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The authors report eight cases of human ORF disease localized to the hand and transmitted to man by contact with the sheep. This disease is characterized by typical lesions on exposed cutaneous zones. Those lesions must be distinguished from milker's nodules, botryomycosis and above all felon because ORF disease never require surgery.
A case of orf affecting the pinna is discussed. This is an unusual presentation of an infection that is common in farming communities. At the initial presentation the diagnosis was not suspected, the management therefore was inappropriate and probably gave rise to the secondary infection that ensued. The history described is classical. Orf affecting the external auditory canal has been reported once, but orf affecting the pinna has not been described before.
This paper reports the development and evaluation of serological tests for the differentiation of antibodies in animals infected with capripox and parapox viruses. Agar-gel immunodiffusion tests using sera from sheep with naturally-acquired infections and from sheep experimentally inoculated with orf or capripox viruses showed cross reactions. Virus-specific antibody responses to structural proteins of the viruses were analysed by Western-blot analysis. This analysis readily differentiated the infections as either capripox or contagious pustular dermatitis. The antibody responses to the 32 kDa and 26 kDa proteins of capripoxvirus provided a firm basis for differentiation.
Orf of the hand is an uncommon zoonotic infection caused by a dermotropic DNA virus that belongs to the Parapoxvirus genus of the family Poxviridae. It is transmitted to humans through contact with infected sheep and goats and is reported as an occupational disease. We report nine cases of human orf seen in the hands of individuals, who were not occupationally exposed, after the feast of sacrifice in Turkey. Three cases were teachers and six out of the nine were housewives. We observed musculoskeletal complications and misdiagnoses. It is important to consider human orf in the differential diagnosis of hand lesions to prevent overtreatment and complications.
Orf virus is a large DNA virus and is the type species of the Parapoxvirus genus of the family Poxviridae. Orf virus infects the epithelium of sheep and goats and is transmissible to humans. Recently we discovered a gene in orf virus that encodes a polypeptide with remarkable homology to mammalian interleukin (IL-10) and viral encoded IL-10s of herpes viruses. The predicted polypeptide sequence shows high levels of amino acid identity to IL-10 of sheep (80%), cattle (75%), humans (67%) and mice (64%), as well as IL-10-like proteins of Epstein-Barr virus (63%) and equine herpes virus (67%). The C-terminal region, comprising two-thirds of the orf virus protein, is identical to ovine IL-10 which suggests that this gene has been captured from its host sheep during the evolution of orf virus. In contrast the N-terminal region shows little homology with cellular IL10s and in this respect resembles other viral IL-10s. IL-10 is a pleiotrophic cytokine that can exert either immunostimulatory or immunosuppressive effects on many cell types. IL-10 is a potent anti-inflammatory cytokine with inhibitory effects on non-specific immunity in particular macrophage function and Thl effector function. Our studies so far, indicate, that the functional activities of orf virus IL-10 are the same as ovine IL-10. Orf virus IL-10 stimulates mouse thymocyte proliferation and inhibits cytokine synthesis in lipopolysaccharide-activated ovine macrophages, peripheral blood monocytes and keratinocytes. Infection of sheep with an IL-10 deletion mutant of orf virus has shown that interferon-gamma levels are higher in tissue infected with the mutant virus than the parent virus. The functional activities of IL-10 and our data on orf virus IL-10 suggest a role in immune evasion.
A case of orf in a 59-year-old man with no direct contact with farm animals is reported. The patient presented with an ulcerating lesion on the upper lip and the diagnosis was confirmed by electron microscopy from a smear of the lesion. The unusual case history, differential diagnosis and method of diagnosis are discussed.
