Smallpox laboratory tests
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Laboratory Findings
There are laboratory tests to specifically identify the smallpox virus. However, in a patient with low to medium level of suspicion of smallpox, a false-positive result would have a great personal and social impacts. Therefore these tests must be used cautiously, and according to certain guidelines.[1][2][3][4]
This chart describes the laboratory testing protocol for a patient that presents with generalized vesicular or pustular rash illness. It is also based upon the risk level the patient has of developing acquiring smallpox.
Laboratory Confirmation
Laboratory Criteria for Confirmation
- Polymerase chain reaction (PCR) identification of variola DNA in a clinical specimen, OR
- Isolation of smallpox (variola) virus from a clinical specimen (WHO Smallpox Reference laboratory or laboratory with appropriate reference capabilities) with variola PCR confirmation.
Laboratory diagnostic testing for variola virus should be conducted in a CDC Laboratory Response Network (LRN) laboratory utilizing LRN-approved PCR tests and protocols for variola virus. Initial confirmation of a smallpox outbreak requires additional testing at CDC.
Note: Generic orthopox PCR and negative stain electron microscopy (EM) identification of a pox virus in a clinical specimen are suggestive of an 'orthopox ' virus infection but not diagnostic for smallpox.
References
- ↑ Moore, Zack S; Seward, Jane F; Lane, J Michael (2006). "Smallpox". The Lancet. 367 (9508): 425–435. doi:10.1016/S0140-6736(06)68143-9. ISSN 0140-6736.
- ↑ Seward JF, Galil K, Damon I, Norton SA, Rotz L, Schmid S; et al. (2004). "Development and experience with an algorithm to evaluate suspected smallpox cases in the United States, 2002-2004". Clin Infect Dis. 39 (10): 1477–83. doi:10.1086/425500. PMID 15546084.
- ↑ Besser JM, Crouch NA, Sullivan M (2003). "Laboratory diagnosis to differentiate smallpox, vaccinia, and other vesicular/pustular illnesses". J Lab Clin Med. 142 (4): 246–51. doi:10.1016/S0022-2143(03)00146-X. PMID 14625530.
- ↑ Madeley, CR (2003). "Diagnosing smallpox in possible bioterrorist attack". The Lancet. 361 (9352): 97–98. doi:10.1016/S0140-6736(03)12241-6. ISSN 0140-6736.