Mpox
Testing
Can specimens for monkeypox testing be collected in the primary care setting? |
| Yes, primary care settings can collect specimens for mpox testing. |
What precautions are required to safely collect specimens? |
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An AIIR is NOT required for specimen collection for mpox testing. A single-patient room with the door closed is recommended. Healthcare workers collecting specimens should wear the following PPE:
View PHO’s IPAC Recommendations in Health Care Settings please click Consult PHO's IPAC Recommendations on Health Care Settings for more information. |
How are specimens collected? |
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Comprehensive specimen collection guidance can be found on the Public Health Ontario’s website here. In patients with skin lesions that can be swabbed or have skin lesion material that can be submitted for testing this is the preferred specimen type. In patients with suspected mpox virus infection who do not have a skin rash (e.g. a close contact of a case with a febrile illness but no rash) or their skin can’t be reliably swabbed (e.g. macular or popular rash only) blood should be submitted along with an NP or throat swab. |
How are specimens transported? |
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Effective June 2, 2022, Transport Canada temporarily reclassified Mpox Virus as a Category B infectious substance for land transport. Mpox specimens can be transported in the same way as other Category B infectious substances your practice might be sending for testing (e.g. STI testing). In addition to the routine Category B requirement, the outer packaging must be marked, on a contrasting background with “TU 0886”, “Temporary Certificate – TU 0886” or “Certificat Temporaire – TU 0886”. For full details on packaging and transporting please view temporary certificate TU 0886: Mpox samples, a temporary certificate pursuant to Subsection 31 (2.10 of the Transportation of Dangerous Goods Act, 1992 from the Government of Canada |
How are confirmed, probable or suspect mpox cases reported to public health? |
| Confirmed, probable or suspect mpox cases can be reported to public health by completing the Ontario Mpox Reporting Tool for Clinicians and faxing it to KFL&A Public Health. Please note that only page 1 is required to be completed for reporting. Mpox case definitions can be found on page 2 of this document. |
Treatment
Mpox Antiviral Guidance for Health Care Providers |
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Ontario continues to monitor for cases of mpox and is working collaboratively with health care providers, Public Health Ontario (PHO), and the Public Health Agency of Canada (PHAC) to address health risk(s). New guidance will continue to emerge as new information becomes available and the epidemiology of this situation evolves. This guidance document provides basic information only. This document is not intended to provide or take the place of medical advice, diagnosis, treatment, or legal advice. |
Resources
Vaccination |
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Suspect monkeypox algorithm for primary care
Complete PHO’s Monkeypox Reporting Tool
(page 1 only) and fax to 613-549-0349
Notify suspect monkeypox patient to isolate until they receive a negative test result or they receive a call from public health
Place patient in a private room with door closed wearing a medical mask (if tolerated)
Don the following PPE: gown, N95, eye protection, gloves
Does the patient have a rash that can be tested? (lesion fluid, crust material, scab, swab of lesion)
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Yes |
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Collect up to 3 skin lesion specimens using a virus culture collection kit:
Note: NP/throat/blood samples are NOT needed if the patient has a rash that can be sampled |
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No |
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Collect an NP or throat swab using a virus respiratory collection kit:
AND Collect a blood sample using a red topped tube (≥5ml):
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Note: difference in swab type (can be used interchangeably if preferred swab not available)
Label specimen tubes: patient full name, date of collection and a unique identifier (DOB or HCN)
Place sample in a biohazard bag
Complete PHO’s General Test Requisition and place in the back fold of the sealed biohazard bag
Place specimens for transport in the appropriate transport bag for ‘Biological Substance Category B’
Mark the transport bag with label “TU 0886”
