Monkeypox Virus Detection in Different Clinical Specimen Types.

A global monkeypox outbreak began in May 2022. Limited data exist on specimen type performance in associated molecular diagnostics. Consequently, a diverse range of specimen sources were collected in the initial weeks of the outbreak in Ontario, Canada. Our clinical evaluation identified skin lesions as the optimal diagnostic specimen source.

Presence of Flavivirus Antibodies Does Not Lead to a Greater Number of Symptoms in a Small Cohort of Canadian Travelers Infected with Zika Virus.

Zika virus (ZIKV) is a mosquito-borne flavivirus associated with a febrile illness as well as severe complications, including microcephaly and Guillain-Barré Syndrome. Antibody cross-reactivity between flaviviruses has been documented, and in regions where ZIKV is circulating, dengue virus (DENV) is also endemic, leaving the potential that previous exposure to DENV could alter clinical features of ZIKV infection. To investigate this, we performed a retrospective case-control study in which we compared Canadian travellers who had been infected with ZIKV and had serological findings indicating previous DENV or other flavivirus exposure (n = 16) to those without any previous exposure (n = 44). Patient samples were collected between February 2016 and September 2017 and submitted to Public Health Ontario for testing. ZIKV infection was determined using real-time RT-PCR and antibodies against DENV were identified by the plaque-reduction neutralization test. The mean time from symptom onset to sample collection was 5 days for both groups; the magnitude of viremia was not statistically different (Ct values: 35.6 vs. 34.9, p-value = 0.2). Clinical scores were also similar. Our findings indicate that previous DENV or other flavivirus exposure did not result in greater viremia or a higher illness score.

Use of the Seeplex RV Detection kit for surveillance of respiratory viral outbreaks in Toronto, Ontario, Canada.

The Seeplex RV Detection kit was used to identify specific respiratory viruses from specimens collected during respiratory outbreaks in the Greater Toronto Area from 1 September 2007 to 1 February 2008. Two hundred-thirty-one patient samples (nasopharyngeal swabs) were collected from 63 respiratory outbreaks. The distribution of outbreaks characterized by molecular means was: 30% (n=19) no identification; 52.5% (n=33) one pathogen; 14.5% (n=9) two pathogens; and 3% (n=2) three pathogens. In contrast, culture-based protocols identified pathogens in fewer outbreaks: 63 % (n=40) no identification; 35% (n=22) 1 pathogen; and 2% (n=1) 2 pathogens (p<0.05). Compared to virus isolation, molecular testing identified a greater proportion of positive specimens for rhinovirus: 22% (n=51/231) vs 5% (n=12/231) (p=0.01); and RSV A/B: 12% (n=27/231) vs 5% (n=11/231) (p<0.05). Superiority of the molecular assay to detect rhinovirus and RSV outbreaks compared to culture is evident from this study.