Beat the clock: One-hour diagnostics of emerging viral threats using fast molecular approaches

BACKGROUND: Emerging viral infections pose significant challenges for clinical management and public health, particularly in non-endemic settings. Rapid and accurate diagnostics are essential to guide therapy, implement infection control measures, and support epidemiological surveillance. Traditional methods, including viral culture and early serology, are often limited by long turnaround times or low sensitivity in the acute phase of infection. In this study, we discuss two cases reported for the first time of emerging viral infections in Calabria, Southern Italy, diagnosed using rapid molecular diagnostics. METHODS: Clinical samples from patients with suspected emerging viral infections in a non-endemic setting were analyzed using rapid cartridge-based molecular assays and serological testing. RESULTS: The first case describes a 54-year-old man with confirmed Monkeypox virus (MPXV) infection, identified through a targeted cross-priming amplification assay (CPA), yielding results within ∼55 minutes and enabling immediate clinical management and isolation. The second case involves a 58-year-old woman with dengue virus serotype 2 (DENV-2) infection detected via a multiplex syndromic molecular panel within 60 minutes. Notably, serological testing was initially negative for both IgM and IgG, with seroconversion occurring one week later, consistent with the high sensitivity of molecular assays for detecting viral RNA during the acute phase. These cases highlight the critical role of rapid molecular diagnostics in timely pathogen identification, early clinical intervention, and support for public health measures. CONCLUSION: Our findings underscore the importance of integrating fast molecular assays into diagnostic pathways, promoting clinician awareness, and combining surveillance with preventive strategies, such as vaccination for travelers.