Orf Virus Infection in Humans: A Review With a Focus on Advances in Diagnosis and Treatment.

Ecthyma contagiosum, also called contagious pustular dermatosis, is a zoonotic disease caused by the orf virus (OrfV). As a member of the poxviridae family and parapoxvirus genus, this dermatotropic virus has developed an array of mechanisms by which to evade the host immune system in both humans and animals. The ubiquitousness of this pathogen in sheep, goats, and deer has led to the development of orf in diverse areas around the world. Human disease occurs via direct contact with infected animals or fomites. Rarely, human-to-human transmission has been reported. The disease progresses through six clinically distinct dermatologic stages and lesions usually heal in three to six weeks without scarring. Farmers, veterinarians, and hunters represent high-risk groups, as their repeated contact with livestock and wild animals predisposes them to infection. With an increasing number of cattle, livestock, and wild animals being kept as pets, human orf may become more prevalent in the future. Taken with the lack of a widely accepted and successful antiviral treatment regimen, this demonstrates the importance of conducting additional research to further elucidate the pathogenic effects of the OrfV in humans. J Drugs Dermatol. 2017;16(7):684-689.

Orf virus infection.

Orf virus (ORFV) is an important pathogen responsible for a highly contagious zoonotic viral infection that threatens those who handle sheep and goats. Orf virus is the prototype of the Parapoxvirus genus, and its resilience in the environment and ability to reinfect its host has contributed to the spread and maintenance of the infection in many species. In healthy humans, the disease usually resolves spontaneously within 3 to 6 weeks. There is no specific treatment and many different approaches such as use of imiquimod, cidofovir, curettage, shave excision, cryotherapy, and electrocautery have all been reported to be successful, without supporting evidence from controlled clinical trials. Throughout its interaction with the different hosts, ORFV has evolved a strategy for immune evasion via the development of an array of virulence factors. The interaction of ORFV with the immune system has been the subject of research for decades. Whole inactivated ORFV has been used as a type of immunomodulating drug; a so called paramunity inducer proposed as both a preventative and a therapeutic immunomodulator across various species. Additional research on the remarkable strategies underlying ORFV infection could lead to improved understanding of skin immunity.

Giant Orf on the Nose.

Orf is a zoonotic infectious disease caused by parapoxvirus. Orf lesions are typically seen on the hand, but they have rarely been reported on the nose. Herein, the authors report a rare patient of an orf lesion on the nose of a 52-year-old man after the Muslim celebration of the feast of the sacrifice. The lesion spontaneously recovered 8 weeks after the initial appearance and showed no evidence of recurrence after 1 year of follow-up. Orf virus infections may occur more often after the celebration of the feast of the sacrifice in Muslim countries.

Infectious Angiogenesis-Different Pathways, the Same Goal.

Infectious angiogenesis is the biological response of neoangiogenesis induced by infectious organisms. The authors present 3 exemplary entities which show paradigmatic clinico-pathological settings of infectious angiogenesis: Bacillary angiomatosis, Orf (ecthyma contagiosum), and Kaposi sarcoma. The authors review the literature and elucidate etiopathogenetic pathways leading to the phenomenon of neovascularization stimulated by infectious organisms. The authors describe the clinical and histological pictures, interactions between microorganisms and host cells, and changes that occur within cellular structures, as well as angiogenic factors that underpin infectious angiogenesis. The importance of chronic inflammation and tumor angiogenesis is emphasized.

Orf virus infection in sheep or goats.

Orf virus, a member of the genus Parapoxvirus, is the causative agent of contagious ecthyma ('Orf'). It is a pathogen with worldwide distribution, causing significant financial losses in livestock production. The disease mainly affects sheep and goats, but various other ruminants and mammals have been reported to be infected as well. It is also a zoonotic disease, affecting mainly people who come in direct or indirect contact with infected animals (e.g. farmers, veterinarians). The disease is usually benign and self-limiting, although in many cases, especially in young animals, it can be persistent and even fatal. Production losses caused by Orf virus are believed to be underestimated, as it is not a notifiable disease. This review of literature presents all latest information regarding the virus; considerations regarding treatment and prevention will be also discussed.

[Orf parapoxvirus can infect humans after relevant exposure]. / Orf-parapoxvirus kan smitte mennesker ved tæt kontakt

Orf virus occurs worldwide among sheep and goats. Transmission to humans is seen by close contact with infected animals, but the incidence in Denmark is unknown. We present a typical case in a sheep farmer with an orf infection of his hands. Upon conservative treatment the infected areas healed without sequelae. We shortly discuss the epidemiology, the natural history, the treatment and the complications of orf virus.

Nosocomial outbreak of disseminated orf infection in a burn unit, Gaziantep, Turkey, October to December 2012.

We report the first outbreak of nosocomial orf infection in a hospital burn unit in Gaziantep, Turkey. The outbreak lasted from October to December 2012 and involved a total of thirteen cases. It demonstrates the risk of introduction of orf virus to a burn unit, and the potential for extensive transmission among patients with compromised skin integrity. The importance of hygiene measures and infection control are highlighted and possible transmission routes of the virus discussed.

