If Monkeypox virus is suspected by the health department, the Montana Communicable Disease Bureau (CD EPI) should be consulted through the Emergency Operations Center (406-444-0273).
Symptoms of monkeypox include fever, headaches, muscle aches, swollen lymph nodes, chills, and exhaustion, followed by a skin rash. The virus is transmitted from one person to another by physical contact with lesions, body fluids, respiratory droplets and contaminated materials. CDC is urging healthcare providers in the U.S. to be alert for patients who have rash illnesses consistent with monkeypox, especially if other diseases have been ruled out.
Specimen Collection: At a minimum, collect multiple dry lesion swabs or lesion crusts as follows:
Specimen collection procedures for preliminary and confirmatory testing
Collect samples from more than one lesion, preferably from different locations on the body and/or from lesions with differing appearances
Vigorously swab or brush lesion with two separate sterile dry polyester or Dacron swabs.
Break off end of applicator of each swab into a sterile 1.5- or 2-mL screw-capped tube with O-ring or place each entire swab in a separate sterile container
Freeze and store specimens within one hour of collection. Specimens can be refrigerated, but storage at temperatures ≤ -20°C is strongly preferred.
Specimens should be packaged and shipped Category B
One dry swab may be tested at MTPHL for presumptive results. CDC can provide Monkeypox virus-specific testing on the second dry swab specimen if the first dry swab is presumptive positive at MTPHL.
Biosafety: Measures should be taken to minimize the risk of transmission when collecting clinical specimens from suspected monkeypox patients. These may include limiting the number of staff collecting specimens, wearing appropriate personal protective equipment, using rigorously applied standard precautions, and avoiding any procedures that could generate infectious aerosols.
Testing: Clinical history and real-time PCR positive results using the LRN Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set assay will result in a positive for a non-variola orthopoxvirus, which may be Monkeypox virus. Specimens meeting this description will be referred to CDC for speciation.
Ordering: On paper requisitions mark "Other Confirmation" under Micro Surveillance and write Monkeypox in the comments box. For online orders, use "Orthopox NV PCR" (Orthopoxvirus; Non-Variola PCR). It can be found by typing monkeypox also.
Recent or updated Monkeypox websites (updated June 24)
Information For Laboratory Personnel | Monkeypox | Poxvirus | CDC [cdc.gov]
2022 Monkeypox Outbreak Global Map | Monkeypox | Poxvirus | CDC [cdc.gov]
HHS Expanding Monkeypox Testing Capacity to Five Commercial Laboratory Companies | HHS.gov [hhs.gov]