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Musser JMB. 2010Diseases in Nature
ORF:ORF:A Shared Vesicular Disease of A Shared Vesicular Disease of
Sheep, Goats, and HumansSheep, Goats, and Humans
Jeffrey MB Musser and Susan L PayneJeffrey MB Musser and Susan L Payne
Department of Veterinary PathobiologyDepartment of Veterinary PathobiologyCollege of Veterinary MedicineCollege of Veterinary Medicine
Texas A&M University Texas A&M University
Musser JMB. 2010Diseases in Nature
Sheep feeder – Sheep feeder –
well developed well developed vesicles on right hand vesicles on right hand
lesser number of lesser number of vesicles on left handvesicles on left hand
Case 1Case 1
Musser JMB. 2010Diseases in Nature
Inoculate sheep with Inoculate sheep with vesicle fluidvesicle fluid
Day 5 – reddening of the Day 5 – reddening of the scratched area scratched area
Day 6 – pustulesDay 6 – pustules
Case 1Case 1
Day 11 – max pustule developmentDay 11 – max pustule developmentBecomes scabs, dry up, and drop offBecomes scabs, dry up, and drop off
Musser JMB. 2010Diseases in Nature
First reported case in First reported case in U.S. of sore mouth U.S. of sore mouth (orf) as a zoonotic (orf) as a zoonotic diseasedisease
Case 1Case 1
Newsom IE and Cross F. Sore mouth in sheep transmissible to man.Newsom IE and Cross F. Sore mouth in sheep transmissible to man.JAVMA 1934.JAVMA 1934.
Musser JMB. 2010Diseases in Nature
Presentation OutlinePresentation Outline
1. Parapox virus overview1. Parapox virus overview
2. Contagious ecthyma in sheep and goats2. Contagious ecthyma in sheep and goats
3. Orf in humans3. Orf in humans
4. Transmission and Risk factors4. Transmission and Risk factors
5. Diseases w/ similar presentations5. Diseases w/ similar presentations
6. Diagnosis6. Diagnosis
7. Prevention7. Prevention
8. Conclusion8. Conclusion
Musser JMB. 2010Diseases in Nature
Parapox virus overviewParapox virus overviewPoxviridae(subclass chordopoxviridae)
Cowpox (cats, cows, rodents, and humans)
Smallpox (humans)
Monkeypox (monkeys, rodents, rabbits, and humans)
Orthopoxvirus
Molluscum contagiosum (humans)
ParapoxvirusContagious ecthyma or Orf (sheep, goats, and humans)
Molluscipoxvirus
Pseudocowpox (cows and humans)
Capripoxvirus Goatpox (goats and humans; most likely not zoonotic)
characterized by generalized or localized cutaneous lesions characterized by generalized or localized cutaneous lesions
Musser JMB. 2010Diseases in Nature
Parapox virus overviewParapox virus overview
Parapox virus - Parapox virus - endemic in major endemic in major sheep and goat sheep and goat rearing areas of the rearing areas of the United States,United States,
such as the Hill such as the Hill Country and West Country and West TexasTexas
Source: USDA 2007 Census of Agriculture
Musser JMB. 2010Diseases in Nature
Lesions - sheep and goatsLesions - sheep and goats
Texas AgriLIFE, Sonora
Musser JMB. 2010Diseases in Nature
Other lesion locationsOther lesion locations
Teats and perianal regionTeats and perianal region
Texas AgriLIFE, Sonora
Musser JMB. 2010Diseases in Nature
Virulent formVirulent form
Texas AgriLIFE, SonoraTexas AgriLIFE, Sonora
Texas AgriLIFE, Sonora
Musser JMB. 2010Diseases in Nature
Clinical presentation - humansClinical presentation - humans
Source SCP-ASIM Bioterrorism resource Center
CDC 2006.
Musser JMB. 2010Diseases in Nature
Clinical presentation - humansClinical presentation - humans
http://www.cdc.govl
Source: Buttner M. 2002.
Musser JMB. 2010Diseases in Nature
Clinical presentation - humansClinical presentation - humans
Source: Al-Salam s. 2007
Source: Lederman 2007
Musser JMB. 2010Diseases in Nature
Clinical presentation - humansClinical presentation - humans
Source: Georgiades G. 2005.Source: Georgiades G. 2005.
Source: Georgiades G. 2005.
