Mpox immune test validated during Rwandan outbreak

An antibody test for the infectious disease Mpox was successfully developed during the new clade 1b outbreak in Rwanda, the first time that an assay of its kind has been validated within this setting.

The test, an IgG ELISA assay, is described in a new paper published in Lancet Infectious Diseases. Developed by a team from the University of Birmingham in collaboration with the Rwanda Biomedical Centre (RBC) and the University of Rwanda, the highly accurate test for Mpox antibodies was successfully trialled within the National Reference Laboratory in Kigali, Rwanda.

The assay tests for antibodies to Mpox virus that appear after infection or vaccination. By detecting this immune signature, public health authorities and researchers can better study key factors in outbreaks of mpox cases such as the networks of disease transmission, who needs priority for vaccination, and the how immunity changes over time.

The project, called MpoxCARE, took blood samples collected and tested in Rwanda from known patients who either had received an Mpox vaccine, had previously had an Mpox infection, or had no exposure to the disease or prior vaccination. The test was validated on whether it would be able to identify patients who had developed Mpox antibodies (immunity) after vaccination or naturally after infection.

Researchers from the MpoxCARE team developed the test using only four key antibody signatures, to ensure that the test was affordable and supplies were accessible in remote laboratories.

Professor Christopher Green from the University of Birmingham, Consultant Physician in Infectious Diseases at University Hospitals Birmingham NHS Trust and Chief Investigator of the MpoxCARE project said: “We are proud to have the capacity to conduct high-quality research in equal partnership with talented scientists in Rwanda in a time of need.

"We remain fully committed to building capacity for managing future outbreaks of infectious disease and we are very grateful to members of the Rwanda public especially who supported this research. It is critical that science is developed in the settings and populations that reflect the need. This is a meaningful step forward to improve global health security and is a real-world demonstration of research in action.”

Building capacity for tackling preventable diseases

The new diagnostic tool is a product of a longstanding relationship between the University of Birmingham and the national health implementation agency for Rwanda, Rwanda Biomedical Centre.

The joint research portfolio is configured with capacity building at the core, which includes international PhD studentships and infectious disease research expertise from the NHS and NIHR to allow for the rapid development of scientific countermeasures for outbreaks of vaccine preventable disease.

The development of an accurate immune diagnostic, which can also utilise dried blood spots where phlebotomy resources are scarce, is an important first step and is now available as part of the wider public health repertoire of tools to understand and interrupt the spread of Mpox virus in the East Africa region.

Professor Claude Mambo Muvunyi, Director General of Rwanda Biomedical Centre, and Principal Investigator of the MpoxCARE project said: “Our work demonstrates the critical importance of conducting high-quality research where outbreaks occur. We are grateful for this partnership, which continues to strengthen the capacity of our National Reference Laboratory to validate new diagnostic tools and reinforces Rwanda’s role as a regional leader in epidemic research, surveillance, and response.”

Professor Alex Richter, Director of the Clinical Immunology Service at the University of Birmingham, and Principal Investigator of the MpoxCARE project said: “Working collaboratively across sectors and across countries has enabled the rapid development of our test. This Mpox antibody test was designed to be used in Rwanda and so the ability to validate in a local population ensures it is fit for purpose.”