Alternative sampling specimens for the molecular detection of mpox (formerly monkeypox) virus

Coppens, Jasmine; Vanroye, Fien; Brosius, Isabel; Liesenborghs, Laurens; Henten, Saskia van; Vanbaelen, Thibaut; Bracke, Stefanie; Berens-Riha, Nicole; Baetselier, Irith De; Kenyon, Chris; Soentjens, Patrick; Florence, Éric; Griensven, Johan van; Ariën, Kevin K.; Jacobs, Bart K M; Bossche, Dorien Van den; Esbroeck, Marjan Van; Vercauteren, Koen

doi:10.1016/j.jcv.2022.105372

Cited by 19 publications

(25 citation statements)

References 13 publications

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“…We also observed that rectal infections and, to a lesser extent, pharyngeal PCR positivity are extremely common in people with symptomatic mpox, that some patients with negative skin lesion tests have positive rectal PCR test results, and that approximately 20% of PCR-positive contacts to mpox are asymptomatic. The finding that rectal and pharyngeal shedding of mpox is common in people with symptomatic infection is aligned with several published reports 2,5–8 . We are not aware of other published reports demonstrating that rectal mpox PCR testing is sometimes positive among asymptomatic contacts to mpox.…”

Section: Discussionsupporting

confidence: 84%

“…The finding that rectal and pharyngeal shedding of mpox is common in people with symptomatic infection is aligned with several published reports. 2,[5][6][7][8] We are not aware of other published reports demonstrating that rectal mpox PCR testing is sometimes positive among asymptomatic contacts to mpox. Given our small numbers, this finding merits confirmation.…”

Section: Discussionmentioning

confidence: 91%

“…1 The mpox virus causes a systemic infection, and shedding of virus across mucosal surfaces, including the rectal and pharyngeal mucosa, is common, even in the absence of visible lesions at those anatomic sites. [2][3][4][5][6][7][8] Studies from Europe, the United States, and Japan have reported asymptomatic mucosal detection of mpox DNA in 0% to 6.5% of gay, bisexual, and other men who have sex with men (GBMSM) seeking care in sexual health and HIV clinics, [9][10][11][12][13][14][15] although, in some instances, cases of asymptomatic infection have been followed by development of characteristic mpox skin lesions, 10 and other cases may have been subclinical rather than truly asymptomatic. 14 How often asymptomatic or subclinical infections occur, particularly among persons who have received the Modified Vaccinia Ankara (MVA) vaccine, remains uncertain.…”

mentioning

confidence: 99%

“…As of January 2024, the 2022–2023 mpox epidemic has resulted in more than 92,000 confirmed cases of mpox infection, including more than 31,000 reported cases in the United States 1 . The mpox virus causes a systemic infection, and shedding of virus across mucosal surfaces, including the rectal and pharyngeal mucosa, is common, even in the absence of visible lesions at those anatomic sites 2–8 . Studies from Europe, the United States, and Japan have reported asymptomatic mucosal detection of mpox DNA in 0% to 6.5% of gay, bisexual, and other men who have sex with men (GBMSM) seeking care in sexual health and HIV clinics, 9–15 although, in some instances, cases of asymptomatic infection have been followed by development of characteristic mpox skin lesions, 10 and other cases may have been subclinical rather than truly asymptomatic 14 …”

mentioning

confidence: 99%

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Asymptomatic and Subclinical Mpox: An Association With Modified Vaccinia Ankara Vaccine

