Research Roundups

Research Roundup: Monkeypox Sample Collection and Transport

July 6, 2022

In this edition, Dr. Sharp summarizes research posters regarding Monkeypox Collection and Transport

Introduction & Current Guidance from the Centers for Disease Control & Prevention

Recent reports of MONKEYPOX infections are circulating in several countries. In this edition of COPAN’s Research Roundup, we’ll explore the virus, transmission and methods for sample collection and transport. The Center for Disease Control (CDC) is tracking multiple cases of monkeypox which have been reported in several countries that do not typically see instances of the disease, including the United States. CDC is urging healthcare providers in the U.S. to be alert for patients who have rash illnesses consistent with monkeypox. CDC is working with state and local health officials to identify people who may have been in contact with individuals that have tested positive for monkeypox, so they can monitor their health. Monkeypox is rare and does not spread easily between people without close contact. The threat of monkeypox to the general U.S. population remains low according to the CDC.

Keep up with cases of monkeypox in the U.S. and worldwide at this CDC link:

The Monkeypox Virus

Monkeypox is a rare disease that is caused by infection with monkeypox virus. Monkeypox virus belongs to the Orthopoxvirus genus in the family Poxviridae. The Orthopoxvirus genus also includes variola virus (which causes smallpox), vaccinia virus (used in the smallpox vaccine), and cowpox virus.

Monkeypox was first discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research, hence the name ‘monkeypox.’ The first human case of monkeypox was recorded in 1970 in the Democratic Republic of the Congo (DRC) during a period of intensified effort to eliminate smallpox. Since then, monkeypox has been reported in people in several other central and western African countries: Cameroon, Central African Republic, Cote d’Ivoire, the Democratic Republic of the Congo, Gabon, Liberia, Nigeria, Republic of the Congo, and Sierra Leone. Historically, the majority of infections are in the Democratic Republic of the Congo.

Monkeypox cases in people have occurred outside of Africa linked to international travel or imported animals, including cases in the United States, as well as Israel, Singapore, and the United Kingdom.

The natural reservoir of monkeypox remains unknown. However, African rodents and non-human primates, such as monkeys, may harbor the virus and infect people.

Monkeypox Transmission

Monkeypox infection pandemic. monkeypox cell with doctor in laboratory lab confirm Monkey Pox virus outbreak pandemic

Monkeypox virus can spread when a person comes into contact with the virus from an infected animal, infected person, or materials contaminated with the virus. The virus can also cross the placenta from the mother to her fetus. Monkeypox virus may spread from animals to people through the bite or scratch of an infected animal, by handling wild game, or through the use of products made from infected animals. The virus may also spread through direct contact with body fluids or sores on an infected person or with materials that have touched body fluids or sores, such as clothing or linens.

Monkeypox spreads between people primarily through direct contact with infectious sores, scabs, or body fluids. It also can be spread by respiratory secretions during prolonged, face-to-face contact. Monkeypox can spread during intimate contact between people, including during sex, as well as activities like kissing, cuddling, or touching parts of the body with monkeypox sores. At this time, it is not known if monkeypox can spread through semen or vaginal fluids.

Monkeypox virus transmisiion infographics contact, fluids, respiratory. world health organization. Infected people spreading from monkey. Flat design with icons

It is not yet known which animal maintains the virus in nature, although African rodents are suspected to play a part in monkeypox transmission to people.

It is also not clear how the people were exposed to monkeypox, but early data suggest that gay, bisexual, and other men who have sex with men make up a high number of cases. However, anyone who has been in close contact with someone who has monkeypox is at risk.

Monkeypox Clinical Presentation

Monkeypox Contagious Virus Outbreak as a contagious infection as blisters and leisons on the skin representing transmission of an infected person with 3D illustration elements.



Descriptions of classic monkeypox disease describe a prodrome including fever, lymphadenopathy, headache, and muscle aches.  This is followed by the development of a characteristic rash culminating in firm, deep-seated, well-circumscribed and sometimes umbilicated lesions. The rash usually starts on the face or in the oral cavity and progresses through several synchronized stages on each affected area and concentrates on the face and extremities, including lesions on the palms and soles of the feet.

