A groundbreaking portable molecular diagnostic platform, Dragonfly, developed by researchers at the Centres for Antimicrobial Optimisation Network (CAMO-Net) in collaboration with the Centre for Bio-inspired Technology (CBIT) and commercialised by Imperial spin-out ProtonDx, now allows for the rapid detection of mpox and other skin-tropic viral infections directly at the point-of-care. This advancement is crucial in enhancing timely diagnosis and effective outbreak management, especially in resource-limited settings.
The research, led by Dr Jesus Rodriguez-Manzano, details Dragonfly’s development and validation and has been published in the science journal Nature Communications. Dr Rodriguez-Manzano, who spearheaded the development of the original Dragonfly diagnostic platform along with first authors Dr Matthew L Cavuto and Dr Kenny Malpartida-Cardenas, is a Senior Lecturer in Diagnostics for Infectious Diseases at Imperial College London’s Department of Infectious Disease. He also serves as Deputy Director and Chief Scientist at the Centre for Antimicrobial Optimisation (CAMO), Research Strategy Advisor for Diagnostics & Innovation at the Fleming Initiative, and is a key member of CAMO-Net UK.
The new diagnostic platform demonstrated high accuracy in diagnosing mpox and other skin-tropic viral infections. The device achieved a sensitivity of 96.1% and specificity of 100% for orthopoxviruses (OPXV), and 94.1% sensitivity and 100% specificity for the mpox virus (MPXV). This means it correctly identified nearly all positive cases while ensuring no false positives, making it a highly reliable diagnostic tool. Its design also eliminates the need for bulky laboratory equipment, making it particularly suitable for decentralised healthcare environments.
Skin-tropic viral infections are viruses that primarily affect the skin, often causing rashes, lesions, or blisters. These include MPXV, herpes simplex virus (HSV), and varicella-zoster virus (VZV), which can present with similar symptoms, making rapid and accurate diagnosis essential for appropriate treatment and infection control.
Overview of the complete mobile Dragonfly testing kit, reconfigured for the simultaneous extraction and detection of OPXV and MPXV from two patient samples
The resurgence of mpox, following the World Health Organization’s (WHO) designation of the virus as a Public Health Emergency of International Concern for the second time in 2024, has underscored the urgent need for effective, decentralised diagnostic solutions. Traditional molecular testing methods, such as quantitative PCR (qPCR), are often confined to centralised laboratories, limiting timely detection and outbreak control efforts. Dragonfly bridges this gap by integrating a power-free nucleic acid extraction method (based on SmartLid technology) with lyophilised colourimetric loop-mediated isothermal amplification (LAMP) chemistry, enabling sample-to-result molecular grade diagnostics in under 40 minutes.
Unlike conventional molecular diagnostic platforms, Dragonfly does not require a thermocycler or complex optical detection systems. Instead, it relies on a colour-based readout designed to simplify result interpretation and ensure compatibility with colour-blind users. The system consists of a single-use sample extraction kit, a lyophilised test panel, and a low-cost isothermal heat block, which can be powered by batteries or solar energy, further enhancing its field usability.
In close collaboration with Dr Marcus Pond from North West London Pathology laboratories, Dragonfly’s efficacy was assessed using 164 clinical samples, including 51 mpox-positive cases, benchmarked against gold-standard qPCR testing. The platform demonstrated robust differentiation between mpox and other viruses with similar skin manifestations, such as HSV and VZV. Its diagnostic accuracy offers a significant advancement in early case detection, infection management, and outbreak surveillance.
Dr Rodriguez-Manzano highlighted the importance of this development: “Dragonfly represents a crucial step in making molecular diagnostics more accessible. By eliminating the need for specialised equipment and trained personnel, we are enabling rapid and accurate detection of mpox and other infectious diseases in settings where it is needed most.”
This innovation is a key output of CAMO-Net and represents its key objective of fighting infectious diseases by addressing the underlying causes of antimicrobial resistance (AMR). CAMO-Net is a Wellcome-funded, multidisciplinary global collaboration of established research institutions addressing AMR. CAMO-Net operates across 13 sites in 11 countries, predominantly in the global south, where communities are disproportionately affected by AMR. The network focuses on producing contextually relevant tools, technologies, guidelines, and practices to optimise antimicrobial use in humans, supported by equitable availability and accessibility.
With mpox cases rising and the WHO’s strategic framework emphasising improved diagnostic capabilities, Dragonfly provides a timely and effective solution. Its potential applications extend beyond mpox, offering a versatile platform adaptable to other emerging infectious diseases. As global health systems continue to address the challenges posed by viral outbreaks, innovations like Dragonfly will play a critical role in strengthening diagnostic resilience worldwide.
