest blog post on the topic.

As information on the 2022 mpox outbreak is evolving, refer to the CDC website for the latest information (CDC, https://www.cdc.gov/poxvirus/monkeypox/about.html, Accessed 7/21/2021).

The United States recently had a case of mpox virus diagnosed in a patient in Dallas County, Texas (CDC, https://emergency.cdc.gov/han/2021/han00446.asp, Accessed 12/13/2023). Organizations in the U.S. now preparing for the potential need to handle patients under investigation or patients with the mpox virus must also consider both the solid and liquid waste associated with such patients. It is also important to develop a communications strategy to alleviate concerns from the general public associated with both the solid and liquid waste.

The waste associated with mpox virus is considered a Category A Waste (DOT, https://www.phmsa.dot.gov/transporting-infectious-substances/planning-guidance-handling-category-solid-waste, accessed 7/21/21) as it is identified as such by United Nations 2814 (DOT, https://www.federalregister.gov/documents/2005/05/19/05-9717/hazardous-materials-infectious-substances-harmonization-with-the-united-nations-recommendations, accessed 7/21/21). Waste from patients infected with the West African Clade of mpox only may be determined exempt from category A Infectious Substance Regulations – contact local public health authorities for further guidance. As organizations begin to prepare or implement their waste handling strategies, they should first check with their local and state health officials (CDC, https://www.cdc.gov/poxvirus/monkeypox/clinicians/infection-control-home.html, Accessed 7/21/2021) who oversee solid and liquid waste as well as the requirements from various federal government agencies. If using a vendor that has a Department of Transportation special permit for Category A waste, you and the vendor should confirm with DOT if an update to the special permit is required to cover mpox. As the waste from the Ebola virus disease (CDC, https://www.cdc.gov/vhf/ebola/clinicians/cleaning/waste-management.html, Accessed 7/21/2021) and the mpox virus are both Category A waste, then organizations may decide to use their existing Ebola virus waste management plan. Contaminated waste must be disposed of according to Category A Infectious Substance regulations (UN2814) and can be disposed of after decontamination by steam sterilization, chemical disinfection and/or incineration.