An Overview of Monkeypox Virus Detection in Different Clinical Samples and Analysis of Temporal Viral Load Dynamics

Rita Cordeiro, Ana Pelerito, Isabel Lopes de Carvalho, Sílvia Lopo, Raquel Neves, Raquel Rocha, Paula Palminha, Nuno Verdasca, Cláudia Palhinhas, Maria José Borrego, Carla Manita, Idalina Ferreira, Célia Bettencourt, Patrícia Vieira, Sónia Silva, Ivone Água-Doce, Carla Roque, Dora Cordeiro, Greice Brondani, João Almeida SantosSusana Martins, Irene Rodrigues, Carlos Ribeiro, Maria Sofia Núncio, João Paulo Gomes, Fernando da Conceição Batista

Research output: Contribution to journalArticlepeer-review

Abstract

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 Ct values (Ct = 23 and Ct = 24), compared to oropharyngeal swabs and urines (Ct = 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.

Original languageEnglish
Article numbere70104
JournalJournal of Medical Virology
Volume96
Issue number12
DOIs
Publication statusPublished - Dec 2024

Bibliographical note

Publisher Copyright:
© 2024 The Author(s). Journal of Medical Virology published by Wiley Periodicals LLC.

Keywords

  • C values
  • Monkeypox virus
  • Portugal
  • clinical samples
  • positive rate
  • viral clearance
  • viral load

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