Mpox diagnostics: a swift and integrated approach to outbreak control

Abstract

The unprecedented global spread of monkeypox (mpox) through physical and sexual transmission revealed significant gaps in diagnostics and sexually transmitted infection (STI) outbreak preparation. An early understanding of viral infectivity and shedding dynamics is critical in informing testing strategies. Capability for viral culture in high-containment laboratories allows rapid dissemination of control materials and evaluation of high-throughput assays, in preparation for testing upscaling. Early genomic characterisation in local clusters informs suitable public health applications and limitations. Monkeypox virus (MPXV) genomics can provide global contextualisation and assist in determining disease importation. As mpox outbreak control strategies evolve towards preventing importation, investment in point-of-care rapid diagnostics such as CRISPRbased lateral flow assays is critical for an agile STI disease-control response.