Alberta Precision Laboratories

--- Query Results ---

Organization:

Alberta Precision Laboratories

Test Name/Synonym:

MPox virus NAT
(Synonym: Monkey Pox Virus, Monkeypox Virus)

Test Includes:

NAT/PCR

Testing for MPox RNA
Testing for Orthopoxvirus RNA

LABID (Connect Care):

LAB 5209

Specimen Collection Requirements:

Specimen Type	How to Submit
Preferred sample type: Swab of fluid/purulent material from skin lesions after deroofing.	First deroof lesions being swabbed. Collect a viral flocked swab of the fluid/purulent material contained in each lesion and place in Universal Transport Media (UTM) (red top tube with pink-coloured liquid). Be sure to consider other related differential diagnoses. It is advised to collect at least 3 separate lesion swabs for monkeypox (Mpox) virus NAT/PCR to rule out infection. Swabs of Mpox lesions must be collected by clinicians. They will not be collected by laboratory staff under any circumstances.
Lesion crust material or scab.	Submit specimens in sterile containers. Ideally 1.5 to 5.0 mL tubes. If not available, use a sterile orange top container.
Tissue and biopsies	Fresh biopsy tissue should be placed in sterile containers.
Formalin or paraffin fixed tissues	Should be sent in plastic containers and clearly identified as being in formalin. Paraffin embedded tissues can be sent as entire blocks or four-six 10 µm sections in a plastic tube or vial. A negative NAT/PCR on formalin or paraffin-fixed tissues does NOT rule out infection with monkeypox (Mpox) virus. Note: This specimen type has not been fully validated and would be considered research-use-only.
Blood	Collect blood in an EDTA (lavender top) tube for molecular detection. In adults, it is ideal to have at least 3-5mL of blood. A negative NAT/PCR of the blood does NOT rule out monkeypox (Mpox) virus infection. Note: There are no serology tests available for monkeypox
Oropharyneal and/or nasopharyngeal swabs	Collect flocked swab in Universal Transport Medium (red top tube with pink-coloured liquid). This specimen type can be useful if testing during the prodrome (e.g. pre-rash in febrile patients who are contacts of cases or patients with macular or popular rashes. Both types of swabs (oropharyngeal and nasopharyngeal) can be submitted. But they should each be submitted in their own Universal Transport Medium container. A negative NAT/PCR on an oropharyngeal or nasopharyngeal swab does NOT rule out monkeypox virus infection. Note: This specimen type has not been fully validated and would be considered research-use-only.
Urine	Collect in sterile container (orange top). A negative urine NAT/PCR does NOT rule out monkeypox virus infection. Note: This specimen type has not been fully validated and would be considered research-use-only.
Rectal swab / stool	Collect a rectal swab by inserting a flocked viral swab into the rectum and ensuring the swab is visibly soiled with stool and place in Universal Transport Medium (red top tube with pink-coloured liquid). For stool samples, please submit fresh stool in a sterile orange-top container. A negative rectal swab or stool sample does NOT rule out Mpox virus infection.
Serology	There is no Mpox virus serology available. Any requests for Mpox serology will be cancelled. Diagnosis is made by Mpox NAT/PCR of material from lesions collected as per information above.

Transportation:

Monkeypox (Mpox) is shipped as:

Air transport - TDG Category B
Ground transport - TDG Category B

Refer to https://tc.canada.ca/en/corporate-services/acts-regulations/list-regulations/transportation-dangerous-goods-regulations

APL personnel - refer to HSM14 Transport of Dangerous Goods (TDG) Program

As of September 18 2024, specimens on which Mpox testing has been requested must be sent to the Public Health Lab. Packaging for transport includes:

Call APL courier dispatch 1-403-770-3311/1-844-770-3311 to advise that a query Monkeypox (Mpox) specimen is requiring pick up. (VOC to provide this information to physician they are consulting, if transport required from a physician office).
- A temporary certificate (TU 0886) is in place to transport query or confirmed Monkeypox specimens as Category B via GROUND or AIR.
- Marked as UN3373, Biological Substance, Category B & TU 0886 (certificate # can be handwritten).
- Specimens with query or confirmed Mpox must be separated from all other specimens. Place specimens in their own secondary packaging (sealable leak-proof bag).

Method and Interpretation of Results:

Each target (MPox virus and Orthopoxvirus) will be reported individually. The MPox virus is the only orthopoxvirus in general circulation at the moment. Thus a positive Orthopoxvirus NAT/PCR result generally implies the sample that is positive for detection of the MPox virus.
Screening asymptomatic individuals for Mpox is NOT advised, and will be cancelled. The only exception to this is arrangements made for Health Canada-related donor screening in specific situations.
This assay is able to detect both clade 1 and clade 2 strains of Mpox (including clade 1b).
Positive results will be reflexed to undergo genotyping using molecular techniques to determine the Mpox virus clade. At the present time, the clade of the Mpox virus isolate is NOT reported. If this information is required, please consult with the Public Health Lab (ProvLab) Microbiologist On-Call

Routine Turn Around Time:

96 hours

Testing Area:

Virology / Molecular Diagnostics

Performing Site:

Provincial Laboratory for Public Health (Calgary and Edmonton)

Additional Test Information:

Risk group 3

While no prior approval is required for MPox virus testing, it is encouraged that clinicians consult with the Public Health Lab (ProvLab) Microbiologist On-Call

Contact Comments:

Consultation with a Medical Zone Officer of Health (MOH) is advised for any positive results. Please consult with the Public Health Lab (ProvLab) Microbiologist On-Call for any questions or concerns.

Last Updated On:

Monday, March 24, 2025

Date of Last Review:

Mar 19 2025 12:00AM