There’s a Monkeypox Testing Bottleneck
When the first case of monkeypox was confirmed in the United States, the country’s public health laboratories had the ability to run 6,000 tests per week. That was way more capacity than needed—until monkeypox started spreading faster than public health officials had anticipated. There are now approximately 5,000 confirmed cases in the US.
For patients, testing is crucial, because a positive result is needed for accessing TPOXX, an antiviral medication that is being used off-label to treat monkeypox. “Having a test result is a self-advocacy tool,” says Keletso Makofane, an HIV epidemiologist at the FXB Center for Health and Human Rights at Harvard University. “If you don’t have a test result, you don’t have evidence of your condition.”
Testing has since expanded to around 80,000 tests per week, after five large commercial laboratories partnered with the federal government to boost the nation’s testing efforts. But while the ability to run more tests has improved, there are still barriers that prevent people from accessing them. And while states are required to report cases of certain diseases, monkeypox isn’t one of them. That makes it difficult for public health officials to gauge the true size of the outbreak and who the disease is infecting, in order to break the chains of transmission.
“One piece of information that we’re missing is how many tests are actually being run and what the percent positivity is,” says Caitlin Rivers, infectious disease epidemiologist at the Johns Hopkins Center for Health Security. “If we had those metrics, we would have a better understanding of how much of our existing capacity is being used and whether it’s reaching enough people to be able to say confidently that we’re finding most cases.”
Testing was initially slow to ramp up, in part because public health officials didn’t expect monkeypox to spread as quickly as it has. “We initially anticipated that demand would be low, because the monkeypox transmission in humans tends to be very limited,” says William Morice, president of Mayo Clinic Laboratories and chair of the board of directors for the American Clinical Laboratory Association. Despite its name, monkeypox is primarily carried by rodents, including tree squirrels and rats. Previously, the biggest outbreak in the US was in 2003, when 47 people in six states—Illinois, Indiana, Kansas, Missouri, Ohio, and Wisconsin—got the disease after having contact with infected pet prairie dogs that were housed near imported small mammals from Ghana.
Unlike with Covid-19, which was a completely new disease, the US already had a test for orthopoxviruses—the family of viruses that includes monkeypox and smallpox. That meant the US Centers for Disease Control didn’t have to start developing a new test from scratch, something that hampered testing in the early days of the Covid pandemic. (A design flaw in the kits that the CDC mailed out to public health labs in February 2020 meant that early Covid-19 tests had a high failure rate.)
via Wired https://www.wired.com
August 1, 2022 at 04:17AM