Dry swabs are required for poxvirus PCR testing. Paired sets of swab samples are required for testing because monkeypox-specific PCR confirmation and clade differentiation is performed as a send-out test to CDC. The swab used should be made of flocked or spun synthetic material. A dry sterile screw cap tube or dry sterile cup (e.g., urine specimen container) should be used for transport of swab. Do not place swabs in any type of transport media.
Providers should review their facility supplies to ensure correct swabs are available.
Specimen collection involves vigorous, firm swabbing of lesions (vesicular, pustular, or crusted) to obtain fluid or pus with paired sets of DRY synthetic swabs. Additionally, scabs or crusts may be removed for collection and placed in a dry, sterile container.
Swab and scab/crust specimens should be stored refrigerated and ideally frozen within 1 hour.
Decisions and approval regarding testing will be made in consultation with the local health department. Consultation is required prior to specimen submission to discuss pertinent medical information (e.g., rash onset date, rash type, symptoms, smallpox vaccination date if relevant), exposure history, and need for photos. Additional details regarding specimen collection and coordination for transport will be provided when the suspect case is reported. Specimens received at the Public Health Laboratory without medical epidemiologist approval will not be tested.