Infecciones virales en piel y mucosas / Cutaneous viral diseases

Diversos virus pueden infectar la piel y las mucosas de los seres humanos, manifestándose en diferentes patologías, de acuerdo a la edad, género y estado inmunológico. Un grupo importante de éstos tiene capacidad de replicar en células epiteliales, originando cuadros clínicos en los cuales se evidencia la destrucción celular o bien la hiperplasia del tejido infectado. Gran parte de estos virus persisten en células infectadas por años y tienen la capacidad de reactivarse y de manifestar nuevamente enfermedades cutáneas o mucosas. En algunos casos, ésta sólo se expresa de manera subclínica en una excreción del virus por secreciones que son fuente de infección. En los últimos años, los avances en técnicas moleculares han permitido contar con metodologías diagnósticas cada vez más sensibles, específicas y rápidas. Así como también el progreso en el área de vacunas y antivirales nos entrega mayores herramientas profilácticas y terapéuticas.

Various viruses can infect the skin and the mucous membranes of human beings, manifesting itself in different diseases, according to age, gender and immune status. An important group has the ability to replicate in epithelial cells, causing clinical manifestations which evidenced the cell destruction either infected tissue hyperplasia. Much of these viruses persist in cells infected by years and have the ability to reactivate and again express cutaneous or mucosal diseases. In some cases, it is only asymptomatically shred in secretions that are a source of infection. In recent years, advances in molecular techniques have allowed to have increasingly sensitive, specific and rapid diagnostic methodologies. As well as, the progress in the area of vaccines and antivirals also gives us greater prophylactic and therapeutic tools.

[The "Orf" virus: focus and review of the literature]. / Le virus "Orf": mise au point et revue de la littérature.

Orf is an infection often unknown to practicians throughout the world. The first known cases were registered at the end of the 19th century. The virus affects ovines and caprins and is characterized by cutaneous and/or mucosae lesions. It is strongly resistant and the survival time is important in the outside environment. The morbidity of Orf is far higher than its mortality. The virus is transmitted by direct and indirect contact among humans, who became vectors themselves. Those subjects that are in contact with the animals in question due to professional reasons are at risk in particular. The same goes for attendants and participants of religious feasts. The preferred localization of lesions in humans is the hands. The diagnostic is easily set by the anamnesis and the clinical characteristics of the lesions except when it happens to be a particular form. The complications are nearly exclusively related to the unawareness of the virus in form of inappropriate medical acts. The evolution is spontaneous and the unique treatment is the prophylaxis of bacterial infection as well as a constant surveillance.

Human ORF (ecthyma contagiosum).

Orf is a viral cutaneous infection typically seen on the hands of people involved in sheep and goat farming. We report 31 cases of orf and consider its pathology, characteristic appearance, diagnosis, treatment and complications.

[Ecthyma contagiosum (Orf) as an uncommon differential diagnosis of infections of the hand]. / Ecthyma contagiosum (Orf) als ungewöhnliche Differenzialdiagnose bei Handinfektionen.

Orf of the hand is considered as an uncommon viral infection which is usually acquired through contact with infected sheep and goats. Indirect infections through contaminated knives or meat have been reported. Many authors feel that the disorder is more common than reported because the disease is often misdiagnosed and the course is usually self-limiting with spontaneous healing within several weeks. Diagnosis is mainly made by patient's history and clinical course. It is important to know the benign nature of human orf, since complications seem to be caused by overtreatment.

Human orf.

Human Orf is an uncommon viral disease acquired through contact with infected sheep and goats. We report five cases of human Orf acquired while preparing mutton. The clinical picture and the management of human Orf are presented. Awareness of the benign nature of the condition is important in preventing ill-advised therapy.

Tonsillectomy-induced changes in anti-keratin antibodies in patients with pustulosis palmaris et plantaris: a clinical correlation.

Titers of anti-keratin antibodies (AKA) involving IgG and IgM fractions were determined by a solid-phase enzyme-linked immunsorbent assay (ELISA) and were found to be significantly higher on average in patients with pustulosis palmaris et plantaris (PPP) than in normal controls. Positive rates of IgG-AKA and IgM-AKA in sera of PPP patients were 50% and 66%, respectively. Following tonsillectomies, patients with high IgM-AKA titers that decreased after surgery were found to benefit by a marked improvement in their skin lesions. There was a close relationship between the degree of this improvement in the skin lesions and the changes in IgM-AKA titers after the operation. These results suggest that PPP may be a tonsil-related immunological skin disease.

Systemic contagious pustular dermatitis or orf

The infectivity of the CPD viral infection in humans and sheep is reviewed over the period 1837 to 1987. Attention is drawn to the prevalence of invasive, systemic complicated orf in humans, and the consistent symptomatology is described. A simple system of treating humans, sheep and goats homoeopathically is outlined. This system was successfully used on the first 100 patients in a continuing series, and also on several hundred sheep