Monkeypox (MPX) – Video – Patient referral and testing guidance

This video provides information on testing and referring patients with suspected monkeypox.



I'm Professor Michael Kidd.

I'm a General Practitioner and Deputy Chief Medical Officer for the Australian Government.

I'm going to walk you through the key steps for collecting specimens from your patients for monkeypox.

Firstly, when it comes to testing people for monkeypox, it's important to know that laboratory testing capacity is currently limited in some states and territories.

If you have a patient with symptoms and signs of monkeypox or someone who may have been exposed to the virus before you collect any specimens you should consult with your local public health authority and inform them that you have a suspected case.

If you are advised to take specimens from your patient, you should also consult with the specialist microbiologist at your pathology provider about special specimen collection and transport requirements.

Depending on the advice of your state or territory public health unit and the specialist microbiologist, collect the specimen and send it for testing.

The initial symptoms of monkeypox may include rash, fever, headache, myalgia, backache, lymphadenopathy, chills and exhaustion.

Lesions can develop on the genitals, perianal region, mouth or face as well as on any other areas of the body.

But some patients may just have a localised rash with no systemic symptoms.

Exposure can include being in close physical contact with someone who has the virus.

In the current outbreak,
most cases have been transmitted through intimate, physical contact during sexual activity.

It's critical to ensure you wear appropriate personal protective equipment while collecting specimens where a disposable, fluid resistant gown, disposable gloves, appropriate eye protection, either a face shield or goggles and a fluid repellent surgical mask, a P2/N95 particulate filter respirator is an option if you choose, but a fluid repellent surgical mask is sufficient.

After discussing the case wth the specialist microbiologist. carefully collect the sample. It's really important here

to make sure infected cells are absorbed by the swab.

And the best way to do that is to vigorously rub the base of one or more of the lesions.

Inadequate specimen collection can result in failure to detect monkeypox virus DNA.

Taking clinical photographs of lesions, and anatomical sites and submitting them alongside the sample can help specialist microbiologists decide whether further specimen collection is required.

Discuss the option of clinical photography
with your patient and the specialist
microbiologist before collecting samples.

Getting consent from the patient is of course essential before taking or sharing any images.

Once you have inserted the specimen in the specimen container, wipe down the outside of the specimen container using disinfectant.

When you have your specimen appropriately and securely packaged, send it for laboratory testing as soon as possible.

Delay is not appropriate
given the infectious nature of this condition.

Thank you for watching.

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