15 labs across the country to start testing for monkeypox

AFTER DETECTING the first case of monkeypox with no international travel history on Sunday, the Indian Council of Medical Research activated 15 of its Virus Research and Diagnostic Laboratories (VRDL) to carry out preliminary testing for the infection. The sample will simultaneously be tested at the National Institute of Virology (NIV-Pune) for confirmation.

At present, a sample of any suspected case from all over the country is sent to NIV-Pune for testing. “Laboratories are slowly being given the responsibility of testing for monkeypox, just as it has been done with Covid-19. This is the way forward to increase testing,” said Dr Priya Abraham, director of the National Institute of Virology in Pune, which will be the apex laboratory.

The 15 laboratories include AIIMS-Delhi; Kasturba Hospital for Infectious Diseases, Mumbai; Bangalore Medical College and Research Institute, Bangalore; Government Medical College in Thiruvananthapuram and NIV field unit in Kerala; King Institute of Preventive Medicine and Research, Chennai; and National Institute of Cholera and Enteric Diseases, Kolkata, among others. “Labs were already trained last month,” a senior ICMR official said.

Patient samples will be referred by the Integrated Disease Surveillance teams to VRDL along with the patient’s clinical history such as origin, gender, age, symptoms or complications they are exhibiting, travel or contact history , comorbidities . Test results must be shared with monitoring teams within 24 hours to ensure control measures can be initiated quickly, sources say.

No sample sent by an individual or a private laboratory will be tested at this time.

Samples sent to VDRL will be divided into three parts – one to be tested by the laboratory itself, one to be sent to NIV-Pune for simultaneous confirmatory testing and one to be stored for future studies.

The VDRL will perform an RT-PCR test which will look for orthopox viruses – a family of viruses including monkeypox, cowpox, buffalopox and eradicated smallpox. If the sample is negative, they will be tested for herpes simplex virus which causes contagious sores mainly around the mouth and genitals, varicella zoster virus which causes chickenpox and enteroviruses which are a group of viruses that use the gut as a pathway. transmission.

NIV-Pune, on the other hand, will perform RT-PCR to specifically detect monkeypox virus. The institute, just as it did with Covid-19, will also isolate and sequence the virus, sources say. RT-PCR is a test method that amplifies the genetic material of a pathogen and compares it to known reference parts of the virus to detect infection in a patient sample. It is readily used nationwide for Covid-19 detection.

Laboratories were also asked to notify the ICMR when they used 50% of the reagents and kits for the monkeypox test.

Union Health Department guidelines state that only “suspected cases” and symptomatic contacts should be tested for monkeypox. The guidelines define a suspected case as someone with an acute, unexplained rash and one or more of the symptoms – swollen lymph nodes, fever, headache, body aches and profound weakness. It also states that the person must have a history of international travel within the past 21 days.

Monkeypox is a viral infection that is passed from person to person through close contact with someone who has a monkeypox rash, but now scientists are also investigating whether the disease is sexually transmitted with cases being diagnosed in men who have sex with men.

The most common symptoms of monkeypox are fever, headache, muscle aches, back pain, lack of energy and swollen lymph nodes, as well as rashes that last two to three weeks. It is a self-limiting disease, but can lead to death, especially in children and people with weakened immune systems. Complications of infection include pneumonia, secondary skin infections, confusion, and eye problems.

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