Palm Springs clinic first in Riverside County to test for monkeypox using phlegm

PS…Test, Riverside County’s first nonprofit clinic, has become the first in the county to collect sputum (phlegm) samples for monkeypox testing.

The Palm Springs clinic has touted itself as a leader in accessible services, known for offering 100% free STI testing and treatment.

The CDC and the Food and Drug Administration (FDA) granted 510(k) clearance* for a polymerase chain reaction (PCR) diagnostic test to detect the Non-variola Orthopoxvirus (NVO)." 

PS...Test uses that PCR test, however, rather than testing samples from monkeypox lesions like the county and other testing sites like DAP Health currently do, the non-profit clinic is at the forefront of saliva-based tests.

“We were sending it to the county and getting a turnaround time of about 48 to 72 hours. You have to get approval first. You have to send a picture in, you have to send the patient’s demographics in, and they approve whether or not they’ll accept your sample,” said Dr. Phyllis Ritchie, CEO and Founder of PS...Test.

That changed after Dr. Ritchie was approached by Los Angeles-based medical laboratory Flow Health regarding a partnership on monkeypox testing using sputum samples.

In August 2022, Flow Health was mentioned as a participant in clinical trials at three testing sites in Los Angeles. While the results are non-peer reviewed, researchers concluded that their "findings provide evidence that saliva-based tests maybe a viable testing method for Human monkeypox and may identify cases earlier than lesion-based tests."

“We send off the test and they’ll turn it around in 24-48 hours. It’s 100% sensitive and specific," said Dr. Ritchie. She added, "this facility accepts our samples, believes us that this patient most likely has monkeypox" and "its 100% free to us. If we use Labcorp, it would be $67 a test which would fall on our shoulders not the patients', and that's expensive for a small free STI testing/treatment clinic."

However, the FDA issued a safety communication in July advising people to use swab samples taken directly from a lesion when testing for the monkeypox virus.

"Although the PCR monkeypox on sputum is not FDA approved yet, the PCR has been done on many other viruses of the sputum including COVID," said Dr. Ritchie. She explained, "Everything we are doing now with monkeypox is figuring out things in real time and the PCR on sputum most likely will be the accepted way of testing soon."

"There needs to be more research. The county and the state are probably busy trying to fund other areas. They are already busy still with COVID," said Dr. Ritchie. She added, "I think the private companies are the ones that led the way for COVID testing, so I think it will be the private companies that lead the way for PCR sputum and anal swabs for monkeypox testing."

By the end of June 2022, less than 10% of the available nationwide LRN NVO testing capacity had been used, according to the Centers for Disease Control and Prevention. In July, production expanded to five commercial laboratories, which the CDC said would "make testing more accessible."

Earlier this month, The Biden Administration declared monkeypox a public health emergency to make testing and vaccines more widely available.

However, some clinicians and patients nationwide have reported continued challenges quickly accessing enough monkeypox tests and vaccines as the number of monkeypox cases rises across Riverside County, including in the Coachella Valley.

Dr. Ritchie said she participated in a meeting on Wednesday with the California Department of Public Health and Dr. Tomás Aragón, during which she and others asked about the status of additional vaccine shipments to their respective regions.

She said state health officials should treat Palms Springs differently than other cities in the way vaccines are allocated because "we have a unique population, being transitory, being a large gay/bisexual/men who have sex with men population."

Ps...Test welcomes walk-ins, however, anyone interested in any of its free services is encouraged to contact the office for an appointment.