Monkeypox: A Laboratory Medicine Perspective

Lab Medicine Rounds
6 Oct 202213:55

Summary

TLDRIn this episode of Lab Medicine Rounds, host Justin Kreuter interviews Dr. Matt Binnicker about the monkeypox outbreak, contrasting it with COVID-19. Dr. Binnicker explains that monkeypox spreads primarily through skin-to-skin contact and often via sexual transmission, unlike COVID-19 which is respiratory. The discussion highlights the importance of laboratory testing for diagnosis, the role of clinical labs in handling the outbreak, and the potential for future point-of-care tests. The conversation underscores the critical link between lab medicine and clinical practice in managing infectious diseases.

Takeaways

  • 🌟 Dr. Matt Binnicker, Director of Clinical Virology at Mayo Clinic, discusses the monkeypox outbreak, marking it as the largest in recorded history with over 50,000 confirmed cases worldwide.
  • 📈 Monkeypox cases have significantly increased, with the U.S. reporting over 20,000 confirmed cases, indicating a substantial outbreak.
  • 🔬 Monkeypox is primarily spread through direct skin-to-skin contact and, in many recent cases, through sexual transmission.
  • 📍 Unlike COVID-19, which is a respiratory illness, monkeypox presents with a viral prodrome followed by a rash that can mimic other diseases.
  • 🧬 The CDC and public health agencies have developed tests to detect monkeypox, with Mayo Clinic being one of five reference laboratories for testing in the U.S.
  • 🏥 Most hospital clinical labs are not yet performing monkeypox testing but are sending samples to reference labs or state public health laboratories.
  • 📋 The FDA requires emergency use authorization for any new monkeypox tests, paving the way for commercial manufacturers to develop their own tests.
  • 🏥🔬 Laboratory medicine professionals play a critical role in diagnosing monkeypox by confirming infections through laboratory testing, which is essential for patient care and disease management.
  • 🧪 Viral culture for monkeypox is not recommended due to the risk of aerosolizing the virus and the need for high biosafety level precautions.
  • 🏠 The possibility of home test kits for monkeypox is being explored, with potential for point-of-care testing in the future, similar to COVID-19 testing.

Q & A

  • What is the primary mode of transmission for monkeypox?

    -Monkeypox is spread primarily through direct skin-to-skin contact, often during sexual transmission, and can also be spread through contact with contaminated objects.

  • How does the monkeypox outbreak in 2022 compare to previous years?

    -The 2022 outbreak is the largest monkeypox outbreak in recorded history, with over 50,000 confirmed cases worldwide and over 20,000 in the U.S., significantly larger than previous outbreaks.

  • What differentiates monkeypox from COVID-19 in terms of symptoms?

    -Monkeypox causes a viral prodrome with fever and body aches, followed by a rash, whereas COVID-19 primarily causes respiratory illness.

  • What is the role of laboratory testing in diagnosing monkeypox?

    -Laboratory testing is crucial for confirming monkeypox infections, as it can present similarly to other diseases. It involves a detailed exposure history, symptoms assessment, and laboratory confirmation.

  • Why are viral cultures not recommended for monkeypox testing?

    -Viral cultures for monkeypox pose a significant safety risk to lab personnel due to the potential for aerosolizing the sample, which could lead to infection.

  • How has the FDA's emergency use authorization process impacted the development of monkeypox tests?

    -The FDA's emergency use authorization process has opened the door for commercial manufacturers to develop their own tests, which will allow hospital and clinical labs to perform testing in-house.

  • What is the significance of Mayo Clinic being identified as one of the reference laboratories for monkeypox testing?

    -Mayo Clinic's identification as a reference laboratory signifies its role in partnering with the CDC to begin testing for monkeypox, contributing to the national response to the outbreak.

  • How does the process of diagnosing monkeypox compare to COVID-19?

    -Diagnosing monkeypox involves a three-pronged approach including exposure history, symptoms assessment, and laboratory confirmation, whereas COVID-19 diagnosis often relies on respiratory samples and molecular tests.

  • What is the potential future for point-of-care testing for monkeypox?

    -While currently most testing is done in reference labs, the future may see point-of-care tests developed and authorized by the FDA, similar to home test kits for COVID-19.

  • Why is it important for hospital labs to perform monkeypox testing locally?

    -Local testing is important for patient care as it allows for quicker diagnosis and treatment, reducing the risk of disease transmission within hospitals or clinics.

  • How does the monkeypox outbreak highlight the evolving science of laboratory medicine?

    -The monkeypox outbreak, like COVID-19, demonstrates the dynamic nature of laboratory medicine, where knowledge and practices evolve in real-time based on emerging public health challenges.

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Related Tags
Monkeypox OutbreakLab MedicineMayo ClinicVirus DiscussionCOVID-19Public HealthDiagnostic TestingMedical PodcastInfectious DiseaseHealthcare Professionals