South Dakota Public Health Laboratory MPox Guidance
Patients with a lesion characteristic of MPox (firm, well-circumscribed, deep-seated, often umbilicated and painful), AND one or more of the following:
- A man who had close or intimate in-person contact with men within the last three weeks
- A person identified as being in close contact with a diagnosed MPox case
- A person who had close contact with a person in a social network experiencing MPox activity within the last three weeks
Specimens from individuals that do not meet the above criteria should not be submitted to SDPHL and may be submitted to a commercial laboratory that provides MPox testing. See the accompanying FAQ for commercial laboratory contact information.
- More than one lesion should be sampled, preferably from different locations on the body and/or from lesions with differing appearances.
- Swab a single lesion with two (2) separate sterile, dry polyester, rayon, nylon, or dacron swabs.
- Collect duplicate swabs from a maximum of three (3) lesions. There should be a maximum of six (6) swabs collected from each patient.
- Each swab should be placed in its own sterile container (do not place two swabs in one container); swabs may be broken off into 1.5-2 mL tubes or left whole in larger containers.
- DO NOT add viral transport medium; only dry swabs should be submitted to SDPHL.
- Each container must be labeled with the patient name, a second unique patient identifier, and specimen collection location (e.g., left hand, right foot, cheek, anus, etc.).
- Swabs should be refrigerated within one (1) hour of collection.
- Specimens are good for seven (7) days in the refrigerator. For longer storage, specimens must be stored at -20 degrees Celsius or less.
Specimen(s) will be rejected if:
- They do not meet the criteria for testing at SDPHL.
- Improperly labeled.
- Submitted without an SDPHL requisition.
- Received at a temperature higher than 8 degrees Celsius.
- SDPHL Monkeypox Laboratory Requisition must accompany specimens. The SDPHL Monkeypox Requisition can be found on the Medical Microbiology page.
- Specimens must be triple-packaged and shipped as a Category B infectious agent in a foam container with dry ice or multiple ice packs. The SDPHL shipping address is as follows:
- South Dakota Public Health Laboratory 615 E. 4th Street Pierre, SD 57501
- Upon request, SDPHL will provide packaging supplies including biohazard bags, Tyvek bags, foam shipping containers with cardboard overpack, and cold packs; SDPHL does not provide dry ice.
**Packaging supplies provided by the SDPHL are expressly for specimen packaging and shipping to SDPHL and should not be used to package specimens for shipment to other laboratories**
- One swab from each specimen collection location (e.g., buttock, right hand, etc.) will be tested at SDPHL.
- Most results will be available within 8 hours of specimen receipt; some specimens may require retesting which will delay results for up to 24 hours.
- The result of SDPHL testing is considered final and will not be confirmed by CDC.
- Positive: Non-Variola Orthopoxvirus DNA Detected
- The assay detects the DNA of common non-variola Orthopoxvirus human pathogens, including Vaccinia, Cowpox, and MPox viruses. This assay result must be used in conjunction with other diagnostic test results, clinical observations, and exposure history.
- Negative: No Non-Variola Orthopoxvirus DNA Detected
- Inconclusive: Inconclusive for non-variola Orthopoxvirus DNA by Real-time PCR.
- An inconclusive result may occur in the case of an inadequate specimen. Adequate specimen collection may result in slight patient discomfort.
**Although the CDC Non-Variola Orthopoxvirus nucleic acid amplification test will detect viral pathogens other than MPox, at this time the CDC considers this test to be confirmatory for MPox.**