Hunting for mpox (monkeypox) mimickers: Use of the Biofire meningitis/encephalitis panel on lesion swabs to support alternative viral diagnoses

Bryn K. Joy; Alexis L. Donovan; Gregory R. McCracken; Janice Pettipas; Elsie Grudeski; Anna Majer; Russell Mandes; Tim F. Booth; Todd F. Hatchette; Glenn Patriquin; Jason J. LeBlanc

doi:10.1016/j.jcv.2022.105356

Hunting for mpox (monkeypox) mimickers: Use of the Biofire meningitis/encephalitis panel on lesion swabs to support alternative viral diagnoses

Bryn K. Joy, Alexis L. Donovan, Gregory R. McCracken, Janice Pettipas, Elsie Grudeski, Anna Majer, Russell Mandes, Tim F. Booth, Todd F. Hatchette, Glenn Patriquin, Jason J. LeBlanc

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

Abstract

Background: Mpox (formerly monkeypox) is an emerging zoonotic disease of public health concern that presents as a rash mimicking other common viral exanthems. Unlike traditional testing algorithms relying on several assays, the BioFire FilmArray meningitis/encephalitis (ME) panel simultaneously detects common viruses causing rashes; however, Biofire ME is only licensed for testing on cerebral spinal fluid. Objectives: This study evaluated use of the Biofire ME panel for detection and discrimination of herpes simplex virus types 1 and 2 (HSV-1 and HSV-2), varicella zoster virus (VZV), human herpesviruses type 6 (HHV-6), enteroviruses (EVs), and human paraechoviruses (HPeVs) from a dermal or mucocutaneous swabs collected in universal transport media (UTM). Study design: Results of the BioFire ME panel were compared against methods used during clinical testing. Ten-fold serial dilutions in UTM of cultured viruses were used to compare analytical sensitivity, and analytical specificity was assessed using panels of microorganisms in UTM. Clinical sensitivity and specificity were assessed using 20 positive specimens each for HHV-1, HHV-2, HHV-6, VZV, EVs, and HPeV, as well as 35 known negative specimens that included 15 mpox-positive specimens. Results: Biofire ME was as sensitive as comparator methods, and correctly discriminated all HSV-1, HSV-2, VZV, HHV-6, EVs, and HPeVs from mpox and mpox-mimickers. Cross-reaction between EV and rhinoviruses A, B, and C were noted in the specificity panel. Conclusions: Swabs in UTM collected for mpox testing are suitable for use on the Biofire ME panel, allowing more streamlined diagnostic testing for viral exanthems in patients under investigation for mpox infection.

Original language	English
Article number	105356
Journal	Journal of Clinical Virology
Volume	159
DOIs	https://doi.org/10.1016/j.jcv.2022.105356
Publication status	Published - Feb 2023

Bibliographical note

Funding Information:
The authors declare that they have no conflicts of interest. This work received no private or public funding. All testing was provided in-kind by NSH or NML. All authors were involved in the design, data acquisition, and data interpretation. All authors contributed to and agreed with the content of the final version of the manuscript.

Publisher Copyright:
© 2022

ASJC Scopus Subject Areas

Virology
Infectious Diseases

PubMed: MeSH publication types

Journal Article

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jcv.2022.105356

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Joy, B. K., Donovan, A. L., McCracken, G. R., Pettipas, J., Grudeski, E., Majer, A., Mandes, R., Booth, T. F., Hatchette, T. F., Patriquin, G., & LeBlanc, J. J. (2023). Hunting for mpox (monkeypox) mimickers: Use of the Biofire meningitis/encephalitis panel on lesion swabs to support alternative viral diagnoses. Journal of Clinical Virology, 159, Article 105356. https://doi.org/10.1016/j.jcv.2022.105356

Joy, BK, Donovan, AL, McCracken, GR, Pettipas, J, Grudeski, E, Majer, A, Mandes, R, Booth, TF, Hatchette, TF, Patriquin, G & LeBlanc, JJ 2023, 'Hunting for mpox (monkeypox) mimickers: Use of the Biofire meningitis/encephalitis panel on lesion swabs to support alternative viral diagnoses', Journal of Clinical Virology, vol. 159, 105356. https://doi.org/10.1016/j.jcv.2022.105356

@article{9325f1b81d9546e7b21d0de8236757a7,

title = "Hunting for mpox (monkeypox) mimickers: Use of the Biofire meningitis/encephalitis panel on lesion swabs to support alternative viral diagnoses",

abstract = "Background: Mpox (formerly monkeypox) is an emerging zoonotic disease of public health concern that presents as a rash mimicking other common viral exanthems. Unlike traditional testing algorithms relying on several assays, the BioFire FilmArray meningitis/encephalitis (ME) panel simultaneously detects common viruses causing rashes; however, Biofire ME is only licensed for testing on cerebral spinal fluid. Objectives: This study evaluated use of the Biofire ME panel for detection and discrimination of herpes simplex virus types 1 and 2 (HSV-1 and HSV-2), varicella zoster virus (VZV), human herpesviruses type 6 (HHV-6), enteroviruses (EVs), and human paraechoviruses (HPeVs) from a dermal or mucocutaneous swabs collected in universal transport media (UTM). Study design: Results of the BioFire ME panel were compared against methods used during clinical testing. Ten-fold serial dilutions in UTM of cultured viruses were used to compare analytical sensitivity, and analytical specificity was assessed using panels of microorganisms in UTM. Clinical sensitivity and specificity were assessed using 20 positive specimens each for HHV-1, HHV-2, HHV-6, VZV, EVs, and HPeV, as well as 35 known negative specimens that included 15 mpox-positive specimens. Results: Biofire ME was as sensitive as comparator methods, and correctly discriminated all HSV-1, HSV-2, VZV, HHV-6, EVs, and HPeVs from mpox and mpox-mimickers. Cross-reaction between EV and rhinoviruses A, B, and C were noted in the specificity panel. Conclusions: Swabs in UTM collected for mpox testing are suitable for use on the Biofire ME panel, allowing more streamlined diagnostic testing for viral exanthems in patients under investigation for mpox infection.",

