title: Retrospective analysis of monkeypox infection.
abstract: Serologic cross-reactivity between orthopoxviruses is a substantial barrier to laboratory diagnosis of specific orthopoxvirus infections and epidemiologic characterization of disease outbreaks. Historically, time-consuming and labor-intensive strategies such as cross-adsorbed neutralization assays, immunofluorescence assays, and hemagglutination-inhibition assays have been used to identify orthopoxvirus infections. We used cross-adsorption to develop a simple and quantitative postadsorption ELISA for distinguishing between monkeypox and vaccinia infections. Despite the difficulty of diagnosing clinically inapparent monkeypox in previously vaccinated persons, this technique exhibited 100% sensitivity and 100% specificity for identifying clinically overt monkeypox infection irrespective of vaccination history. We also describe a Western blot technique in which up to 3 diagnostic bands may be used to distinguish between vaccinia and monkeypox infection. The techniques described provide independent diagnostic tests suitable for retrospective analysis of monkeypox outbreaks.
authors.affiliation: Vaccine and Gene Therapy Institute, Oregon Health and Science University, Beaverton, OR 97006, USA.
authors.forename: Melissa E
authors.initials: ME
authors.lastname: Dubois
authors.forename: Mark K
authors.initials: MK
authors.lastname: Slifka
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D015153:Blotting, Western; D002460:Cell Line; D004196:Disease Outbreaks; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D045908:Mpox, Monkeypox / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D008993:Monkeypox virus / Q000276:immunology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014922:Wisconsin / Q000453:epidemiology
chemical_list: D000914:Antibodies, Viral