What is the diagnostic test for Orthopoxvirus (monkeypox) infection?

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Last updated: April 21, 2025View editorial policy

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From the Guidelines

Testing for monkeypox involves a PCR test that detects viral DNA from a sample taken from skin lesions, and it is crucial to contact a healthcare provider immediately for testing if monkeypox is suspected. According to the available evidence, diagnostic tests for orthopoxviruses, such as monkeypox, include electron microscopy, gene amplification (polymerase chain reaction [PCR]), and viral culture 1. However, these tests are typically only available through specialized laboratories, such as those in the Laboratory Response Network (LRN), and may require consultation with state and local health departments. When testing for monkeypox, a swab of fluid or material from skin lesions (blisters, pustules, or scabs) is usually required, and results can take 24-72 hours. Some key points to consider when testing for monkeypox include:

  • Testing is recommended for anyone with characteristic rash or lesions, especially after close contact with a confirmed case or travel to areas with outbreaks
  • Early testing is crucial as it allows for prompt isolation to prevent transmission and early treatment if needed
  • While waiting for results, self-isolation and avoiding close contact with others, particularly pregnant women, children, and immunocompromised individuals, is essential
  • Monkeypox testing is specific for orthopoxviruses and helps distinguish this infection from other conditions with similar symptoms like chickenpox, herpes, or syphilis.

From the Research

Testing for Monkeypox

  • The recommended laboratory test for monkeypox is polymerase chain reaction (PCR) detection of viral DNA 2.
  • PCR testing of lesions and secretions is one of the ways to diagnose monkeypox 3.
  • Laboratory confirmation of specimens from suspected cases is done using nucleic acid amplification testing, such as real-time or conventional polymerase chain reaction 4.
  • Suitable samples for testing include surface lesion and/or skin materials such as exudates swabs and crusts 4.

Types of Tests

  • Nucleic acid amplification tests, such as PCR, are the most commonly used laboratory techniques for MPXV detection 5.
  • Immunological methods have also been applied to diagnose the disease, which can help improve diagnostic accuracy and guide future prevention and control strategies 5.

Importance of Testing

  • Testing is crucial for diagnosing monkeypox, especially in cases with atypical appearances, as it may be difficult to distinguish from other conditions that cause skin rashes 4.
  • PCR is the only method capable of being deployed at sufficient speed to provide timely feedback on any public health interventions 6.
  • Ensuring PCR accuracy is important to support harmonization and ease regulatory conformance, especially as testing requirements increase rapidly and specimens become more diverse 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Managing Monkeypox Virus Infections: A Contemporary Review.

Iranian journal of medical sciences, 2024

Research

Diagnosis of monkeypox virus - An overview.

Travel medicine and infectious disease, 2022

Research

Mpox: a review of laboratory detection techniques.

Archives of virology, 2023

Research

Monkeypox: another test for PCR.

Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin, 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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