Monkeypox Virus: What Healthcare Providers Need to Know

Monkeypox Information for Local Healthcare Providers:

As the number of cases of Monkeypox continues to increase in the US, the likelihood of your need to test a patient also increases.  Please feel free to contact the Putnam County Health Department with any questions.  As a quick reference, please see the below pertinent information regarding testing suspect cases.

Typical disease progression is as follows:

Viral symptoms including fever, headache, body aches, fatigue accompanied by lymphadenopathy followed by the appearance of a rash.  Lesions tend to progress through the following stages: macule, papule, vesicle, pustule, scab.  The patient is contagious until new skin has formed under the scabs.  The illness usually lasts 2-4 weeks and is self-limited.  Transmission is through direct contact of the lesions and/or contaminated bedding or clothing.  There is also evidence of transmission through large respiratory droplets and bodily fluids.

Clinical criteria include:

  1. New onset rash: macular, papular, vesicular or pustular. May be generalized or localized, discreet or confluent.
  2. Fever
  3. Other signs/symptoms that may include chills/sweats or new lymphadenopathy.

Epidemiologic criteria include:

Within the last 21 days prior to illness onset:

Contact with a person or people with a similar rash or whom have been diagnosed with monkeypox


Close or intimate contact with individuals in a high-risk social network including MSM, online meeting apps or social events


Travel outside the US to a country with confirmed Monkeypox outbreaks or where Monkeypox is endemic


Contact with a dead or live wild animal or exotic pet that is an African endemic species

If you see a patient that fits the above criteria:

  1. Isolate patient and provide a mask. Cover any lesions that may be exposed with a sheet or gown.
  2. Use appropriate PPE: gown, mask, face shield, gloves.
  3. Vigorously swab the lesions using a sterile synthetic swab. The rash may be in various stages in different areas of the body.  It is best to take two samples from at least two different lesions for a thorough sample.  Break off the applicator and place into a 1.5 mL or 2 mL screw capped tube.  Please use a separate tube for each swab.
  4. Contact the Health Department for instructions for specimen shipment to the WV Office of Laboratory Services.
  5. Freeze specimens within an hour of collection
  6. Specimens must be shipped on dry ice, as any specimens above 8 degrees C will be rejected by the lab.

The WVDHHR Monkeypox Surveillance and Investigation Protocol document is linked here for a more in-depth study. Please don’t hesitate to reach out with any questions or concerns.

Samia Turner, MD
Health Officer
Putnam County Health Department

Additional Resources:
CDC | Clinical Recognition of Monkeypox Virus
WV HAN Health Alert #202 Monkeypox Update

Updated August 12, 2022