Orthopoxviruses (Variola, Vaccinia, Mpox Clade I, Cowpox)
Clinical Specimen Submission Guidance
Submit all specimens to 50 Orms St, Providence RI 02904. Open Monday to Friday 8:30 AM to 4:30 PM
Molecular Diagnostics Laboratory 401-222-5538
Variola, Vaccinia, Monkeypox, Cowpox viruses
Pustular Rash diseases (Small pox, monkeypox, cowpox)
Real time PCR testing is conducted at the RI State Health Laboratories on specimens from patients meeting the definition of low to moderate risk of having smallpox. Specimens from patients who have a clinical history consistent with a “high risk” of smallpox are sent from the RI State Health Laboratories to a laboratory that has the capacity to identify variola virus (CDC or the NY State Health Department Laboratory). The CDC “Acute, Generalized Vesicular or Pustular Rash Illness Protocol” algorithm is used to determine smallpox risk. The algorithm can be found on the CDC website at the following: https://www.cdc.gov/smallpox/clinicians/algorithm-protocol.html
PREAUTHORIZATION by the RIDOH Center for Acute Infectious Disease Epidemiology (401) 222-2577 is required prior to transporting specimens.
If Mpox specifically suspected refer to Non-variola Monkeypox (Mpox) guidance.
If smallpox is suspected, detailed specimen collection instructions are provided in the specialized "Smallpox Collection Kit."
CLIA regulations require specimens be labeled with at least two patient identifiers. Examples of identifiers are first and last name, date of birth, chart/medical record number. The specimen container must be labeled to match the test requisition or the electronic order.
Rhode Island State Health Laboratories (RISHL) test requisition form https://health.ri.gov/forms/LabRequisitionForm.pdf
Biothreat Agent rule-out
Specimens must be received in a "RI State Health Laboratories Smallpox Collection and Transport Kit" (see Kit section for instructions on how to obtain).
Specimens must be packaged & transported in accordance with current federal shipping regulations.
Strict adherence to the specimen collection instructions provided in the specialized collection and transport kit.
PCR negative for orthopoxvirus
Providers must report patient information on Pustular Rash diseases immediately using the RIDOH reportable disease form.
PCR result within 24 hours
Specialized “Smallpox Collection & Transport Kits” are available by calling the RISHL Molecular Diagnostics Laboratory at (401) 222-5538. Detailed specimen collection and transport instructions are included in the kit.