Monkey pox can’t use the same home testing manual as COVID-19

Two years after COVID-19, the conversation surrounding monkeypox testing evokes a sense of déjà vu. The similarities are the painful tampons, the struggle to even find the test, the hurdles and the long wait for results. But because the diseases are so different, experience with COVID-19 hasn’t helped researchers much in their efforts to improve the monkeypox testing process.

In the early days of the COVID-19 pandemic, experts complained about the lack of investment in rapid, at-home testing for various diseases in the United States. The thinking was that if the infrastructure was in place before the outbreak of the coronavirus, it would be easier to scale up testing and perhaps help control the pandemic. In the end, it was the scale anyway. Money and resources poured into testing projects, and soon home-based COVID-19 tests became ubiquitous. This experience was to set the stage for the future with easy access to home tests for a wide variety of diseases once they hit the scene.

Against this background, monkeypox seems to offer the perfect test. This unknown disease is spreading rapidly and the demand for tests is high. But monkeypox isn’t the best predictor of whether that future will happen, says Ben Pinsky, director of the Stanford Health Checkpoints Center. “It’s quite another infection,” he says.

Monkeypox is not a respiratory disease like COVID-19, where the nose and mouth are open targets – both for the virus and for testing. Symptoms of monkeypox can include painful, blister-like sores and other symptoms such as fever and muscle aches. Currently, tests for monkeypox involve swabbing the sores that form during the course of the infection. There are no at-home tests for other sores, such as herpes, Pinsky said. There is still more work to be done to determine whether people can successfully clean their wounds, which can be painful or painful, she says.

Case-based reliance means that patients can only be tested if they develop obvious symptoms of illness – a sign that they should be isolated from others anyway. A person with monkeypox and a fever but no sores will not pass the test. On the other hand, people can get tested for COVID-19 without waiting for any symptoms to appear. “I’m a strong proponent of at-home disease testing, but you have to get the right sample at the right time, and we’re not there yet,” said Paul Jaeger, a professor in the university’s department of bioengineering. Washington, D.C., via email The Verge.

It may be possible to test for monkeypox through saliva or semen, according to a small study of 12 patients in June. And some companies are working on tests that don’t hurt at all. California-based Flow Health has developed a saliva-based molecular test for monkeypox that asks people to spit into a tube and then send the sample for PCR testing.

The trial was not approved by the Food and Drug Administration. This is offered through a program that allows certified laboratories to develop and run their own in-house tests without going through the normal regulatory process. Currently, the FDA still says monkeypox tests should be performed on lesions. Flow Health CEO Alex Meshkin said the company is sharing saliva test data with the FDA as the agency reviews whether to update its guidance. The Verge.

There is still much work to be done to determine how and when the monkeypox virus appears in different parts of the body during the course of the disease, which affects how effective and accurate non-lesion tests are. . If the monkeypox virus, for example, is present in saliva before the lesions appear, a saliva-based test can help detect the disease early. But if not, this type of test may not be very useful. According to Meshkin, Flow Health tested a person who had been in close contact with those who had the monkeypox, but who was not yet affected, and that person tested positive. More patients will need to be tested to find out exactly when and how the virus developed.

As the science diverges, the regulatory and political landscape surrounding monkeypox will also diverge from COVID-19. Monkey disease is not currently declared a federal public health emergency in the United States. This will change the way different groups develop tests. Currently, at-home COVID-19 tests are available first when approved for emergency use — an expedited process that allows tests to go to market faster during an emergency. Meshkin said Flow Health is prepared to issue an emergency use permit if a public health emergency is declared, which could come as soon as this week.

Companies that conduct at-home testing without an emergency permit cannot take some of the same steps they did in the early stages of the COVID-19 pandemic. They also can’t use the Flow Health method, which doesn’t require FDA sign-off to test saliva in a lab. A home test, by definition, does not use a laboratory to diagnose patients. These factors may contribute to why many of the rapid testing platforms that have emerged in response to COVID-19 have not focused directly on monkeypox. Cue Health, which has a rapid molecular COVID-19 test, is working on “a variety of diagnostic tests,” but did not specify which ones, spokeswoman Shannon Olivas said. The Verge. Rapid molecular COVID-19 test company Detect says monkeypox test in ‘concept phase’, chief technology officer Eric Kauderer-Abrams said in an email The Verge.

all of this reasons Why Monkeypox Testing Needs to Work Directly Based on COVID-19 Experience. But they are not excuses. The health care system could still be better prepared for this particular epidemic. The disease has been prevalent in Africa for many years, but global public health resources have failed to focus on understanding and preventing it. A Nigerian doctor who tried to raise the alarm about the disease in 2017 was not taken seriously by officials and the international medical community. If more attention has been paid to the disease in the past few years, infectious disease experts may have a better understanding of how the virus affects the body – giving them the information they need to develop easy at-home tests more quickly.

Leaving aside testing at home and logistical differences between the two diseases, you’d think that after two years of brutal pandemics, the U.S. would know how urgently testing is needed to combat an outbreak. The demand for the tests is still greater than the tests available, and some people suspected of having the disease are being dismissed by doctors as they struggle to cope with painful symptoms. Unlike the start of the COVID-19 pandemic, monkeypox is a known disease with tests, treatments and vaccines, but the sluggish response to the U.S. outbreaks shows how little the public health system has learned — even after two years of devastation. How disease can destroy the world.

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