Laboratory Test Reference Guide

A Suspected MPOX case is Notifiable to the Medical Officer of Health, so please do this.

Notify the laboratory that specimens are coming (ext 98606) to ensure they are recognised promptly on arrival.

We recommend that suspected cases be discussed with specialist services:

      Cases in the community - sexual health clinic

      Cases in hospital - infectious diseases service.

Please refer to Health Pathways for further pre-testing requirements: Health Pathways

The preferred samples are skin and lesion swabs in viral transport medium. Nasopharyngeal swabs are not preferred because these do not allow adequate scraping of lesions to obtain cellular material. Dried scabs are also sometimes sent for testing but this is les sensitive than swabbing active lesions. Throat swabs are recommended only if there are definite symptoms and other pathogens need to be tested for too. EDTA blood is also sometimes tested, but seldom positive. NPS and blood are currently recommended in some clinical guidelines and so they are routinely received here.

If routine laboratory specimens are also being sent, MPOX PCR specimens require a separate laboratory request form and separate bag

Include details of suspected contact, travel, date of onset on laboratory request form

Viral swab from base of deroofed vesicle

Dried scabs in dry sterile container

EDTA blood if systemically unwell

Monkeypox is a notifiable disease.  At present (Dec 2022), clinicians are required to discuss with the medical officer of health before testing.  Positive results automatically go to the Ministry of Health and at this stage of the epidemic we don’t want these arriving unexpectedly, as they trigger a lot of work

EDTA whole blood, nasopharyngeal and throat swabs, and tissue biopsies are referred to LabPlus for confirmation.

1 mL