1921
Volume 96, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract

Monkeypox virus (MPXV), a zoonotic orthopoxvirus (OPX), is endemic in the Democratic Republic of Congo (DRC). Currently, diagnostic assays for human monkeypox (MPX) focus on real-time quantitative polymerase chain reaction (PCR) assays, which are typically performed in sophisticated laboratory settings. Herein, we evaluated the accuracy and utility of a multiplex MPX assay using the GeneXpert platform, a portable rapid diagnostic device that may serve as a point-of-care test to diagnose infections in endemic areas. The multiplex MPX/OPX assay includes a MPX-specific PCR test, OPX-generic PCR test, and an internal control PCR test. In total, 164 diagnostic specimens (50 crusts and 114 vesicular swabs) were collected from suspected MPX cases in Tshuapa Province, DRC, under national surveillance guidelines. The specimens were tested with the GeneXpert MPX/OPX assay and an OPX PCR assay at the Institut National de Recherche Biomedicale (INRB) in Kinshasa. Aliquots of each specimen were tested in parallel with a MPX-specific PCR assay at the Centers for Disease Control and Prevention. The results of the MPX PCR were used as the gold standard for all analyses. The GeneXpert MPX/OPX assay performed at INRB had a sensitivity of 98.8% and specificity of 100%. The GeneXpert assay performed well with both crust and vesicle samples. The GeneXpert MPX/OPX test incorporates a simple methodology that performs well in both laboratory and field conditions, suggesting its viability as a diagnostic platform that may expand and expedite current MPX detection capabilities.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.16-0567
2017-02-08
2017-09-24
Loading full text...

Full text loading...

/deliver/fulltext/14761645/96/2/405.html?itemId=/content/journals/10.4269/ajtmh.16-0567&mimeType=html&fmt=ahah

