Monkeypox laboratory tests: Difference between revisions
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*Confirmation of monkeypox virus (MPXV) infection is based on nucleic acid amplification testing, using real-time or conventional PCR, for detection of unique sequences of viral DNA. PCR can be used alone, or in combination with sequencing<ref name="urlLaboratory testing for the monkeypox virus: Interim guidance">{{cite web |url=https://www.who.int/publications/i/item/WHO-MPX-laboratory-2022.1 |title=Laboratory testing for the monkeypox virus: Interim guidance |format= |work= |accessdate=2022-06-15}}</ref>. | *Confirmation of monkeypox virus (MPXV) infection is based on nucleic acid amplification testing, using real-time or conventional PCR, for detection of unique sequences of viral DNA. PCR can be used alone, or in combination with sequencing<ref name="urlLaboratory testing for the monkeypox virus: Interim guidance">{{cite web |url=https://www.who.int/publications/i/item/WHO-MPX-laboratory-2022.1 |title=Laboratory testing for the monkeypox virus: Interim guidance |format= |work= |accessdate=2022-06-15}}</ref>. | ||
*Preferred test given its accuracy and sensitivity | *Preferred test given its accuracy and sensitivity. | ||
*Samples advisably obtained skin lesions, precisely, the roof or fluid from vesicles and pustules, and dry crusts | *Samples advisably obtained skin lesions, precisely, the roof or fluid from vesicles and pustules, and dry crusts. | ||
*PCR blood tests are usually inconclusive because the does not live long in the blood<ref name="urlMonkeypox">{{cite web |url=https://www.who.int/en/news-room/fact-sheets/detail/monkeypox |title=Monkeypox |format= |work= |accessdate=2022-06-15}}</ref>. | *PCR blood tests are usually inconclusive because the does not live long in the blood<ref name="urlMonkeypox">{{cite web |url=https://www.who.int/en/news-room/fact-sheets/detail/monkeypox |title=Monkeypox |format= |work= |accessdate=2022-06-15}}</ref>. | ||
*Commerical PCR kits to detect MPXV are under development<ref name="pmid27994107">{{cite journal| author=Li D, Wilkins K, McCollum AM, Osadebe L, Kabamba J, Nguete B | display-authors=etal| title=Evaluation of the GeneXpert for Human Monkeypox Diagnosis. | journal=Am J Trop Med Hyg | year= 2017 | volume= 96 | issue= 2 | pages= 405-410 | pmid=27994107 | doi=10.4269/ajtmh.16-0567 | pmc=5303045 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27994107 }} </ref><ref name="pmid22981983">{{cite journal| author=Townsend MB, MacNeil A, Reynolds MG, Hughes CM, Olson VA, Damon IK | display-authors=etal| title=Evaluation of the Tetracore Orthopox BioThreat® antigen detection assay using laboratory grown orthopoxviruses and rash illness clinical specimens. | journal=J Virol Methods | year= 2013 | volume= 187 | issue= 1 | pages= 37-42 | pmid=22981983 | doi=10.1016/j.jviromet.2012.08.023 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22981983 }} </ref>. | *Commerical PCR kits to detect MPXV are under development<ref name="pmid27994107">{{cite journal| author=Li D, Wilkins K, McCollum AM, Osadebe L, Kabamba J, Nguete B | display-authors=etal| title=Evaluation of the GeneXpert for Human Monkeypox Diagnosis. | journal=Am J Trop Med Hyg | year= 2017 | volume= 96 | issue= 2 | pages= 405-410 | pmid=27994107 | doi=10.4269/ajtmh.16-0567 | pmc=5303045 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27994107 }} </ref><ref name="pmid22981983">{{cite journal| author=Townsend MB, MacNeil A, Reynolds MG, Hughes CM, Olson VA, Damon IK | display-authors=etal| title=Evaluation of the Tetracore Orthopox BioThreat® antigen detection assay using laboratory grown orthopoxviruses and rash illness clinical specimens. | journal=J Virol Methods | year= 2013 | volume= 187 | issue= 1 | pages= 37-42 | pmid=22981983 | doi=10.1016/j.jviromet.2012.08.023 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22981983 }} </ref>. | ||
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===Molecular detection=== | ===Molecular detection=== | ||
* In case a of monkeypox suspected case, swabs from lesions, crusts and vesicular fluids to be obtained and tested for MPXV using a real-time PCR. Positive findings should be reported to healthcare authorities, followed by distinction of clades: Congo Basin and West African<ref name="pmid20643162">{{cite journal| author=Li Y, Zhao H, Wilkins K, Hughes C, Damon IK| title=Real-time PCR assays for the specific detection of monkeypox virus West African and Congo Basin strain DNA. | journal=J Virol Methods | year= 2010 | volume= 169 | issue= 1 | pages= 223-7 | pmid=20643162 | doi=10.1016/j.jviromet.2010.07.012 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20643162 }} </ref>. | *In case a of monkeypox suspected case, swabs from lesions, crusts and vesicular fluids to be obtained and tested for MPXV using a real-time PCR. Positive findings should be reported to healthcare authorities, followed by distinction of clades: Congo Basin and West African<ref name="pmid20643162">{{cite journal| author=Li Y, Zhao H, Wilkins K, Hughes C, Damon IK| title=Real-time PCR assays for the specific detection of monkeypox virus West African and Congo Basin strain DNA. | journal=J Virol Methods | year= 2010 | volume= 169 | issue= 1 | pages= 223-7 | pmid=20643162 | doi=10.1016/j.jviromet.2010.07.012 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20643162 }} </ref>. | ||
