IPSN Community of Practice on specialized surveillance for emergency response

The IPSN is a global network of pathogen genomic actors, hosted by the WHO Hub for Pandemic and Epidemic Intelligence, to accelerate progress on the deployment of pathogen genomics and improve public health decision-making in line with the implementation of the Global Genomic Strategy for Pathogens with Pandemic and Epidemic Potential.

WHO Director-General Dr Tedros Adhanom Ghebreyesus has determined that the upsurge of mpox in the Democratic Republic of the Congo (DRC) and a growing number of countries in Africa constitutes a public health emergency of international concern (PHEIC) under the International Health Regulations (2005) (IHR). To support this response IPSN is standing-up a Community of Practice (CoP) for specialized surveillance for emergency response to facilitate the coordination of pathogen genomics actors. 

Community of Practice Objective & Structure 

Objective 

The objective of this CoP is to support members to exchange knowledge that enhances their ability to make informed decisions, solve challenges, and identify new opportunities for utilizing pathogen genomics and wastewater surveillance in the emergency response to Mpox.

Working Groups & Workstreams 

The CoP is divided into two working groups: Pathogen Genomics Working group (PG) and Wastewater Surveillance Working Group (WES). Within each work group, there are distinct workstreams which enable members to focus on specific issues most salient to them.  

Pathogen Genomics Working group  

This working group will:  

• Support harmonization and in-country deployment of the bioinformatics analysis of MPXV genome data to strengthen quality of the analysis
• Build consensus on standards for genomic data and linked metadata to be uploaded to pathogen genomic data sharing platforms 
• Identify mechanisms to promote and facilitate sharing of raw sequencing data 
• Support analysis and interpretation of MPXV sequencing data to characterize and monitor changes in disease transmission including identifying new clades, identification/verification of mutations of interest, and monitoring transmission chains.  
• Support the integration of sequence data into epidemiological and contextual information as reported by countries. 

Two work streams have been defined for PGS: 

Data and Benefits sharing 

This work stream will focus on: 

• Identify appropriate mechanisms for timely MPXV genomic data sharing

• Identify mechanisms to avoid data fragmentation 

• Identify strategies for selection of samples for sequencing 

  Better Tools and Standards 

This workstream will focus on: 

• Identifying preferred wet lab and bioinformatic workflows
• Harmonizing data standards and protocols 

This workstream is undertaking a landscape analysis of the current status in mpox genomics and maintaining a repository to catalogue regions of the MPXV genome that should be masked for phylogenetic inference.

Wastewater Surveillance Working Group 

Wastewater surveillance has emerged as a valuable tool for detecting and quantifying the mpox virus. The virus is excreted in urine and stool at high levels, and its stability in the environment makes it well-suited for monitoring through sewage. Research has shown that wastewater surveillance for monkeypox virus is highly sensitive, capable of detecting viral DNA even when there are just a few confirmed cases. This method's flexibility allows it to be tailored to meet varying public health needs, capacity, and resources.

This working group will:

• Explore the different use cases for WES in the emergency response to Mpox
• Support knowledge sharing around best practices for implementation and ongoing learnings
• Tackle ongoing challenges to accelerate progress for use of WES in the Mpox response

To achieve this goal, three workstreams have been defined: 

Technical Methods & Approaches

• Technique Evaluation: Discuss and assess different analytic methods and their role in rapid deployment of wastewater surveillance for Mpox detection.  
• Contextual Adaptation: Share experiences on how different techniques perform under varying conditions, including differences in sanitation systems and outbreak scales. 
• Standard Operating Procedures: Review and compare existing guidelines and recommendations for wastewater surveillance across various institutions to identify inconsistencies and gaps.  

Data Interpretation, Integration, and Communication 

• Interpreting Findings: Discuss approaches for distinguishing meaningful patterns from Mpox data from wastewater; and the implication for insights into the situation.  
• Data Integration and Consistency: Explore challenges and solutions related to integrating clinical and genomic datasets with wastewater data. 
• Effective Communication with Stakeholders: Consider strategies for tailoring communication to different stakeholders to ensure the relevance and impact of shared information. 

Sampling Protocols

• Assessment of Sampling Protocols: Explore the effectiveness of sampling protocols in various settings, including healthcare facilities and community environments. 
• Adaptation of Sampling Techniques: Discuss how sampling methods can be adapted based on resource availability and local conditions. 
• Evaluation of Sampling Method Performance: Evaluate the sensitivity and specificity of different sampling techniques for detecting mpox in wastewater. 

If you are interested in joining these community of practice please contact the IPSN Secretariat