Monkeypox laboratory tests
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Diagnosis |
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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.
- PCR kits detecting MPXV are under development but no commercial validated PCR kits are currently available widely.
DNA extraction
- DNA can be extracted from samples using any standard extraction protocols or kits.
- 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.
- 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.