MONKEYPOX

VIRUS

SPECIMEN
COLLECTION
SPECIMEN COLLECTION
 BIOSAFETY AND
CONSIDERATION
• All specimens collected for laboratory investigations are
potentially infectious and should be handled with
caution
• Objective: Minimize the risk of transmission
based on risk assessment
• All personnel collecting samples shall wear appropriate
PPE to protect against contact and droplet transmission
• Disposable gown/coverall, gloves, respirator, eye
protection
• Ensure safe work practices
• Proper donning and doffing, keeping hands away from face, limit
surfaces touched, changing gloves when torn or heavily
contaminated, performing hand hygiene
Personal Protective Equipment
 Any individual meeting the
definition for a suspected case
should be offered testing.
 SPECIMEN COLLECTION Considerations
Preffered Specimen?

• Objective of collection is to get as many virus-infected cells as

possible  increase yield and chances of successful lab testing
• Preferred specimen is skin lesional material
 Monkeypox Characteristics: Lesions
• Lesions are well circumscribed, deep seated, and
often develop umbilication (resembles a dot on the
top of the lesion)
• Lesions are relatively the same size and same
stage of development on a single site of the
body (ex: pustules on face or vesicles on legs)
• Fever before rash
• Lymphadenopathy common
• Disseminated rash is centrifugal (more lesions on
extremities, face)
• Lesions on palms, soles
• Lesions are often described as painful until the
healing phase when they become itchy (crusts)
 SPECIMEN COLLECTION
Consideration
• Best to sample
fresh fluid-filled
lesions as more
viruses are
recovered from
these lesions than
from older crusted
vesicles
• Fluid and base of
the lesion should be
sampled
 SPECIMEN COLLECTION
Consideration

• Per patient there may be multiple specimens collected (lesion swab,

roof/vesicle top, crust/scab)
• Lesions, crusts and vesicular fluids should not be mixed in the same tube.
• Per DOH DM 2022-0220, 2 lesions/samples shall be prepared for each
institution. Same sample types in each container (eg. Swab-swab; crust-crust;
vesicle-vesicle)
• RITM
• PGC
 SPECIMEN COLLECTION
Consideration
Materials Required:

• If there is no scalpel or scraper, a sterile surgical blade or G23 needle may be used to unroof vesicles. Be careful
so as not to cause injury to the patient, or self-injury.
• Swab should be polyester/dacron/rayon. Use a swab with rigid shaft (NPS may be too soft
to use). Do not use cotton/wooden swabs as these can interfere with the testing.
Do not use cotton/wooden swabs
SPECIMEN COLLECTION
Materials Needed
 SPECIMEN COLLECTION
Consideration

Preapare the Patient

• Explain the procedure to be
done to the patient/guardian as
multiple specimens shall be
taken, and this may cause
some pain or discomfort
 SPECIMEN COLLECTION – LESION ROOF/
VESICLE T O P and SWABS O F T H E
LESION BASE

• Remove the lesion roof.

• Swab the base of the lesion vigorously*
• Swab at least 2 lesions from different parts of the body and place them in a single
container. Place the vesicle roof in a separate sterile container.
• Label the specimens properly.
SPECIMEN COLLECTION –
CRUST/ SCAB

• For crusted lesions/lesions with scabs

• Place the crust/scab in a separate sterile
container
• Label the specimens properly.
 SPECIMEN
PACKAGING

SPECIMEN COLLECľION – LESION

ROOÏ/ VESICLE ľ O P and SWABS O Ï
ľ H E LESION BASE
 Sealing

Secure the
cap with
Parafilm
to prevent
leakage
during
transport.
 Secondary
Container
Place the Secure the
Cryovial inside
Conical
the Conical tube,
this will serve as tube inside
a Secondary a Ziplock
Container. bag.

Wrap in
absorbent
material before
placing inside the
conical tube
 Transport Box
Send to the RITM-Clinical Lab
Place the with Completely filled out CIF
sample inside and LRF.
the Transport *Do not put the documents
Box with cold inside the Transport Box.
packs (6 to 8
frozen)

Disinfect the
external part of
the Transport
Box prior to
transport.
STORING SPECIMEN
 SAMPLE REFERRAL T O RITM
For all referrals, the RESU or the referring institution shall coordinate with the Surveillance and
Response Unit of the Research Institute for Tropical Medicine (RITM-SRU).

DETAILS NEEDED:

a. Date of Request
b. Region
c. Referring institution/ESU
d. Requesting physician/health worker
e. Outbreak details: Number of cases, location
f. Suspected pathogen
g. Test requested
h. Purpose (i.e. confirmatory testing for outbreak investigation)
i. Specimen type and total number sent
j. Expected date of arrival in testing laboratory
k. Courier (if applicable) including tracking number
l. Shipper’s name, signature, position, institution/agency and contact information
 DOCUMENTS REQUIRED

a. Completely filled-out
Case Investigation
Form
(CIF)/ Case Report Form
(CRF)
b. Linelist of referred
samples
c.Laboratory Request Form
THANK YOU!