Musser JMB. 2010Diseases in Nature
TransmissionTransmission
Damage to skin or mucosa allows the virus to infect Damage to skin or mucosa allows the virus to infect and replicate in regenerating epidermal cellsand replicate in regenerating epidermal cells
Musser JMB. 2010Diseases in Nature
TransmissionTransmission
Risk FactorsRisk Factors
Direct contact with sheep or goats Direct contact with sheep or goats
Time of year (season)Time of year (season)
Use of vaccineUse of vaccine
Bottle feeding and caring for ill animalsBottle feeding and caring for ill animals
Not wearing glovesNot wearing gloves
Musser JMB. 2010Diseases in Nature
TransmissionTransmission
www.motmplus.com
Petting zoosPetting zoos4- H Projects4- H Projects
La Graciosa 4-H Market Goat Project
Musser JMB. 2010Diseases in Nature
Diseases w/ similar presentationDiseases w/ similar presentation
Orf can be clinically confused with other Poxvirus Orf can be clinically confused with other Poxvirus infections and other cutaneous disease such as:infections and other cutaneous disease such as:
cutaneous anthraxcutaneous anthrax
tularemiatularemia
cutaneous leishmaniasiscutaneous leishmaniasis
monkey poxmonkey pox
erysipeloiderysipeloid
pseudocowpox (milker’s nodules)pseudocowpox (milker’s nodules)
ecthymaecthyma
Musser JMB. 2010Diseases in Nature
Diseases w/ similar presentationDiseases w/ similar presentation
Orf lesionOrf lesionContact with sheep or Contact with sheep or
goatsgoats
Lesion primarily on the Lesion primarily on the dorsal fingersdorsal fingers
Lesion associated with Lesion associated with crusts and scabbingcrusts and scabbing
Cutaneous anthraxCutaneous anthraxCharacteristic non-pitting Characteristic non-pitting
edema surrounding ulcer edema surrounding ulcer and escharand eschar
Lesion is not limited to Lesion is not limited to fingersfingers
Ulcer is painlessUlcer is painless
Source: ACP-ASIM Bioterrorism Resource Center
Musser JMB. 2010Diseases in Nature
Diseases w/ similar presentationDiseases w/ similar presentation
TularemiaTularemiaContact with cats, rabbits, Contact with cats, rabbits,
foxes, squirrels, foxes, squirrels, muskrats, beavers, and muskrats, beavers, and pheasants or potential pheasants or potential exposure to tick or deer exposure to tick or deer fly vectorfly vector
Lesion is painful papule or Lesion is painful papule or ulcerulcer
Source: NABC. Kansas State University
Orf lesionOrf lesionContact with sheep or Contact with sheep or
goatsgoats
Lesion primarily on the Lesion primarily on the dorsal fingersdorsal fingers
Lesion associated with Lesion associated with crusts and scabbingcrusts and scabbing
Musser JMB. 2010Diseases in Nature
Diseases w/ similar presentationDiseases w/ similar presentation
Cutaneous LeishmaniasisCutaneous LeishmaniasisPatient has traveled to or Patient has traveled to or
resides in an endemic arearesides in an endemic area
Lesion slowly evolves from Lesion slowly evolves from papule to ulcerpapule to ulcer
Nodular lymphangitis may be Nodular lymphangitis may be presentpresent
Source: ACP-ASIM Bioterrorism Resource Center
Orf lesionOrf lesionContact with sheep or Contact with sheep or
goatsgoats
Lesion primarily on the Lesion primarily on the dorsal fingersdorsal fingers
Lesion associated with Lesion associated with crusts and scabbingcrusts and scabbing
Musser JMB. 2010Diseases in Nature
Diseases w/ similar presentationDiseases w/ similar presentation
Monkey poxMonkey poxContact with monkeys, Contact with monkeys,
rodents, and rabbitsrodents, and rabbits
Fever, headache, myalgia, Fever, headache, myalgia, exhaustion, (flu like)exhaustion, (flu like)
Lymph nodes usually Lymph nodes usually enlargedenlarged
Orf lesionOrf lesionContact with sheep or Contact with sheep or
goatsgoats
Lesion primarily on the Lesion primarily on the dorsal fingersdorsal fingers
Lesion associated with Lesion associated with crusts and scabbingcrusts and scabbing
Source Davis R.G. CRSPH, Iowa State University Source Davis R.G. CRSPH, Iowa State University
Musser JMB. 2010Diseases in Nature
DiagnosticsDiagnostics
Clinical signs and HistoryClinical signs and History
HistopathologyHistopathology
Electron microscopyElectron microscopy
SerologySerology
rtPCR - amplification of a rtPCR - amplification of a 70 bp fragment from the 70 bp fragment from the ORFV ORFV B2LB2L gene that gene that encodes the major encodes the major envelope protein.envelope protein.
100 nm Image by Ross Payne, VTPB,CVM,TAMU
Musser JMB. 2010Diseases in Nature
PreventionPrevention
KnowledgeKnowledge
Proper hand hygieneProper hand hygiene
DisinfectionDisinfection
GlovesGloves
Musser JMB. 2010Diseases in Nature
ConclusionConclusion
a self-limiting conditiona self-limiting condition
easily recognized by easily recognized by people at risk who do people at risk who do not always seek not always seek medical caremedical care
physicians may be physicians may be unfamiliar with disease unfamiliar with disease and clinical signsand clinical signs
true prevalence of human orf infection likely true prevalence of human orf infection likely underestimatedunderestimated
Source: Buttner M. 2002.
Musser JMB. 2010Diseases in Nature
Good resourcesGood resources
Texas Department of State Health ServicesTexas Department of State Health Services
ACP-ASIM Bioterrorism Resource CenterACP-ASIM Bioterrorism Resource Center
USDA and CDCUSDA and CDC
faq: Frequently Asked Questionsfaq: Frequently Asked Questions
About Sore Mouth (orf virus)About Sore Mouth (orf virus)
Center for Food Security & Public HealthCenter for Food Security & Public Health
(Iowa State University)(Iowa State University)
Musser JMB. 2010Diseases in Nature
The Entry of the Animals into Noah's ArkThe Entry of the Animals into Noah's ArkJan Brueghel the Elder, 1613 Jan Brueghel the Elder, 1613
Questions?Questions?