Table 5.
Diagnostic tests overview for MPXV, including disease stage and suitable samples to be collected.
| Tests | Disease Stage | Suitable Samples | Description |
|---|---|---|---|
| NAAT (PCR) | Febrile stage | Oropharyngeal swab or/and EDTA blood | Detects DNA MPXV and identifies the viral clade. NAAT can be generic to OPXV or specific to MPXV |
| Rash stage | Skin lesion material a | ||
| Immunohistochemistry (antigen detection) | Rash stage | Skin lesion material | Uses an antibody directed against an OPXV antigen and proves the presence of a current infection. Not specific for MPXV |
| Viral culture/isolation | Rash stage | Skin lesion material | Detects viral particles. Requires facilities, appropriate expertise, and skills. Time and resource intensive. Not specific for MPXV |
| Electron microscopy | Rash stage | Skin lesion material or viral culture | Identify virus morphology. Requires facilities, appropriate expertise, and skills. Time and resource intensive. Not specific for MPXV |
| Serological analysis for specific antibodies (IgM and IgG antibody detection) | Rash stage | Serum or plasma (two samples, at 21 days apart, first sample collected during the first week of illness) |
Uses an antigen directed against the antibody but has a limited diagnostic value because it proves a current or past infection/vaccination. Not specific for MPXV |
| Recovery |
a Other clinical samples can be considered for research purposes. DNA, Deoxyribonucleic acid; EDTA, Ethylenediamine tetraacetic acid; IgG, immunoglobulin G; IgM, immunoglobulin M; MPXV, Monkeypox virus; NAAT, Nucleic Acid Amplification Testing; OPXV, Orthopoxvirus; PCR, Polymerase Chain Reaction.