Monkeypox laboratory tests: Difference between revisions

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* It is the preferred test due to its accuracy and sensitivity.
* It is the preferred test due to its accuracy and sensitivity.
*Samples advisably obtained from skin lesions, precisely, the roof or fluid from vesicles and pustules, and dry crusts.
*Samples advisably obtained from 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 virus 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>.



Revision as of 19:15, 20 October 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.[2]

Overview

Polymerase chain reaction (PCR) is the preferred test to confirm monkeypox virus (MPXV) given its sensitivity and accuracy. Samples should be obtained from skin lesions, precisely, the roof or fluid from vesicles and pustules, and dry crusts[1]. PCR blood tests are usually inconclusive because the does not live long in the blood[2].

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[3][1].
  • It is the preferred test due to its accuracy and sensitivity.
  • Samples advisably obtained from skin lesions, precisely, the roof or fluid from vesicles and pustules, and dry crusts.
  • PCR blood tests are usually inconclusive because the virus does not live long in the blood[2].
  • Commerical PCR kits to detect MPXV are under development[4][5].

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

  • Swabs from lesions, crusts and vesicular fluids can 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[6].
  • 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 must be reported to healthcare authorities[1].

References

  1. 1.0 1.1 1.2 1.3 "Laboratory testing for the monkeypox virus: Interim guidance". Retrieved 2022-06-15.
  2. 2.0 2.1 "Monkeypox". Retrieved 2022-06-15.
  3. "www.cdc.gov" (PDF). Retrieved 2022-06-15.
  4. 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.
  5. 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.
  6. 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.