Golden,

Soge,

Mills

et al. 2024

Sexual Trans Dis

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Background How often mpox causes asymptomatic infections, particularly among persons who have received the Modified Vaccinia Ankara (MVA) vaccine, is unknown. Methods We performed mpox PCR testing on rectal and pharyngeal specimens collected from symptomatic and asymptomatic patients at a sexual health clinic in Seattle, WA, USA between May 2022 and May 2023. Analyses evaluated the prevalence of asymptomatic or subclinical infection and, among persons with PCR positive tests, the association of MVA vaccination status with the symptomatic infection. Results The study population included 1663 persons tested for mpox during 2,353 clinic visits. Ninety-three percent of study participants were cis-gender men and 96% were men who have sex with men. A total of 198 (30%) symptomatic patients had a first mpox positive test during 664 visits. Eighteen (1.1%) patients tested during 1,689 visits had asymptomatic or subclinical mpox based on a positive rectal or pharyngeal test done in the absence of testing done because of clinical suspicion for mpox. Fourteen (78%) of 18 persons with asymptomatic/subclinical mpox and 53 (26%) of 198 persons with symptomatic mpox had received at least one dose of the MVA vaccine (p < .0001). Controlling for calendar month, study subjects who received one and two doses of MVA vaccine were 4.4 (95% CI 1.3-15) and 11.9 (3.6-40) times more likely to have asymptomatic versus symptomatic mpox, respectively, than persons who were unvaccinated. Conclusions Asymptomatic mpox is uncommon. MVA vaccination is associated with an asymptomatic/subclinical infection among persons with mpox.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 91%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Asymptomatic and Subclinical Mpox: An Association With Modified Vaccinia Ankara Vaccine

Golden,

Soge,

Mills

et al. 2024

Sexual Trans Dis

View full text Add to dashboard Cite

show abstract

“…The best diagnostic specimens are obtained directly from the rash–skin, fluid, or crusts, or a biopsy where feasible. In addition, MPXV detection has been reported in the anus, throat, and blood [ 15 , 16 ]. Compared to the more commonly used qPCR, ddPCR provides absolute quantification of DNA copies in samples without the need for standard curves and has the ability to detect lower genomic yields.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a ddPCR Commercial Assay for the Absolute Quantification of the Monkeypox Virus West Africa in Clinical Samples

et al. 2023

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Background: Monkeypox virus (MPXV) is a double-stranded DNA virus belonging to the orthopoxvirus genus in the family Poxviridae. Distinct clades are identified: the clade I belonging to the Central African (or Congo Basin) clade and the subclades IIa and IIb belonging to the West African clade. Here, a commercial droplet digital PCR (ddPCR) assay was evaluated for the quantification of the MPXV West Africa clade in clinical samples. Methods: The ddPCR reaction was assessed as a duplex assay using RPP30 as an internal amplification control. A total of 60 clinical specimens were tested, 40 positives (skin lesions, n=10; rectal swabs, n = 10; pharyngeal swabs, n = 10; and whole blood, n = 10), and 20 negatives (n = 5 for each biological matrix) were found at the routine molecular diagnostics (orthopoxvirus qPCR followed by confirmation with Sanger sequencing). To evaluate the analytical sensitivity, the ddPCR reaction was first analyzed on serial dilutions of synthetic DNA spiked in water and in negative biological matrices, achieving a limit of detection of 3.5 copy/µL. Results: Regarding the clinical samples, compared to routine molecular diagnostics, the ddPCR duplex assay showed 100% of specificity for all biological matrices and 100% sensitivity (10/10) for lesions, 100% (10/10) for rectal swabs, 90% (9/10) for pharyngeal swabs, and 60% (6/10) for whole blood. Conclusion: Overall, our data showed that the commercial ddPCR assay allowed the DNA detection of MPXV in 87.5% (35/40) of our cohort, highlighting useful technical indications for the different specimens with a potential greatest performance for skin lesions and rectal swabs.

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Mpox virus DNA detection in different clinical specimens: tertiary-level laboratory experience, Bosnia and Herzegovina, 2022

et al. 2024

Diagnostic Microbiology and Infectious Disease

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Alternative sampling specimens for the molecular detection of mpox (formerly monkeypox) virus

Cited by 19 publications

References 13 publications

Asymptomatic and Subclinical Mpox: An Association With Modified Vaccinia Ankara Vaccine

Asymptomatic and Subclinical Mpox: An Association With Modified Vaccinia Ankara Vaccine

Evaluation of a ddPCR Commercial Assay for the Absolute Quantification of the Monkeypox Virus West Africa in Clinical Samples

Mpox virus DNA detection in different clinical specimens: tertiary-level laboratory experience, Bosnia and Herzegovina, 2022

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