References

  1. Reynolds MG, Carroll DS, Karem KL, , 2012. Factors affecting the likelihood of monkeypox's emergence and spread in the post-smallpox era. Curr Opin Virol 2: 335343.[Crossref]
  2. Arita I, Gispen R, Kalter SS, Wah LT, Marennikova SS, Netter R, Tagaya I, , 1972. Outbreaks of monkeypox and serological surveys in nonhuman primates. Bull World Health Organ 46: 625631.
  3. Berthet N, Nakouné E, Whist E, Selekon B, Burguière AM, Manuguerra JC, Gessain A, Kazanji M, , 2011. Maculopapular lesions in the Central African Republic. Lancet 378: 1354.[Crossref]
  4. Formenty P, Muntasir MO, Damon I, Chowdhary V, Opoka ML, Monimart C, Mutasim EM, Manuguerra JC, Davidson WB, Karem KL, Cabeza J, Wang S, Malik MR, Durand T, Khalid A, Rioton T, Kuong-Ruay A, Babiker AA, Karsani ME, Abdalla MS, , 2010. Human monkeypox outbreak caused by novel virus belonging to Congo Basin clade, Sudan, 2005. Emerg Infect Dis 16: 15391545.[Crossref]
  5. Learned LA, Reynolds MG, Wassa DW, Li Y, Olson VA, Karem K, Stempora LL, Braden ZH, Kline R, Likos A, Libama F, Moudzeo H, Bolanda JD, Tarangonia P, Boumandoki P, Formenty P, Harvey JM, Damon IK, , 2005. Extended interhuman transmission of monkeypox in a hospital community in the Republic of the Congo, 2003. Am J Trop Med Hyg 73: 428434.
  6. Macneil A, Abel J, Reynolds MG, Lash R, Fonnie R, Kanneh LD, Robert W, Lungay VK, Goba A, Moses LM, Damon IK, Karem K, Bausch DG, , 2011. Serologic evidence of human orthopoxvirus infections in Sierra Leone. BMC Res Notes 4: 465.[Crossref]
  7. Jezek Z, Grab B, Szczeniowski MV, Paluku KM, Mutombo M, , 1988. Human monkeypox: secondary attack rates. Bull World Health Organ 66: 465470.
  8. Reynolds MG, Damon IK, , 2012. Outbreaks of human monkeypox after cessation of smallpox vaccination. Trends Microbiol 20: 8087.[Crossref]
  9. Rimoin AW, Mulembakani PM, Johnston SC, Lloyd Smith JO, Kisalu NK, Kinkela TL, Blumberg S, Thomassen HA, Pike BL, Fair JN, Wolfe ND, Shongo RL, Graham BS, Formenty P, Okitolonda E, Hensley LE, Meyer H, Wright LL, Muyembe JJ, , 2010. Major increase in human monkeypox incidence 30 years after smallpox vaccination campaigns cease in the Democratic Republic of Congo. Proc Natl Acad Sci USA 107: 1626216267.[Crossref]
  10. Nolen LD, Osadebe L, Katomba J, Likofata J, Mukadi D, Monroe B, Doty J, Hughes CM, Kabamba J, Malekani J, Bomponda PL, Lokota JI, Balilo MP, Likafi T, Lushima RS, Ilunga BK, Nkawa F, Pukuta E, Karhemere S, Tamfum JJ, Nguete B, Wemakoy EO, McCollum AM, Reynolds MG, , 2016. Extended human-to-human transmission during a monkeypox outbreak in the Democratic Republic of the Congo. Emerg Infect Dis 22: 10141021.[Crossref]
  11. Nakazawa Y, Lash RR, Carroll DS, Damon IK, Karem KL, Reynolds MG, Osorio JE, Rocke TE, Malekani JM, Muyembe JJ, Formenty P, Peterson AT, , 2013. Mapping monkeypox transmission risk through time and space in the Congo Basin. PLoS One 8: e74816.[Crossref]
  12. Hutson CL, Lee KN, Abel J, Carroll DS, Montgomery JM, Olson VA, Li Y, Davidson W, Hughes C, Dillon M, Spurlock P, Kazmierczak JJ, Austin C, Miser L, Sorhage FE, Howell J, Davis JP, Reynolds MG, Braden Z, Karem KL, Damon IK, Regnery RL, , 2007. Monkeypox zoonotic associations: insights from laboratory evaluation of animals associated with the multi-state US outbreak. Am J Trop Med Hyg 76: 757768.
  13. Nolen LD, Osadebe L, Katomba J, Likofata J, Mukadi D, Monroe B, Doty J, Kalemba L, Malekani J, Kabamba J, Bomponda PL, Lokota JI, Balilo MP, Likafi T, Lushima RS, Tamfum JJ, Okitolonda EW, McCollum AM, Reynolds MG, , 2015. Introduction of monkeypox into a community and household: risk factors and zoonotic reservoirs in the Democratic Republic of the Congo. Am J Trop Med Hyg 93: 410415.[Crossref]
  14. Jezek Z, Szczeniowski M, Paluku KM, Mutombo M, , 1987. Human monkeypox: clinical features of 282 patients. J Infect Dis 156: 293298.[Crossref]
  15. Reynolds MG, Yorita KL, Kuehnert MJ, Davidson WB, Huhn GD, Holman RC, Damon IK, , 2006. Clinical manifestations of human monkeypox influenced by route of infection. J Infect Dis 194: 773780.[Crossref]
  16. Huhn GD, Bauer AM, Yorita K, Graham MB, Sejvar J, Likos A, Damon IK, Reynolds MG, Kuehnert MJ, , 2005. Clinical characteristics of human monkeypox, and risk factors for severe disease. Clin Infect Dis 41: 17421751.[Crossref]
  17. Jezek Z, Grab B, Paluku KM, Szczeniowski MV, , 1988. Human monkeypox: disease pattern, incidence and attack rates in a rural area of northern Zaire. Trop Geogr Med 40: 7383.
  18. MacNeil A, Reynolds MG, Carroll DS, Karem K, Braden Z, Lash R, Moundeli A, Mombouli JV, Jumaan AO, Schmid DS, Damon IK, , 2009. Monkeypox or varicella? Lessons from a rash outbreak investigation in the Republic of the Congo. Am J Trop Med Hyg 80: 503507.
  19. McCollum AM, Damon IK, , 2014. Human monkeypox. Clin Infect Dis 58: 260267.[Crossref]
  20. van Vuren PJ, Grobbelaar A, Storm N, Conteh O, Konneh K, Kamara A, Sanne I, Paweska JT, , 2015. Comparative evaluation of the prototype Cepheid GeneXpert(R) Ebola Assay diagnostic performance. J Clin Microbiol 54: 359367.[Crossref]
  21. Evans CA, , 2011. GeneXpert: a game-changer for tuberculosis control? PLoS Med 8: e1001064.[Crossref]
  22. Rossney AS, Herra CM, Brennan GI, Morgan PM, O'Connell B, , 2008. Evaluation of the Xpert methicillin-resistant Staphylococcus aureus (MRSA) assay using the GeneXpert real-time PCR platform for rapid detection of MRSA from screening specimens. J Clin Microbiol 46: 32853290.[Crossref]
  23. Kulesh DA, Loveless BM, Norwood D, Garrison J, Whitehouse CA, Hartmann C, Mucker E, Miller D, Wasieloski LP, Jr Huggins J, Huhn G, Miser LL, Imig C, Martinez M, Larsen T, Rossi CA, Ludwig GV, , 2004. Monkeypox virus detection in rodents using real-time 3′-minor groove binder TaqMan assays on the Roche LightCycler. Lab Invest 84: 12001208.[Crossref]
  24. Li Y, Zhao H, Wilkins K, Hughes C, Damon IK, , 2010. Real-time PCR assays for the specific detection of monkeypox virus West African and Congo Basin strain DNA. J Virol Methods 169: 223227.[Crossref]
  25. Li Y, Olson VA, Laue T, Laker MT, Damon IK, , 2006. Detection of monkeypox virus with real-time PCR assays. J Clin Virol 36: 194203.[Crossref]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.16-0567
Loading
/content/journals/10.4269/ajtmh.16-0567
Loading

Data & Media loading...

  • Received : 11 Jul 2016
  • Accepted : 27 Oct 2016

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error