An Overview of <i>Monkeypox Virus</i> Detection in Different Clinical Samples and Analysis of Temporal Viral Load Dynamics
Mpox is a zoonotic disease caused by the Monkeypox virus (MPXV), and since May 2022, tens of thousands of cases have been reported in non-endemic countries. We aimed to evaluate the suitability of different sample types for mpox diagnostic and assess the temporal dynamics of viral load. We evaluated 1914 samples from 953 laboratory-confirmed cases. The positivity rate was higher for lesion (91.3%) and rectal swabs (86.1%) when compared with oropharyngeal swabs (69.5%) and urines (41.2%), indicating higher viral loads for the former. Supporting this, lesion and rectal swabs showed lower median PCR C<sub>t</sub> values (C<sub>t</sub> = 23 and C<sub>t</sub> = 24), compared to oropharyngeal swabs and urines (C<sub>t</sub> = 31). Stable MPXV loads were observed in swabs from lesions up to 30 days after symptoms onset, contrasting with a considerable decrease in viral load in rectal and oropharyngeal swabs. Overall, these results point to lesion swabs as the most suitable samples for detecting MPXV in the 2022-2023 multicountry outbreak and show comparable accuracy to rectal swabs up to 8 days after symptoms onset. These findings, together with the observation that about 5% of patients were diagnosed through oropharyngeal swabs while having negative lesions, suggest that multisite testing should be performed to increase diagnostic sensitivity.
Authors
- Ivone Água‐Doce
- Idalina Ferreira (ORCID: https://orcid.org/0000-0001-9134-1297)
- Sílvia Lopo (ORCID: https://orcid.org/0000-0002-1553-3470)
- Carla Manita (ORCID: https://orcid.org/0000-0003-0152-9937)
- Raquel Neves
- Nuno Verdasca (ORCID: https://orcid.org/0000-0002-4673-5411)
- João Almeida Santos (ORCID: https://orcid.org/0000-0002-8564-1098)
- Dora Cordeiro (ORCID: https://orcid.org/0000-0003-2626-5368)
- Rita Cordeiro (ORCID: https://orcid.org/0000-0001-5321-3657)
- Isabel Lopes de Carvalho (ORCID: https://orcid.org/0000-0002-4693-3952)
- Raquel Rocha (ORCID: https://orcid.org/0000-0002-2687-2080)
- Célia Rodrigues Bettencourt (ORCID: https://orcid.org/0000-0001-7827-8887)
- Irene Pimenta Rodrigues (ORCID: https://orcid.org/0000-0003-2370-3019)
- João Paulo Gomes (ORCID: https://orcid.org/0000-0002-2697-2399)
- Carla Roque (ORCID: https://orcid.org/0009-0009-4407-4320)
- Paula Palminha
- Greice Brondani
- Ana Pelerito (ORCID: https://orcid.org/0000-0003-4770-9079)
- Maria Sofia Núncio (ORCID: https://orcid.org/0000-0001-5182-6150)
- Carlos Ribeiro (ORCID: https://orcid.org/0000-0002-9542-7335)
- Susana Martins (ORCID: https://orcid.org/0000-0001-6183-7064)
- Fernando da Conceição Batista (ORCID: https://orcid.org/0000-0002-1494-4163)
- Patrícia Vieira (ORCID: https://orcid.org/0000-0002-3471-1025)
- Sónia Silva (ORCID: https://orcid.org/0000-0003-3700-3072)
- Maria José Borrego (ORCID: https://orcid.org/0000-0002-8604-8800)
- Cláudia Palhinhas
Institutions
- University of Lisbon (PT)
- Instituto Politécnico de Leiria (PT)
- National Institute of Health Dr. Ricardo Jorge (PT)
- Universidade Lusófona (PT)
Publication Details
- Journal
- Journal of Medical Virology
- Published
- 2024-12-01
- DOI
- https://doi.org/10.1002/jmv.70104
- Citations
- 7
- Primary Topic
- Poxvirus research and outbreaks
- Type
- article
- Field-Weighted Citation Impact
- 2.06