Monkeypox: Expert calls for ramping up testing, surveillance

The state has had three suspected cases of monkeypox, so far, all of which turned out negative. Of these, the first two were tested at the NIV, Pune while the third sample, that of a nine-year-old from Karwar, was tested at the Virus Research and Diagnostic Lab (VRDL) at Bangalore Medical College and Research Institute (BMCRI) in the first week of August. VRDL, the only facility for monkeypox testing in Karnataka, hasn’t received any samples since then.

Dr Ambica R, Professor and HoD of Microbiology at BMCRI, says that any sample tested here is sent to NIV Pune for confirmation. “We are supposed to release the test report within 24 hours of getting the sample, but it could take more time as confirmation from NIV would also be needed.” ICMR has designated 15 labs across the country to test for monkeypox.

VRDL receives samples only from hospitals that see suspected cases. “If a hospital finds a suspected case, they should contact the District Surveillance Officers (DSOs) who will decide if testing is needed and then collect samples. DSOs will then send the samples to us. In the case of faraway districts, DSOs are supposed to ship the sample in dry ice so that the quality is not compromised,” says Dr Ambica.

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Unlike in the case of Covid, a larger number of samples - from the patient’s lesions, nasopharyngeal and oropharyngeal swabs, blood and urine - are needed for a monkeypox test. However, the test done is RT-PCR, the same as Covid. Currently, VRDL is using its existing staff and facilities for monkeypox testing. “We already have the equipment since we have been testing for Covid, and our staff have been trained in monkeypox testing. We have been asked to inform the NIV well in advance if our requirement scales up,” says Dr Ambica.

Community Surveillance

While VRDL has been testing cases they receive from hospitals, what about cases in the community that may get missed? Dr Giridhar R Babu, the member of the state’s Covid TAC, says ICMR should soon validate testing kits developed by various companies so that testing can be commonly done in private labs. Government can also work with civil society organisations to create awareness in the community so that anyone with symptoms will report it quickly and isolate themselves.

Health Commissioner D Randeep says a pilot would soon be launched for wastewater surveillance which will help detect the community spread of monkeypox. “This was effective for COVID surveillance, and TAC has recommended this. An organisation has come forward to take this up, at no cost to the government.”