The effect of cyclosporin A (CsA) on host immunity to cutaneous reinfection with the parapoxvirus orf virus was studied in 6-month-old lambs. In control reinfected animals, clinical lesions and viral replication (measured by the presence of vesicular/pustular lesions and viral antigen) in regenerating epidermal cells were at a maximum on day 4 with resolution by day 9. Lesion histology revealed recruitment of T cells, B cells and dermal dendritic cells (DDC) which increased and decreased in parallel with the clinical course of the reinfection. In animals treated with CsA (25 mg/kg/day) 1 day before and for 8 days after reinfection, more severe clinical lesions and viral replication typical of primary infections were recorded and had not resolved by 28 days following reinfection. During CsA treatment, the recruitment of T cells, B cells and DDC was inhibited. With cessation of CsA treatment there was dramatic recruitment of CD4+ T cells followed by DDC then B cells to the lesion site but rapid onset of acquired immunity was not recorded. Reverse transcription-polymerase chain reaction (RT-PCR) analysis of cytokine mRNAs from lesion biopsies showed individual sheep variations. However, interleukin-2 (IL-2) and interferon-gamma (IFN-gamma) mRNAs were detected in the control reinfected animals on days 3 and/or 9 after reinfection but not on these days in animals undergoing treatment with CsA. In the untreated lambs there was an inexplicable lack of IL-2 and IFN-gamma mRNAs on day 6 after reinfection. Tumour necrosis factor-alpha (TNF-alpha) and vascular endothelial growth factor (VEGF) mRNAs were unaffected by CsA treatment. The data suggest that CsA abrogates acquired immunity to orf virus reinfection by targetting T-cell lymphokine production.
In order to study the effects of sheep teat disorders on the protection of the mammary gland, we used a Mannheimia haemolytica isolate, which did not cause clinical mastitis when deposited into intact teats. In the first experiment, this was deposited into the duct of teats with orf (Group A, n=5) or papilloma (Group B, n=3). In the second, teats were chapped and then, the organism was deposited into the duct (Group C, n=7) or on the skin (Group D, n=4). Ewes with healthy teats were controls (Group E, deposition into duct, n=5; Group F, deposition on skin, n=2). The ewes in Groups A, B or C developed clinical mastitis 5 h later, whilst the ewes in Group D developed it 2 d later; no control ewe developed clinical mastitis. In ewes with teat lesions, the organism was isolated from secretion samples and the California Mastitis Test became positive 5 h after challenge; neutrophils and lymphocytes were seen in Giemsa-stained secretion films from Group A or B ewes, whilst macrophages, neutrophils and lymphocytes in films from Group C or D ewes; neutrophils were predominating in films from Group E or F ewes. Inside the teats of Group A, B, C or D ewes, folds, hyperaemia and mucosal thickness were seen; histologically, subepithelial leucocytic infiltration was seen. In Group A or B ewes, no evidence of lymphoid tissue at the teat duct-cistern border was found. In Group C or D ewes, intense erosion and ulceration of the teat skin and conspicuous lymphoid tissue at the teat duct-cistern border, were evident; lesions characteristic of haemorrhagic mastitis were in the mammary parenchyma. In control ewes, subepithelial leucocytic infiltration in the teat duct and lymphoid tissue as above, were evident. We postulate that teat lesions can be predisposing factor to mastitis, by adversely affecting defences and speeding the process of infection and making it more severe.
During the co-evolution of viruses with their vertebrate hosts, the DNA viruses have acquired an impressive array of immunomodulatory genes to combat host immune responses and their hosts have developed a sophisticated immune system to contain virus infections. In order to replicate, the viruses have evolved mechanisms to inhibit key host anti-virus responses that include apoptosis, interferon production, chemokine production, inflammatory cytokine production, and the activity of cytotoxic T-cells, natural killer cells and antibody. In addition, some of the viruses encode cytokine or chemokine homologues that recruit or expand cell numbers for infection or that subvert the host cellular response from a protective response to a benign one. The specificity of the viral immunomodulatory molecules reflects the life cycle and the pathogenesis of the viruses. Herpesviruses achieve latency in host cells by inducing cell survival and protecting infected cells from immune recognition. This involves interference with cell signal transduction pathways. Many of the viral immunomodulatory proteins are homologues of host proteins that appear to have been pirated from the host and reassorted in the virus genomes. Some of these have unique functions and indicate novel or important aspects of both viral pathogenesis and host immunity to viruses. The specific example of orf virus infection of sheep is described.
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