Mpox immune test validated during Rwanda outbreak response

A new antibody test has been validated for mpox during an outbreak in Rwanda, offering health authorities a practical way to track infection and guide vaccination strategies in real time.

Researchers from the University of Birmingham (UK), working with the Rwanda Biomedical Centre and the University of Rwanda (both Kigali, Rwanda), have developed and validated a new antibody test for mpox during the recent clade 1b outbreak in Rwanda. The IgG ELISA assay, reported in The Lancet Infectious Diseases, detects antibodies generated after infection or vaccination, providing a practical tool to support outbreak control and vaccine prioritization.

Tracking immunity during outbreaks is crucial but often difficult in resource-limited settings. Serological tools that identify who has been infected or vaccinated help researchers understand transmission patterns, estimate population immunity and guide targeted vaccination programs.

The test, the first of its kind that has been validated within this setting, was developed through the MpoxCARE research project and validated at Rwanda’s National Reference Laboratory in Kigali using serum and dried blood spot samples from three groups: vaccinated individuals, individuals previously infected with mpox, and individuals with no known exposure or vaccination.

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Using an IgG ELISA platform, the assay works by detecting antibodies produced against the mpox virus. Importantly, researchers designed the test to focus on just four key immunodominant mpox antigens, keeping costs low and ensuring the assay can be used in laboratories with limited resources.

A major innovation is the test’s ability to work with dried blood spots. Instead of requiring standard venous blood samples, small drops of blood collected on filter paper can be analyzed, expanding testing capacity to remote clinics where phlebotomy services may be limited.

Validation of the assay demonstrated its ability to accurately distinguish individuals with mpox antibodies generated either through natural infection or vaccination. This allows public health teams to map transmission networks, track immunity trends and prioritize vaccine doses for populations most at risk.

“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,” commented Christopher Green, a Consultant Physician in Infectious Diseases at University Hospitals Birmingham NHS Trust and Chief Investigator of the MpoxCARE project.

Researchers say the test will become part of a regional public health toolkit for mpox monitoring in East Africa. The collaboration also highlights a broader model for outbreak science: developing and validating an accessible diagnostic tool during an active outbreak where epidemics occur, improving preparedness for future emerging diseases.