* Some protocols advise to detect OPXV via real-time PCR. Upon positive findings, additional testing for MPXV via real-time PCR to be performed. Confirmed cases of MPXV to be reported to healthcare authorities<ref name="urlLaboratory testing for the monkeypox virus: Interim guidance">{{cite web |url=https://www.who.int/publications/i/item/WHO-MPX-laboratory-2022.1 |title=Laboratory testing for the monkeypox virus: Interim guidance |format= |work= |accessdate=2022-06-15}}</ref>. | *Some protocols advise to detect OPXV via real-time PCR. Upon positive findings, additional testing for MPXV via real-time PCR to be performed. Confirmed cases of MPXV to be reported to healthcare authorities<ref name="urlLaboratory testing for the monkeypox virus: Interim guidance">{{cite web |url=https://www.who.int/publications/i/item/WHO-MPX-laboratory-2022.1 |title=Laboratory testing for the monkeypox virus: Interim guidance |format= |work= |accessdate=2022-06-15}}</ref>. | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 16:06, 15 June 2022
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Bassel Almarie, M.D.
Overview
The laboratory findings of chickenpox include blood tests that can be done to identify the response to acute infection (IgM) or previous infection and subsequent immunity (IgG). Prenatal diagnosis of fetal varicella infection can be performed using ultrasound at 5 weeks following primary maternal infection. A PCR test of the mother's amniotic fluid can also be performed, though the risk of spontaneous abortion due to the amniocentesis procedure is higher than the risk of the baby developing fetal varicella syndrome.
Laboratory Findings
Molecular Methods
Polymerase chain reaction (PCR)
- Confirmation of monkeypox virus (MPXV) infection is based on nucleic acid amplification testing, using real-time or conventional PCR, for detection of unique sequences of viral DNA. PCR can be used alone, or in combination with sequencing[1].
- Preferred test given its accuracy and sensitivity.
- Samples advisably obtained skin lesions, precisely, the roof or fluid from vesicles and pustules, and dry crusts.
- PCR blood tests are usually inconclusive because the does not live long in the blood[2].
- Commerical PCR kits to detect MPXV are under development[3][4].
DNA extraction
- DNA can be extracted from samples using any standard extraction protocols or kits[1].
- Sample lysis in DNA extraction inactivates live virus. Therefore, sample lysis should be performed under a biosafety cabinet.
- For crust samples, DNA extraction kit for tissue samples should be used to insure appropriate sample lysis.
Molecular detection
- In case a of monkeypox suspected case, swabs from lesions, crusts and vesicular fluids to be obtained and tested for MPXV using a real-time PCR. Positive findings should be reported to healthcare authorities, followed by distinction of clades: Congo Basin and West African[5].
- Some protocols advise to detect OPXV via real-time PCR. Upon positive findings, additional testing for MPXV via real-time PCR to be performed. Confirmed cases of MPXV to be reported to healthcare authorities[1].
References
- ↑ 1.0 1.1 1.2 "Laboratory testing for the monkeypox virus: Interim guidance". Retrieved 2022-06-15.
- ↑ "Monkeypox". Retrieved 2022-06-15.
- ↑ Li D, Wilkins K, McCollum AM, Osadebe L, Kabamba J, Nguete B; et al. (2017). "Evaluation of the GeneXpert for Human Monkeypox Diagnosis". Am J Trop Med Hyg. 96 (2): 405–410. doi:10.4269/ajtmh.16-0567. PMC 5303045. PMID 27994107.
- ↑ Townsend MB, MacNeil A, Reynolds MG, Hughes CM, Olson VA, Damon IK; et al. (2013). "Evaluation of the Tetracore Orthopox BioThreat® antigen detection assay using laboratory grown orthopoxviruses and rash illness clinical specimens". J Virol Methods. 187 (1): 37–42. doi:10.1016/j.jviromet.2012.08.023. PMID 22981983.
- ↑ Li Y, Zhao H, Wilkins K, Hughes C, Damon IK (2010). "Real-time PCR assays for the specific detection of monkeypox virus West African and Congo Basin strain DNA". J Virol Methods. 169 (1): 223–7. doi:10.1016/j.jviromet.2010.07.012. PMID 20643162.