Interim Laboratory Biosafety Guidelines for Handling and Processing Suspected Monkeypox Specimens

Cases of Monkeypox have been recently detected in countries that are not endemic for its actiologic agent – the Monkeypox virus. Monkeypox virus is an enveloped double-stranded DNA virus (Orthopoxvirus genus of the Poxviridae family). Monkeypox virus belongs to the genus that includes variola virus/smallpox vaccinia virus, and cowpox virus. Monkeypox virus is a Risk Group 3 pathogen and listed as an Infectious Substance Category A (specimen and culture) , a sub-classification under IATA Dangerous Good Class 6.2 with UN Number 2814 and proper shipping name Infectious substance, affecting human.

Monkeypox is a rare viral zoonotic disease whose first human case was initially reported in Democratic Republic of the Congo (DRC) and in several other central and western African countries. The natural reservoir of monkeypox remains unknown. African rodents and non-human primates (like monkeys) may harbor the virus and infect people.

Monkeypox typically presents clinically with fever, rash and swollen lymph nodes and may lead to a range of medical complications. The clinical presentation of monkeypox resembles that of smallpox, however less contagious and commonly presents a less severe illness. Monkeypox is a self-limited disease with the symptoms lasting from 2 to 4 weeks. In recent times, the case fatality ratio has been around 3-6%.

Monkeypox is transmitted to humans through close contact with an infected person or animal, or with material contaminated with the virus (e.g., lesions, body fluids, respiratory droplets and other contaminated materials. Outside Africa, transmission is linked to international travel or imported animals. An antiviral agent developed has been licensed for the treatment of monkeypox. Vaccines have been developed and approved for prevention of monkeypox.

The Pathogen Safety Data Sheet listed ingestion, parenteral inoculation, droplet or aerosol exposure of mucous membranes or broken skin, or contact with infectious fluids or tissues as the primary hazard in laboratory.