Guidelines for Monkeypox Specimen Collection

Skin specimens of the lesions should be collected as soon as monkeypox is suspected. Proper specimen collection is the most important step in the laboratory diagnosis of infectious diseases. Improperly collected specimens may lead to false negatives or inconclusive results. Below are a guidelines for monkeypox specimen collection.

1. Remove 1 specimen collection swab from its package. Do not touch the tip of the swab with your hands. Only 1 swab per lesion is required for testing.
2. Unscrew the top of the collection tube. Hold the swab in 1 hand and the collection tube in the other.
3. Swab a pustule/lesion vigorously without unroofing or lancing the lesion.
4. Insert the swab into the viral transport medium without touching the outside of the collection tube, and break off the end of the swab, if required.
5. Screw the top of the collection tube back on tightly. Leaking specimens will be rejected.

Note:

• Optimum personal protective equipment (PPE) for specimen collection is a gown,gloves, eye protection (e.g. goggles or a face shield that covers the front and sides of the face), and a NIOSH-approved particulate respirator equipped with N95 filters or higher.
• Specimens should be collected in a single-person room, with the door closed (if safe to do so). Special air handling is not required.
• Use a sterile nylon, polyester, or Dacron swab with a plastic or thin aluminum shaft. Do not use other types of swabs. Do not use swabs contained within a media transport system (e.g. ESwab)
• Vigorously swab or brush lesion. If the skin atop the vesicle or pustule is intact, it may be necessary to gently lance and lift the lesion.
• Place each specimen in a separate sterile container