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Monkeypox cannot use the same home testing playbook as COVID-19

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Two years after COVID-19, conversations about monkeypox testing evoke a disturbing déjà vu. The similarities are right there. Painful swabs, trouble finding tests, bottlenecks, and long waits for results. But the disease is sufficiently different that the COVID-19 experience has not contributed much to researchers’ efforts to improve the monkeypox testing process.

Early in the COVID-19 pandemic, experts said lamented the lack of investment In rapid home testing for various diseases in the United States. It was thought that with the infrastructure in place before the coronavirus emerged, it would be easier to scale up the tests, which could help control the pandemic. Up happened anyway. Money and resources flooded into testing projects, and soon his COVID-19 testing at home was ubiquitous.the experience was supposed to be Prepare for the future by making it easy to test at home for any number of illnesses as they appear on the scene.

Against that background, it seems that monkeypox might provide a perfect test case. An unfamiliar disease that spreads rapidly and is in high demand for testing. But monkeypox isn’t the best benchmark for whether that future will materialize, says Ben Pinsky, medical co-director of point-of-care testing at Stanford Health Care. “It’s a different enough infection,” he says.

Monkeypox is not a respiratory disease like COVID-19. With COVID-19, the nose and mouth are clear targets for both virus and testing. Symptoms of monkeypox are painful, blistering pains that may be accompanied by other symptoms such as fever and muscle aches. Currently, the monkeypox test involves swabbing ulcers that appear during the course of infection. There are no home tests for other lesions, such as herpes, for example, Pinsky said. Determining whether people can successfully wipe their lesions still requires a lot of work and can be painful or difficult.

Lesion-dependence means that patients can only be tested after obvious signs of disease. People with monkeypox who have a fever but no disease should not be tested. Testing for COVID-19, on the other hand, can be done without waiting for specific symptoms to appear. “I am a strong proponent of home testing for illness, but the need to have the right samples at the right time has not yet materialized,” he said in an email to Washington. The Barge.

Saliva and semen may be tested for monkeypox. one little study of 12 patients performed in June. Some companies are working on non-damaging inspections. California-based Flow Health, Inc. evolved A saliva-based molecular test for monkeypox that asks people to spit into tubes and send samples for PCR testing.

This test is not approved or approved by the Food and Drug Administration. This is offered through a program that allows accredited labs to develop and run their own in-house tests without going through the normal regulatory process. Currently, the FDA still says that monkeypox testing should be done on lesions. Flow Health CEO Alex Meshkin said the agency is sharing saliva test data with the FDA to see if it needs to update its guidance. The Barge.

Much work remains to be done to figure out how and when the monkeypox virus manifests itself in different parts of the body during the course of the disease. This will have implications for effective and accurate methods of lesion-free testing. For example, if monkeypox virus appears in saliva before lesions develop, saliva-based testing may aid in early detection of disease. But otherwise, that type of testing may not be very useful. Meshkin says Flow Health tested a person who was closely related to a monkeypox patient but who did not yet have the disease, and that person tested positive. More patients need to be tested to know for sure how they will appear.

In addition to the different science, the regulatory and political landscape around monkeypox also deviates from COVID-19. At this time, monkeypox has not been declared a federal public health emergency in the United States. This changes how different groups develop their tests. Home testing for COVID-19 is currently available primarily under emergency use authorizations. This is an accelerated process that allows tests to be brought to market faster in an emergency. Meshkin said Flow Health stands ready to apply for an Emergency Use Authorization if a public health emergency is declared. this week.

Without emergency permits, home testing companies will not be able to take some of the same steps they did in the early stages of the COVID-19 pandemic. They also can’t take Flow Health’s approach, which doesn’t require FDA approval to perform saliva testing in a lab. plug. These factors may contribute to why many rapid testing platforms that have emerged in response to COVID-19 have not been redirected directly to monkeypox. Cue Health, which does rapid molecular testing for COVID-19, is working on a “variety of diagnostic tests” but has not specified which ones. The Verge. Detect, which also does rapid molecular COVID-19 testing, said it is in the “concept stage” of a monkeypox test, the chief technology officer said. Eric Caudeler Abrams said in an email: The Barge.

they are all cause Why Monkeypox Testing Needs More Work Than Building COVID-19 Experience Directly. But they are not excuses.Health systems could have been far better prepared for this particular outbreak. I could hardly allocate resources to what I was doing. Nigerian doctor Doctors who tried to warn about the disease in 2017 were not taken seriously by officials and the international medical community. Given the growing interest in the disease over the past few years, infectious disease experts may have a better understanding of the effects the virus has on the body. In short, we now have the kind of information we need to develop simpler home tests more quickly.

Even setting aside home testing and the logistical differences between the two diseases, after two years of brutal pandemics, the United States has learned how urgent testing is to deal with infectious disease outbreaks. You would think so.there is more more demand For tests than there are tests available struggle to cure painful symptoms. Unlike the beginning of the COVID-19 pandemic, monkeypox is a known disease and there are existing tests, treatments and vaccines, but the slow response to the outbreak in the United States shows how. some lessons The public health system has learned even after a two-year intensive course on how disease can disrupt the world.

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2/ https://www.theverge.com/2022/8/4/23292267/monkeypox-home-testing-saliva-lesions-covid

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