Diagnosis (References)

29 July 2022

Nörz D, Tang HT, Emmerich P, et al. Rapid Adaptation of Established High-Throughput Molecular Testing Infrastructure for Monkeypox Virus Detection. Emerg Infect Dis. 2022 Jul 29;28(9). PubMed: https://pubmed.gov/35905463. Full text: https://wwwnc.cdc.gov/eid/article/28/9/22-0917_article

The authors adapted 2 published quantitative PCRs for use as a dual-target monkeypox virus test on widely used automated high-throughput PCR systems. The lower limit of detection for the combined assays was 4.795 (95% CI 3.6–8.6) copies/mL. The assay showed 100% positive (n = 11) and 100% negative (n = 56) agreement.


26 July 2022

Suran M. Expanding Monkeypox Testing. JAMA. 2022 Jul 26;328(4):321. PubMed: https://pubmed.gov/35881138. Full text: https://doi.org/10.1001/jama.2022.11839

“To increase the accessibility of monkeypox testing, the US Department of Health and Human Services (HHS) began shipping monkeypox tests in late June to 5 commercial laboratory companies: Aegis Science, Labcorp, Mayo Clinic Laboratories, Quest Diagnostics, and Sonic Healthcare.”

16 July 2022

Peiró-Mestres A, Fuertes I, Camprubí-Ferrer D, et al. Frequent detection of monkeypox virus DNA in saliva, semen, and other clinical samples from 12 patients, Barcelona, Spain, May to June 2022. Euro Surveill. 2022 Jul;27(28). PubMed: https://pubmed.gov/35837964. Full text: https://doi.org/10.2807/1560-7917.ES.2022.27.28.2200503

In 147 clinical samples from 12 patients tested by by real-time PCR, monkeypox virus DNA was detected in saliva from all cases, sometimes with high viral loads. Other samples were frequently positive: rectal swab (11/12 cases), nasopharyngeal swab (10/12 cases), semen (7/9 cases), urine (9/12 cases) and faeces (8/12 cases).


15 July 2022

Aden TA, Blevins P, York SW, et al. Rapid Diagnostic Testing for Response to the Monkeypox Outbreak – Laboratory Response Network, United States, May 17-June 30, 2022. MMWR Morb Mortal Wkly Rep. 2022 Jul 15;71(28):904-907. PubMed: https://pubmed.gov/35834423. Full text: https://doi.org/10.15585/mmwr.mm7128e1

By the end of June 2022, <10% of the US Laboratory Response Network (LRN) non-variola Orthopoxvirus (NVO) testing capacity had been used. Expansion to five commercial laboratories starting the week of July 5 will make testing in more accessible and increase convenience for providers and patients.


6 July 2022

Mande G, Akonda I, De Weggheleire A, et al. Enhanced surveillance of monkeypox in Bas-Uélé, Democratic Republic of Congo: the limitations of symptom-based case definitions. Int J Infect Dis. 2022 Jul 6:S1201-9712(22)00390-3. PubMed: https://pubmed.gov/35809857. Full text: https://doi.org/10.1016/j.ijid.2022.06.060

In this study from the Democratic Republic of Congo, the authors find that only 27% of suspect cases, as identified by an adapted “community” case definition, were confirmed as monkeypox. Most cases were finally diagnosed as chickenpox. Only three clinical features (monomorphic rash, rash on palms of hands, and rash on soles of feet) had some discriminative value for monkeypox.


4 July 2022

Ulaeto DO, Lonsdale SG, Laidlaw SM, Clark GC, Horby P, Carroll MW. A prototype lateral flow assay for detection of orthopoxviruses. Lancet Infect Dis. 2022 Jul 4:S1473-3099(22)00440-6. PubMed: https://pubmed.gov/35798023. Full text: https://doi.org/10.1016/S1473-3099(22)00440-6

The authors describe a prototype lateral flow assay that uses a cocktail of four monoclonal antibodies specific for Old World orthopoxviruses. The monoclonal antibodies do not recognise New World orthopoxviruses or members of the Parapoxvirus, Leporipoxvirus, or Suipoxvirus genera.


24 June 2022

Vandenbogaert M, Kwasiborski A, Gonofio E, et al. Nanopore sequencing of a monkeypox virus strain isolated from a pustular lesion in the Central African Republic. Sci Rep. 2022 Jun 24;12(1):10768. PubMed: https://pubmed.gov/35750759. Full text: https://doi.org/10.1038/s41598-022-15073-1

The authors evaluated the use of the portable real-time ONT sequencer (MinION) to target and sequence the full MPXV genome from DNA isolated from a pustular lesion in the context of an epidemic in a remote area of the Central African Republic.