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U.S. look to expand monkeypox testing as cases rise

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U.S. health officials are working to expand capabilities to test for monkeypox beyond a narrow group of public health labs, heeding calls from infectious disease experts who say testing for the virus needs to become part of routine care.

U.S. Centers for Disease Control and Prevention (CDC) Director Dr. Rochelle Walensky said during a conference call on Friday that her agency is working with the Food and Drug Administration and Centers for Medicare and Medicaid Services (CMS) to expand testing capacity to include commercial laboratories.

The CDC did not respond to a request for further details.

Currently, preliminary monkeypox testing in the United States is done through a network of 69 public health laboratories, which send results to the CDC for confirmation.

There have been 45 confirmed monkeypox cases in 16 U.S. states so far, with the bulk of the current outbreak outside of Africa, where the virus is endemic, occurring in Europe.

The United States has conducted roughly 300 monkeypox tests. While testing for the virus rose by 45% last week, that needs to increase dramatically if the outbreak is to be contained, infectious disease experts said.

“There is not enough testing going on now for monkeypox in the United States,” said Dr. Tom Inglesby, director of the Johns Hopkins Center for Health Security.

“The commercial labs are used to working with healthcare providers from across the country, moving samples around quickly, reporting results quickly in a way that providers understand and expect,” he said.

Large commercial U.S. testing companies include Quest Diagnostics and Labcorp.

For commercial labs to do this testing, they need access to monkeypox samples to validate their tests, regulatory guidance from the FDA and commercial billing codes set by CMS, said Inglesby, a former senior White House adviser for the COVID-19 response.

“My sense is all of that is moving forward,” he said.

In a detailed report of 17 cases published by the CDC last week, most patients identified as men who have sex with men.

In many of the cases, the monkeypox rash started in the genital area, which could lead some doctors to misdiagnose it as a more common sexually transmitted infection such as herpes or syphilis.

“Monkeypox symptoms are mimicking other sexually transmitted infections,” said David Harvey, executive director of the National Coalition of Sexually Transmitted Disease Directors. “We need to mount a bigger national response.”

The Association of Public Health Laboratories said it has plenty of capacity now, but would work to expand testing to commercial labs should the outbreak continue to grow.

Monkeypox cases around the world

Around 30 countries where monkeypox is not endemic have reported outbreaks of the viral disease as confirmed cases crossed 1,300, most of them in Europe.

Monkeypox, which spreads through close contact and was first found in monkeys, mostly occurs in west and central Africa and only very occasionally spreads elsewhere.

Below is a list of non-endemic countries that have so far reported suspected or confirmed cases, in alphabetical order:

ASIA-PACIFIC

* AUSTRALIA, which on May 20 reported its first case, had confirmed eight as of June 10.

EUROPE

* AUSTRIA confirmed its first case on May 22.

* BELGIUM detected its first two cases on May 20 and a total of 24 by June 8.

* CZECH REPUBLIC detected its first case on May 24, reaching a total of six as of June 2.

* DENMARK confirmed its first case on May 23 and a total of three as of June 3.

* FINLAND reported its first case on May 27, second on June 2.

* FRANCE had confirmed 91 cases by June 9.

* GERMANY reported its first case on May 20 and a total of 131 by June 9.

* GIBRALTAR confirmed its first case on June 1.

* GREECE detected its first case on June 8.

* HUNGARY confirmed its first case on May 31 and reached a total of three by June 10.

* ICELAND diagnosed two cases on June 8 in initial tests, pending confirmation from foreign testing. Local health authority expects the primary diagnosis to be correct.

* IRELAND had confirmed seven cases as of June 7, with first on May 28.

* ITALY had detected 29 cases as of June 9, since its first on May 19.

* LATVIA confirmed its first case on June 3, a second on June 8.

* MALTA reported one case on June 2.

* The NETHERLANDS, which reported its first case on May 20, had confirmed 60 as of June 9.

* NORWAY reported its first case on May 31.

* POLAND reported first case on June 10.

* PORTUGAL confirmed 18 new cases on June 9, bringing its total to 209.

* SLOVENIA has reported a total of six cases since its first one on May 24.

* SPAIN had confirmed 259 cases by June 9.

* SWEDEN confirmed its first case on May 19 and a total of five by June 2.

* SWITZERLAND had confirmed a total of 12 cases as of June 8, with first on May 21.

* The UNITED KINGDOM had confirmed 366 cases as of June 9, including 348 in England, 12 in Scotland, two in Northern Ireland and four in Wales.

MIDDLE EAST & AFRICA

* ISRAEL had reported four cases as of June 9, with its first on May 21.

* MOROCCO reported its first case on June 2.

* The UNITED ARAB EMIRATES had reported a total of 13 infections since its first on May 24.

AMERICAS

* ARGENTINA had confirmed two cases as of June 2.

* BRAZIL recorded its first case on June 8.

* CANADA had confirmed 112 infections as of June 9.

* MEXICO confirmed its first case on May 28.

* The UNITED STATES had confirmed 45 cases in 12 states and the District of Colombia by June 9.

Sources: Data from World Health Organization and U.S. Centers for Disease Control and Prevention, Reuters stories, releases from local authorities

(Reporting by Julie Steenhuysen; Editing by Bill Berkrot)

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