Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Bassel Almarie M.D.[2]
Polymerase chain reaction (PCR) is the preferred test to confirm monkeypox virus (MPXV) given its sensitivity and accuracy. Samples should be obtained from skin lesions, precisely, the roof or fluid from vesicles and pustules, and dry crusts[1]. PCR blood tests are usually inconclusive because the virus does not live long in the blood[2].
Polymerase chain reaction (PCR)[edit | edit source]
- 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[3][1].
- It is the preferred test due to its accuracy and sensitivity.
- Samples advisably obtained from skin lesions, precisely, the roof or fluid from vesicles and pustules, and dry crusts.
- PCR blood tests are usually inconclusive because the virus does not live long in the blood[2].
- DNA can be extracted from samples using any standard extraction protocols or kits[1].
- 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.
- Swabs from lesions, crusts and vesicular fluids can 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[4].
- 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 must be reported to healthcare authorities[1].