Skip to main content

Oregon State Flag An official website of the State of Oregon »

Oregon.gov Homepage

Test Menu Details




Orthopoxvirus, Real-Time PCR

Updated

8/10/2022 (reviewed 5/23/2023)

Search Terms Variola; Smallpox; Vaccinia; Cowpox; hMPXV; Monkeypox; Camelpox; Ectromelia; Gerbilpox

How to Order

Submit one Virology/Immunology Test Request Form (OHA0042) per specimen. In the “Other” section, write in "Orthopox PCR."

Availability

Specimens submitted must meet the criteria outlined in the Submitting Specimens for Orthopox (monkeypox) Testing guidance.

Note: OSPHL does not perform testing for specimens deemed “High risk” for smallpox, which would be immediately sent out for referral.

Performed

Mondays, Wednesdays, and Fridays on regular business days

Time to Reporting

Within 3 working days after receipt of specimen.

CPT Code 87798


Specimen Collection Details

Collection
Collect two dry lesion swabs from the same lesion. Use sterile nylon, polyester, or Dacron swabs with plastic or aluminum shafts. Swab or brush lesion vigorously with two separate dry swabs. Place each swab in a separate sterile container (one swab per container). DO NOT ADD VTM OR UTM TO CONTAINERS.

If possible, repeat the collection procedure for an additional lesion site.

Label each specimen with at least two unique patient identifiers and a brief description of the lesion location. 

Optimal Volume

2-4 separate, dry lesion swabs

Minimum Volume

2 dry lesion swabs

Handling

Refrigerate (2-8°C) or freeze (-20°C or lower) specimens within an hour after collection. Store refrigerated for up to 7 days and frozen up to 60 days.  Handle as infectious agent using universal precautions.  

Refer to biosafety measures for collection and handling of suspected Orthopox patients and specimens   https://www.cdc.gov/poxvirus/monkeypox/lab-personnel/lab-procedures.html

Transport

Refrigerated specimens should be transported with cold packs and frozen with dry ice. 

Transport for receipt at OSPHL as soon as possible after collection. 

Rejection Criteria

Specimens are subject to the requirements of the OSPHL Specimen Submission Policy and Criteria, available at http://bit.ly/SpecimenCriteria.

Comments

OSPHL utilizes CDC's Orthopoxvirus PCR procedure and CDC's FDA cleared non-variola Orthopoxvirus DNA PCR assay. Both assays will detect the members of the Orthopox genus such as vaccinia, cowpox, monkeypox, camelpox, ectromelia, and gerbilpox, but neither assay will differentiate between the species. Neither test will detect molluscum or orf virus.

Testing may be paired with PCR for Vaccinia and/or Varicella Zoster virus.

OSPHL Orthopox PCR results may be the only result received. OSPHL no longer sends every Orthopox-positive PCR to CDC for speciation when monkeypox is suspected. CDC notes that monkeypox is currently the only Orthopoxvirus virus circulating in the United States. In alignment with CDC guidance, OSPHL will send a sub-set of Orthopox-positive specimens to CDC for public health surveillance. If you have reason to suspect a patient is infected with another Orthopox species, contact the OHA Acute and Communicable Disease Prevention Section immediately at 971-673-1111.

OSPHL does not perform testing for specimens deemed “High risk" for smallpox, which would be immediately sent out for referral.

Original material submitted for testing is retained for 7 calendar days after receipt at the laboratory.

Method Details

Methodology
LRN Reference real-time Polymerase Chain Reaction (PCR)
Performance
Specifications
Method performance specifications determined by the Centers for Disease Control and Prevention (CDC). Please contact the CDC for specifications if needed.

Change Log

5/23/2023
Reviewed; no changes
8/10/2022Remove request to notify Public Health Division with suspect cases; Update notes regarding species detection and specimen forwarding to CDC. 
7/27/2022Add acceptable swab types
7/11/2022 Remove requirement for approval to test; Add days performed; Clarify collection instructions
5/31/2022

Clarify How to Order; Availability; Collection

5/24/2022

New Test Menu page