author = "Joy, {Bryn K.} and Donovan, {Alexis L.} and McCracken, {Gregory R.} and Janice Pettipas and Elsie Grudeski and Anna Majer and Russell Mandes and Booth, {Tim F.} and Hatchette, {Todd F.} and Glenn Patriquin and LeBlanc, {Jason J.}",

note = "Funding Information: The authors declare that they have no conflicts of interest. This work received no private or public funding. All testing was provided in-kind by NSH or NML. All authors were involved in the design, data acquisition, and data interpretation. All authors contributed to and agreed with the content of the final version of the manuscript. Publisher Copyright: {\textcopyright} 2022",

year = "2023",

month = feb,

doi = "10.1016/j.jcv.2022.105356",

language = "English",

volume = "159",

journal = "Journal of Clinical Virology",

issn = "1386-6532",

publisher = "Elsevier",

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TY - JOUR

T1 - Hunting for mpox (monkeypox) mimickers

T2 - Use of the Biofire meningitis/encephalitis panel on lesion swabs to support alternative viral diagnoses

AU - Joy, Bryn K.

AU - Donovan, Alexis L.

AU - McCracken, Gregory R.

AU - Pettipas, Janice

AU - Grudeski, Elsie

AU - Majer, Anna

AU - Mandes, Russell

AU - Booth, Tim F.

AU - Hatchette, Todd F.

AU - Patriquin, Glenn

AU - LeBlanc, Jason J.

N1 - Funding Information: The authors declare that they have no conflicts of interest. This work received no private or public funding. All testing was provided in-kind by NSH or NML. All authors were involved in the design, data acquisition, and data interpretation. All authors contributed to and agreed with the content of the final version of the manuscript. Publisher Copyright: © 2022

PY - 2023/2

Y1 - 2023/2

N2 - Background: Mpox (formerly monkeypox) is an emerging zoonotic disease of public health concern that presents as a rash mimicking other common viral exanthems. Unlike traditional testing algorithms relying on several assays, the BioFire FilmArray meningitis/encephalitis (ME) panel simultaneously detects common viruses causing rashes; however, Biofire ME is only licensed for testing on cerebral spinal fluid. Objectives: This study evaluated use of the Biofire ME panel for detection and discrimination of herpes simplex virus types 1 and 2 (HSV-1 and HSV-2), varicella zoster virus (VZV), human herpesviruses type 6 (HHV-6), enteroviruses (EVs), and human paraechoviruses (HPeVs) from a dermal or mucocutaneous swabs collected in universal transport media (UTM). Study design: Results of the BioFire ME panel were compared against methods used during clinical testing. Ten-fold serial dilutions in UTM of cultured viruses were used to compare analytical sensitivity, and analytical specificity was assessed using panels of microorganisms in UTM. Clinical sensitivity and specificity were assessed using 20 positive specimens each for HHV-1, HHV-2, HHV-6, VZV, EVs, and HPeV, as well as 35 known negative specimens that included 15 mpox-positive specimens. Results: Biofire ME was as sensitive as comparator methods, and correctly discriminated all HSV-1, HSV-2, VZV, HHV-6, EVs, and HPeVs from mpox and mpox-mimickers. Cross-reaction between EV and rhinoviruses A, B, and C were noted in the specificity panel. Conclusions: Swabs in UTM collected for mpox testing are suitable for use on the Biofire ME panel, allowing more streamlined diagnostic testing for viral exanthems in patients under investigation for mpox infection.

AB - Background: Mpox (formerly monkeypox) is an emerging zoonotic disease of public health concern that presents as a rash mimicking other common viral exanthems. Unlike traditional testing algorithms relying on several assays, the BioFire FilmArray meningitis/encephalitis (ME) panel simultaneously detects common viruses causing rashes; however, Biofire ME is only licensed for testing on cerebral spinal fluid. Objectives: This study evaluated use of the Biofire ME panel for detection and discrimination of herpes simplex virus types 1 and 2 (HSV-1 and HSV-2), varicella zoster virus (VZV), human herpesviruses type 6 (HHV-6), enteroviruses (EVs), and human paraechoviruses (HPeVs) from a dermal or mucocutaneous swabs collected in universal transport media (UTM). Study design: Results of the BioFire ME panel were compared against methods used during clinical testing. Ten-fold serial dilutions in UTM of cultured viruses were used to compare analytical sensitivity, and analytical specificity was assessed using panels of microorganisms in UTM. Clinical sensitivity and specificity were assessed using 20 positive specimens each for HHV-1, HHV-2, HHV-6, VZV, EVs, and HPeV, as well as 35 known negative specimens that included 15 mpox-positive specimens. Results: Biofire ME was as sensitive as comparator methods, and correctly discriminated all HSV-1, HSV-2, VZV, HHV-6, EVs, and HPeVs from mpox and mpox-mimickers. Cross-reaction between EV and rhinoviruses A, B, and C were noted in the specificity panel. Conclusions: Swabs in UTM collected for mpox testing are suitable for use on the Biofire ME panel, allowing more streamlined diagnostic testing for viral exanthems in patients under investigation for mpox infection.

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Hunting for mpox (monkeypox) mimickers: Use of the Biofire meningitis/encephalitis panel on lesion swabs to support alternative viral diagnoses

Abstract

Bibliographical note

ASJC Scopus Subject Areas

PubMed: MeSH publication types

UN SDGs

Access to Document

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