• Notifying DSHS of Monkeypox-Positive Cases and Submitting Specimens to DSHS Laboratory for Sequencing
• Submitting Monkeypox-Positive Specimens to DSHS Laboratory for Disease Surveillance
• Labeling Monkeypox Specimens & Completing Line List Correctly
• Packaging and Shipping Monkeypox-Positive Specimens to DSHS
• All four-page PDF Version

Notify Health Dept. Contact in Patient’s County of Residence

Positive Human Monkeypox virus (hMpxV) results MUST be reported to the health department contact listed for the county of the patient’s residence.

• Disease reporting contacts by county/public health region.
• Before submitting specimens to the DSHS Lab, submitter must email details of each specimen to the Lab at WGS.DSHS@dshs.texas.gov and to the HCID epidemiology team at EAIDUMonitoring@dshs.texas.gov.
• Do not submit specimens without first discussing with the HCID epi and Lab teams.

Required Information for Monkeypox Specimen Submissions

• Patient name
• Patient date of birth
• Patient sex
• Date of collection
• Patient race and ethnicity
• Patient residential address (at least to the county level)

Preferred Information for Monkeypox Specimen Submissions

• Site of collection
• Date of symptom onset or date of rash onset
• Vaccine history (for possible vaccine break-through cases)
• Contact history (when investigating transmission chains)

Additional Patient Information That Would Be Very Helpful

• Travel history (for travel-associated cases)
• Vaccine history (for possible vaccine break-through cases)
• Contact history (when investigating transmission chains)

For Severe or Complicated Cases, or Suspected Antiviral Resistance

• Two separate specimens from two distinct sites of lesions are preferred.

Submitting Monkeypox-Positive Specimens to DSHS Laboratory for Disease Surveillance

If sequencing is for severe or complicated cases, or suspected antiviral resistance, two separate specimens from two distinct lesion sites are preferred.

Preferred Specimens for Sequencing
PCR Positive Human Monkeypox Virus (hMpxV) extracts

• Target gene Ct value: ≤ 29 (higher values may be acceptable; please discuss with the DSHS HCID team and microbial genomics lab group before submission)
• Minimum Required Volume: 10 μL DNA
• Storage and Shipping: Store and ship overnight at -20°C.
• Extracts may be shipped as Category B Biological Substances.
• Specimens that arrive at ambient temperatures cannot be tested.