Information for Healthcare Providers
Monkeypox Information for Healthcare Providers
If you are evaluating a patient suspected of having monkeypox, call Alexandria Health Department (AHD) at 703.746.4951.
Monkeypox is a considered a rapidly reportable disease, and healthcare providers are required to report suspect cases, even if testing using a commercial laboratory such as Labcorp. Do not wait for confirmatory or rule-out testing before calling. AHD can advise on risk factors, testing resources, patient isolation instructions, treatment considerations, and infection prevention practices for your healthcare setting.
When to Suspect Monkeypox:
If the patient has a new characteristic rash or if the patient meets 1 of the epidemiologic criteria listed below and there is a high clinical suspicion for monkeypox.
Within previous 21 days, patient:
- Had contact with a person with a similar appearing rash or who received a diagnosis of confirmed or probable monkeypox
- Had skin-to-skin contact with someone in a social network experiencing monkeypox activity, this includes men who have sex with men
- Those who traveled to places or attended events where monkeypox cases have been confirmed in the month before symptoms appeared
- Had contact with laboratory specimens or other items that could serve as fomites that have been in contact with a person or animal with a suspected or known orthopox or monkeypox virus infection
- Had contact with a dead or live wild animal or exotic pet that is an African endemic species or used a product derived from such animals (e.g., game meat, creams, etc)
Lab Testing Guidance
Commercial Lab Testing
- Monkeypox (orthopox) testing is becoming more widely available through commercial labs.
- Once available, providers can order the monkeypox test just as they normally would other tests.
- As of 7/6 Labcorp offers monkeypox (orthopox testing)
- As of 7/12 Mayo clinic offers monkeypox (orthopox testing)
State Lab Testing (Free – no cost to patient or provider)
- If your practice does not have access to commercial lab monkeypox (orthopox) testing, work with AHD to obtain approval for testing through our state public health laboratory, Department of Consolidated Laboratory (DCLS)
Testing Instructions for Suspected Monkeypox (orthopox)
What PPE to Wear
How to collect
Real time PCR
Collect dry swabs (2 swabs per site)
Pair dry lesion swabs from different parts of the body
Collect 2-4 dry swabs of lesions from different parts of the body
*Can use VZV or SARS-COV-2 collection swabs as long as they are placed into a dry tube
Wear gown, gloves, eye protection, and N95 while collecting specimens
-Rub lesions vigorously
-Place swabs of lesions from different body areas into separate, dry, sterile tubes or containers (e.g. urine cup if tubes unavailable)
-Do not use viral transport media (VTM) or universal transport media (UTM)
-Label specimens with patient name, DOB, specimen site, date/time of collection
-Refrigerate specimens within 1 hour of collection
-Ship on ice packs
To join the healthcare provider email list for updates, please email firstname.lastname@example.org.
Additional resources from AHD: public website with general info about the monkeypox virus, One-pager/poster for provider's offices and follow up info for people with monkeypox .
Reporting a Disease or Outbreak?
To report a disease to Alexandria Health Department, please follow these steps.
Consult Virginia Reportable Disease List.
If disease should be reported immediately (within 24 hours for rapidly reportable conditions), call 703.746.4951. For TB (or suspected TB), call 703.746.4960 and press 2 to speak with a nurse.
If disease should be reported within 3 days:
- Report online through the Online Disease Reporting Portal (links to the Virginia Department of Health)
- Call 703.746.4951
- If you experience technical issues with the VDH Disease Reporting Portal, please download the VDH Disease Reporting Form (Epi-1) and
- Fax form to: 703.746.4953
- Mail form to: ATTN: Communicable Disease, 4850 Mark Center Drive, Alexandria, VA 22311
- Reports must include: Patient's name, home address, and phone number; patient's date of birth; date of diagnosis; date of symptom onset
Suspect a disease of public health concern but no confirmation yet?
Virginia Department of Health (VDH) encourages you to report suspected cases of diseases before laboratory confirmation (e.g. mumps, B. pertussis, meningitis, etc.) to the Health Department immediately so we can:
- Provide guidance on lab testing and facilitate sending specimens to the state public health lab
- Offer infection control recommendations
- Start a public health investigation right away
If you would like to report aggregate influenza testing results please use the AHD Weekly Influenza Reporting Form
Virginia State law requires requires all physicians report certain diseases to the local health department serving the jurisdiction where the physician practices.
- Code of Virginia, sections 32.1-36 and 32.1-37
- Regulations for Disease Reporting and Control from the Board of Health, sections 12 VAC 5-90-80 and 12 VAC 5-90-90
Looking for another local health department? Visit the VDH Local Health District Directory.
Local Reports to Clinicians
Annual Summary of Reportable Diseases: Every year, our epidemiology program compiles a report summarizing cases of reportable diseases investigated by Alexandria Health Department. The report also highlights notable public health topics and initiatives in our community. Past reports are available below.
Monthly Local Public Health Alerts: Alexandria’s epidemiology program sends monthly reports to providers with important public health information.
Please email email@example.com or call 703.746.4951 to add your office to the distribution list for our annual or monthly reports. Visit our Epidemiology page to learn more about Alexandria Health Department's program.
Additional Resources for Clinicians
Virginia Department of Health offers useful resources for healthcare providers including: letters to clinicians from the State Health Commissioner, training opportunities, best practices and more. Visit: www.vdh.virginia.gov/clinicians/
How do a I start a Respiratory Protection Program for my office?
For more information on creating a Respiratory Protection Program visit https://www.osha.gov/Publications/osha3079.pdf