Detection of mpox and other orthopoxviruses using a lateral flow device as a point-of-care diagnostic

Laidlaw, SM; Ulaeto, D; Lonsdale, S; Clark, G; Sumner, R; Edwards, T; Adams, E; Logist, A-S; Van Holm, B; Maluquer de Motes, C; Horby, P; Maes, P; Carroll, MW

Journal article

Detection of mpox and other orthopoxviruses using a lateral flow device as a point-of-care diagnostic

Abstract:: In 2022, the World Health Organization declared the worldwide outbreak of mpox to be a public health emergency of international concern. The causative monkeypox virus (MPXV) belonged to clade IIb and is transmitted through sexual contact with a low case fatality rate (0.1%), which, together with under-detection, all contributed to a rapid global spread particularly within the MSM (men who have sex with men) community. As MPXV clade II remains circulating worldwide, a new outbreak of the more fatal clade I disease has been declared in Central and East Africa, and remains uncontrolled in part due to the lack of point-of-care (POC) diagnostics for rapid decisions on treatment and self-isolation. To address the lack of POC solutions for mpox, we have designed and evaluated an orthopoxvirus-specific lateral flow device (LFD) that could be used for the diagnosis of mpox. Using an LFD comprising four monoclonal antibodies against the A27 protein, we demonstrate sensitivity to 3 × 105 pfu/mL. This sensitivity is expected to be sufficient for the detection of MPXV from lesion sites and may also be sufficient for other sample types such as saliva and urine. We found that the presence of guanidinium thiocyanate, a common ingredient in inactivating viral transport media, masked the LFD antigen, resulting in false negatives. POC diagnosis of mpox may be possible using an LFD to reduce delays arising from sample shipment to centralized laboratory testing facilities. In order to achieve this, our work demonstrates that an LFD-optimized buffer is required, as the sample collection buffer may have a detrimental impact on sensitivity for clinical material.

Publication status:: Published

Peer review status:: Peer reviewed

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APA Style

Laidlaw, S. M., Ulaeto, D., Lonsdale, S., Clark, G., Sumner, R., Edwards, T., Adams, E., Logist, A.-S., Van Holm, B., Maluquer de Motes, C., Horby, P., Maes, P., & Carroll, M. W. (2025). Detection of mpox and other orthopoxviruses using a lateral flow device as a point-of-care diagnostic. Microbiology Spectrum, 13(4).

MLA Style

Laidlaw, SM, et al. “Detection of Mpox and Other Orthopoxviruses Using a Lateral Flow Device as a Point-of-Care Diagnostic.” Microbiology Spectrum, vol. 13, no. 4, 2025.

Chicago Style

Laidlaw, SM, D Ulaeto, S Lonsdale, et al. 2025. “Detection of Mpox and Other Orthopoxviruses Using a Lateral Flow Device as a Point-of-Care Diagnostic.” Microbiology Spectrum 13 (4).
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