New rapid diagnostic tool for combating mpox

Researchers have created a new globally accessible and robust point-of-care diagnostic test for mpox.

Dr Jesus Rodriguez-Manzano and his team at Imperial College London have developed a portable molecular diagnostic test for point-of-care (POC) detection of mpox and other diseases, capable of delivering PCR-grade results in less than 40 minutes. The paper has now been published in Nature Communications.

The platform, called Dragonfly, works by analysing a swab from a patient’s skin lesion to detect the presence of viral nucleic acids. Its design is similar to high-performance PCR tests used during the COVID-19 pandemic to detect SARS-CoV-2, but without relying on specialised laboratory equipment or infrastructure, which is important in regions that may have limited access to such resources. The Dragonfly platform incorporates an innovative, laboratory-free sample preparation technology which enables extraction of nucleic acids in less than 5 minutes (Analytical Chemistry, 2024).

Mpox is a viral disease caused by the mpox virus (MPXV), which spreads through close physical contact, causing rashes and painful skin lesions. Currently, diagnosis is accomplished with a lab-based PCR test, with results taking as long as 2-4 days in low-resource settings. The new test developed by the Imperial team enables rapid detection of orthopoxviruses (OPXV), MPXV and other viruses causing similar symptoms such as herpes simplex virus (HSV) and varicella-zoster virus (VZV). It is hoped this will enable healthcare workers to make more timely and informed treatment decisions and could be most beneficial in regions where the disease is endemic and where there is limited access to testing facilities.

The mpox epidemic

Like many diseases caused by a virus, mpox has different types known as ‘clades.’ There are two major clades of mpox; clade II has been present in the UK and USA since 2022, and clade I is now increasing transmission in several countries, including the Democratic Republic of Congo. The first cases of clade I appeared in Sweden, Thailand, Germany and the UK in 2024. The rapid global spread of MPXV clade II and sustained transmission of the more virulent clade I highlights a critical gap in POC diagnostics for this emergent disease.

The WHO declared mpox a PHEIC in August 2024 for the second time in two years, emphasising the fact that currently available solutions are insufficient to combat this increasing threat, and that there is an urgent need for a platform like Dragonfly.

The creation of a rapid test

To evaluate the platform a team, led by Dr Rodriguez-Manzano, along with Dr Cavuto and Dr Malpartida-Cardenas, studied 164 patient clinical skin lesion swabbed samples. This included 51 mpox clade II positive cases. Orthopoxviruses were detected with 96.1% accuracy, and monkeypox virus with 94.1% accuracy. The results were compared to gold-standard PCR assays, demonstrating high sensitivity and specificity.

The project involved partners at the University of Surrey (Professor Carlos Maluquer de Motes) and the Defence Science and Technology Laboratory (Dr David Ulaeto), and collaborated closely with Dr Marcus Pond from North West London Pathology, an NHS pathology service that provides testing for three West London NHS trusts. North West London Pathology has been conducting mpox testing since the onset of the 2022 outbreak.

Recent data shows a growing clade I mpox    outbreak that is spreading in a new epidemiologic pattern similar to the global clade II outbreak. Constant changes in pathogen behaviour, emerging threats and shifts in environmental and external factors require diagnostic platforms to adapt. Unlike other diagnostic systems, Dragonfly was redesigned to address the emerging mpox diagnostic needs. Its an adaptable system that can be repurposed for different sample types (e.g. blood, tissue, stool), targets (e.g. viral, bacterial) and applications in response to emerging requirements. The whole system weighs less than 1kg, can be used in a range of environments (as it doesn’t require cold storage). This means healthcare professionals could use it in remote areas efficiently.

Professor Pantelis Georgiou, Co-Founder of ProtonDx, said: “At ProtonDx, we are transforming point-of-care testing with rapid, affordable multi-pathogen diagnostic technology. Dragonfly can fit in your backpack and travel anywhere. It addresses the requirements for rapid molecular grade detection of mpox, removing the need to send a sample off to a lab.”

Using the Dragonfly system

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The Dragonfly platform is cost-effective which means it can be manufactured for a fraction of the costs of other systems, enabling wider access and economic viability on a large scale. ProtonDx, an Imperial spin-out co-founded by Dr Jesus Rodriguez-Manzano, Professor Pantelis Georgiou and Dr Nicolas Moser in 2020, helped fund the research and has now commercialised the Dragonfly diagnostic platform. The Respiratory Test Panel version of the Dragonfly was used by Team GB at the 2022 Winter Olympic Games in Beijing.  More recently, as part of the NIHR Global Health Research Group on Digital Diagnostics for African Health Systems, the Dragonfly platform has been adapted and field-deployed for the detection of malaria parasites in asymptomatic individuals directly from fingerprick blood. 

Dr Jesus Rodriquez-Manzano, Senior Lecturer at Imperial, and Co-Founder and Chief Scientific Officer at ProtonDx, said: “Dragonfly is commercially available for mpox detection as a Research Use Only (RUO) product via ProtonDx; we are currently pursuing regulatory approval. Its use is intended for decentralised testing (i.e., the first point of contact with the patient or subject), both within the NHS (e.g., A&E departments, GUM clinics, GP offices) and in endemic regions.”

As emphasised by the recent WHO Strategic framework for enhancing prevention and control of mpox  (2024-2027), point-of-care tests are needed to support early mpox detection and disease surveillance, especially in resource-limited settings where access to diagnostics is more restricted.

The Dragonfly platform’s accuracy, portability, and rapid multi-pathogen sample-to-result capability make it a versatile tool with significant potential to contribute to global efforts to combat emerging and endemic infectious diseases, particularly in low-resource environments.

The work was supported by the Imperial College London UKRI Impact Acceleration Account (MRC – MR/X502959/1), the Wellcome Trust CAMO-Net programme (226691/Z/22/Z), and the Biotechnology and Biological Science Research Council (BB/X011569/1) as part of a new UK-based consortium to tackle monkeypox outbreaks.   

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'Portable molecular diagnostic platform for rapid point-of-care detection of mpox and other diseases' is published in natures communications (Nat Commun) 16, 2875 (2025). https://doi.org/10.1038/s41467-025-57647-3 

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