Mpox (Monkeypox)

Mpox (Monkey pox)

NB Label all samples as “Infection Risk” and include details of exposure, travel history and dates, and inform laboratory BEFORE sending samples (tel 01782 674960 9am-10:30pm, bleep on-call Microbiology BMS at other times)


For UKHSA guidance see Mpox (monkeypox): guidance - GOV.UK (www.gov.uk)

Test/Storage

3 Lilac Remel swabs:
1 swab for Mpox PCR,
1 swab for HSV, VZV & Enterovirus PCR, and
1 swab for storage for any further testing if needed (e.g molluscum contagiosum, syphilis PCR)

 
Sample Container

NB: SEND AT LEAST 3 SWABS FROM LESIONS TO ENSURE NO DELAY IN TESTING!
USE LILAC TOP REMEL (labelled Remel M4RT)

Do NOT use Copan eswabs (pink top)
Sample sites
  • Vesicles
  • Infected lesions
  • Throat if no lesions present

 
Test/Storage

Pus swab for M,C&S (e.g. BHS-A)

 
Sample Container

 
Sample sites
  • Vesicles
  • Infected lesions
  • Throat if no lesions present

 
Test/Storage

If in differential:
Serology for HIV, T. pallidum, CMV, EBV, VZV and parvovirus

 
Sample Container

 
Sample sites

2 x 5ml Venous blood

 
Test/Storage

If in differential:
Gonorrhoea

 
Sample Container

 
Sample sites

Urine sample from male
Endocervical and HVS swab from female

 

The most important samples to take are 3 LILAC TOP REMEL viral swabs in viral transport medium from the base of a vesicle/blister, or from open sore if no vesicle/blister present, requested for mpox PCR. Lesions could appear on skin or mucosal surface anywhere on the body, including in the genital and anal area, hence a thorough clinical examination prior to obtaining samples is essential. If other wounds are present, ensure that the sample is taken from a vesicle/blister or ulcer, or else from under a crusted lesion. Deroofing should be avoided if a wet vesicular lesion or blister is available for swabbing. Always state recent travel history with requests.


A LILAC TOP REMEL viral throat swab can be taken and requested for mpox PCR from a close contact of a confirmed or highly probable case of mpox who have developed systemic symptoms but do not have a rash or lesions that can be sampled (yet). Samples for investigation of other infections, including sexually transmitted infections, should be packaged separately, with separate request forms. Ensure these are labelled “INFECTION RISK”.