Summary about Disease
Infectious ecthyma (also known as contagious ecthyma, orf, or scabby mouth) is a viral skin disease primarily affecting sheep and goats, but transmissible to humans. It is caused by the Orf virus, a parapoxvirus. In humans, it typically presents as a solitary nodule or pustule, most commonly on the hands. The lesions are generally self-limiting but can be painful and occasionally lead to complications.
Symptoms
A small, firm, red papule (bump) develops at the site of infection, usually on the fingers, hands, or arms.
The papule evolves into a larger, raised, and often painful nodule.
The nodule may develop a central ulcer or scab.
The lesion may be surrounded by a red, inflamed halo.
Multiple lesions can occur, although less common.
Occasionally, systemic symptoms like mild fever or swollen lymph nodes may be present.
Causes
Infectious ecthyma is caused by the Orf virus, a parapoxvirus. Humans contract the virus through direct contact with infected animals (sheep, goats) or contaminated fomites (objects). The virus enters the skin through abrasions or breaks in the skin barrier. High-risk occupations include farmers, veterinarians, and slaughterhouse workers.
Medicine Used
Treatment is generally supportive, focusing on symptom relief and preventing secondary bacterial infections.
Wound Care: Keeping the lesion clean and covered with a sterile dressing.
Topical Antibiotics: May be used to prevent or treat secondary bacterial infections.
Pain Relief: Over-the-counter pain relievers like ibuprofen or acetaminophen.
Cryotherapy or surgical excision: May be considered for cosmetic reasons or if the lesion is particularly large or persistent.
Is Communicable
Yes, infectious ecthyma is communicable. The virus can spread from infected animals to humans through direct contact with lesions or contaminated objects. Human-to-human transmission is rare but possible through direct contact with an active lesion.
Precautions
Wear gloves when handling livestock, especially sheep and goats.
Avoid contact with animals exhibiting signs of scabby mouth (lesions around the mouth, nose, or feet).
Wash hands thoroughly with soap and water after contact with animals or potentially contaminated surfaces.
Cover any cuts or abrasions on your hands with a bandage before working with animals.
Properly disinfect equipment and surfaces that may have come into contact with the virus.
How long does an outbreak last?
In humans, infectious ecthyma lesions typically resolve spontaneously within 3-6 weeks.
How is it diagnosed?
Diagnosis is usually made based on the characteristic appearance of the lesion and a history of contact with infected animals. A biopsy of the lesion can be performed for laboratory confirmation, including electron microscopy or PCR testing to detect the Orf virus.
Timeline of Symptoms
Incubation Period: 3-5 days after exposure.
Initial Papule: A small, firm, red bump appears.
Nodule Formation: The papule enlarges and becomes a raised nodule over the next 1-2 weeks.
Ulceration/Scabbing: The nodule may ulcerate or develop a scab in the center.
Resolution: The lesion gradually heals over 3-6 weeks, often leaving a scar.
Important Considerations
Secondary bacterial infections are a potential complication.
Large or persistent lesions may require surgical removal or cryotherapy.
Consult a healthcare professional for diagnosis and management, especially if the lesion is painful, infected, or not healing properly.
Individuals with weakened immune systems may experience more severe or prolonged infections.
While rare, Orf virus can cause significant morbidity; prompt diagnosis and supportive care can help minimize complications.