Faculty of Medicine, Riga Stradiņš University, Dzirciema Street 16, Riga, 1007, Latvia.
Joint Microbiology Laboratory, Pauls Stradins Clinical University Hospital, Pilsonu Street 13, Riga, 1002, Latvia.
Adv Exp Med Biol. 2024;1451:253-271. doi: 10.1007/978-3-031-57165-7_16.
An outbreak of monkeypox (Mpox) was reported in more than 40 countries in early 2022. Accurate diagnosis of Mpox can be challenging, but history, clinical findings, and laboratory diagnosis can establish the diagnosis. The pre-analytic phase of testing includes collecting, storing, and transporting specimens. It is advised to swab the lesion site with virus transport medium (VTM) containing Dacron or polyester flock swabs from two different sites. Blood, urine, and semen samples may also be used. Timely sampling is necessary to obtain a sufficient amount of virus or antibodies. The analytical phase of infectious disease control involves diagnostic tools to determine the presence of the virus. While polymerase chain reaction (PCR) is the gold standard for detecting Mpox, genome sequencing is for identifying new or modified viruses. As a complement to these methods, isothermal amplification methods have been designed. ELISA assays are also available for the determination of antibodies. Electron microscopy is another effective diagnostic method for tissue identification of the virus. Wastewater fingerprinting provides some of the most effective diagnostic methods for virus identification at the community level. The advantages and disadvantages of these methods are further discussed. Post-analytic phase requires proper interpretation of test results and the preparation of accurate patient reports that include relevant medical history, clinical guidelines, and recommendations for follow-up testing or treatment.
2022 年初，40 多个国家报告了猴痘（Mpox）疫情。猴痘的准确诊断具有挑战性，但病史、临床发现和实验室诊断可以确立诊断。检测的预分析阶段包括采集、储存和运输标本。建议用含有 Dacron 或聚酯纤维绒毛的病毒运输介质（VTM）从两个不同部位擦拭病变部位。也可以使用血液、尿液和精液样本。及时采样对于获得足够数量的病毒或抗体很有必要。传染病控制的分析阶段包括用于确定病毒存在的诊断工具。聚合酶链反应（PCR）虽然是检测猴痘的金标准，但基因组测序是用于识别新的或改良的病毒。作为这些方法的补充，已经设计了等温扩增方法。酶联免疫吸附测定（ELISA）检测也可用于确定抗体。电子显微镜是另一种有效的组织鉴定病毒的诊断方法。废水指纹分析为在社区层面识别病毒提供了一些最有效的诊断方法。进一步讨论了这些方法的优缺点。分析后阶段需要对检测结果进行正确的解释，并准备准确的患者报告，包括相关病史、临床指南以及对后续检测或治疗的建议。