In the current 2022 outbreak, all patients diagnosed with monkeypox in the United States have experienced a rash or enanthem. Although the characteristic firm, deep-seated, well-circumscribed and sometimes umbilicated rash has been observed, the rash has often begun in mucosal areas (e.g., genital, perianal, oral mucosa). In some infected patients, the lesions have been scattered or localized to a specific body site rather than diffused and have not involved the face or extremities. In some instances, patients have presented with symptoms such as anorectal pain, tenesmus, and rectal bleeding which, upon physical examination, have been found to be associated with visible perianal vesicular, pustular, or ulcerative skin lesions and proctitis.

Monkeypox Case Classification & Diagnosis

Glasses and data sheet on monkeypox test positive results in a laboratory.


Monkeypox Specimen Collection and Transport

The CDC indicates that dry swabs of lesions should be collected and submitted in a dry tube, or specimens may be submitted in viral transport media for testing in suspected cases of monkeypox. This section is intended to indicate COPAN products and methods commonly used for the collection and transport of monkeypox samples that are consistent with CDC guidelines.*

*Refer to the CDC’s “Preparation and Collection of Specimens for Monkeypox” for the most current guidance for sample collection indications and devices for Monkeypox.

All laboratory specimens should be sent through the state and territorial public health department, unless authorized to send them directly to CDC.

Lesion Collection

For additional specimen collection information:

Copan Collection Products Suitable for Monkeypox Collections

This section is intended to indicate COPAN products and methods commonly used for the collection and transport of monkeypox samples.* Specimens can be transported dry or in a tube using viral transport medium or equivalent (e.g., UTM®) under required conditions. Check your institution’s guidance on swab transport and a list of transport media that may be used for different reference laboratories.

*Refer to the CDC’s “Preparation and Collection of Specimens for Monkeypox” for the most current guidance for sample collection indications and devices for Monkeypox.

FLOQSwab® Flocked Swab Dry Collection Kits

FLOQSwabs® 5C164N01

FLOQSwabs® 5C164N01- Regular Size Flocked Swab with Dry Tube

FLOQSwabs® 5C165N01

FLOQSwabs® 5C165N01 – Two Regular Size Flocked Swabs with Two Dry Tubes

FLOQSwabs® 5C166N01

Regular Size Flocked Swab with Dry Tube + Biohazard Bag

Stay Informed

With tens of thousands of scientific papers published each year, it is hard to stay informed on the relevant research. Each month COPAN’s Research Roundup will feature a comprehensive review and commentary on recent scientific publications covering a particular topic by experts in the field to help keep you up to date on the latest research. Sign up today so you don’t miss the latest findings!

About Dr. Susan Sharp

Dr. Sharp has been a clinical microbiologist for over 30 years and joined Copan Diagnostics as the Scientific Director in 2018.

Dr. Sharp is actively involved with the American Society for Microbiology (ASM) and is a past-president of ASM. She is a Diplomat of the American Board of Medical Microbiology and a Fellow in the American Academy of Microbiology.

Dr. Sharp currently serves as a member of the Board of the Clinical and Laboratory Standards Institute, a member of the Sub-Committee for Antimicrobial Susceptibility Testing for CLSI, a member of the CLSI Microbiology Expert panel, is a Governor for the American Academy of Microbiology, and is a past member of the Board of Scientific Councilors for the Office of Infectious Diseases at the CDC.

She has lectured both nationally and internationally and has published numerous scientific articles and book chapters in the field of clinical microbiology. Her most prominent area of interest has centered on cost-effective, clinically-relevant diagnostic microbiology.

Medical Disclaimer: This page is for informational purposes only and should not be a substitute for professional medical advice, diagnosis, or treatment. Always refer to the Centers for Disease Control & Prevention, professional healthcare organizations, or other qualified healthcare providers for current guidance.