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Obermeier PE, Buder SC, Hillen U. Pockenvirusinfektionen in der Dermatologie: Poxvirus infections in dermatology - the neglected, the notable, and the notorious. J Dtsch Dermatol Ges 2024; 22:56-96. [PMID: 38212918 DOI: 10.1111/ddg.15257_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/20/2023] [Indexed: 01/13/2024]
Abstract
ZusammenfassungDie Familie Poxviridae umfasst derzeit 22 Gattungen, die Wirbeltiere infizieren können. Humanpathogene Pockenviren gehören den Gattungen Ortho‐, Para‐, Mollusci‐ und Yatapoxvirus an. Bis zur Eradikation der Variola vera im Jahr 1979 waren die Pocken, im Volksmund auch Blattern genannt, eine schwerwiegende Gesundheitsbedrohung für die Bevölkerung. Noch heute sind Dermatologen mit zahlreichen Pockenvirusinfektionen konfrontiert, wie den Bauernhofpocken, die als Zoonosen nach Tierkontakten in ländlichen Gebieten oder nach Massenversammlungen auftreten können. In den Tropen können Erkrankungen durch Tanapox‐ oder Vaccinia‐Viren zu den Differenzialdiagnosen gehören. Dellwarzen sind weltweit verbreitet und werden in bestimmten Fällen als sexuell übertragbare Pockenvirusinfektion angesehen. In jüngster Zeit hatten sich Mpox (Affenpocken) zu einer gesundheitlichen Notlage von internationaler Tragweite entwickelt, die eine rasche Identifizierung und angemessene Behandlung durch Dermatologen und Infektiologen erfordert. Fortschritte und neue Erkenntnisse über Epidemiologie, Diagnose, klinische Manifestationen und Komplikationen sowie Behandlung und Prävention von Pockenvirusinfektionen erfordern ein hohes Maß an Fachwissen und interdisziplinärer Zusammenarbeit in den Bereichen Virologie, Infektiologie und Dermatologie. Dieser CME‐Artikel bietet einen aktualisierten systematischen Überblick, um praktizierende Dermatologen bei der Identifizierung, Differenzialdiagnose und Behandlung klinisch relevanter Pockenvirusinfektionen zu unterstützen.
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Affiliation(s)
- Patrick E Obermeier
- Klinik für Dermatologie und Venerologie, Vivantes Klinikum Neukölln, Berlin, Deutschland
- Abteilung für Infektionskrankheiten, Vaccine Safety Initiative, Berlin, Deutschland
| | - Susanne C Buder
- Klinik für Dermatologie und Venerologie, Vivantes Klinikum Neukölln, Berlin, Deutschland
- Konsiliarlabor für Gonokokken, Fachgebiet Sexuell übertragbare bakterielle Krankheitserreger, Robert Koch-Institut, Berlin, Deutschland
| | - Uwe Hillen
- Klinik für Dermatologie und Venerologie, Vivantes Klinikum Neukölln, Berlin, Deutschland
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Obermeier PE, Buder SC, Hillen U. Poxvirus infections in dermatology - the neglected, the notable, and the notorious. J Dtsch Dermatol Ges 2024; 22:56-93. [PMID: 38085140 DOI: 10.1111/ddg.15257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/20/2023] [Indexed: 12/22/2023]
Abstract
The family Poxviridae currently comprises 22 genera that infect vertebrates. Of these, members of the Ortho-, Para-, Mollusci- and Yatapoxvirus genera have been associated with human diseases of high clinical relevance in dermatology. Historically, smallpox had been a notorious health threat until it was declared eradicated by the World Health Organization in 1979. Today, dermatologists are confronted with a variety of poxviral infections, such as farmyard pox, which occurs as a zoonotic infection after contact with animals. In the tropics, tanapox or vaccinia may be in the differential diagnosis as neglected tropical dermatoses. Molluscum contagiosum virus infection accounts for significant disease burden worldwide and is classified as a sexually transmitted infection in certain scenarios. Recently, mpox (monkeypox) has emerged as a public health emergency of international concern, requiring rapid recognition and appropriate management by dermatologists and infectious disease specialists. Advances and new insights into the epidemiology, diagnosis, clinical manifestations and complications, treatment, and prevention of poxviral infections require a high level of expertise and interdisciplinary skills from healthcare professionals linking virology, infectious diseases, and dermatology. This CME article provides a systematic overview and update to assist the practicing dermatologist in the identification, differential diagnosis, and management of poxviral infections.
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Affiliation(s)
- Patrick E Obermeier
- Department of Dermatology and Venereology, Vivantes Hospital Neukölln, Berlin, Germany
- Department of Infectious Diseases, Vaccine Safety Initiative, Berlin, Germany
| | - Susanne C Buder
- Department of Dermatology and Venereology, Vivantes Hospital Neukölln, Berlin, Germany
- German Reference Laboratory for Gonococci, Unit Sexually Transmitted Bacterial Pathogens, Department for Infectious Diseases, Robert Koch-Institute, Berlin, Germany
| | - Uwe Hillen
- Department of Dermatology and Venereology, Vivantes Hospital Neukölln, Berlin, Germany
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Lacasta D, Ríos M, Ruiz de Arcaute M, Ortín A, Ramos JJ, Villanueva-Saz S, Tejedor MT, Ruiz H, Borobia M, Reina R, Gómez A, Navarro T, Windsor PA. Use of a Local Anaesthetic/Antiseptic Formulation for the Treatment of Lambs Experimentally Infected with Orf Virus. Animals (Basel) 2023; 13:2962. [PMID: 37760362 PMCID: PMC10525785 DOI: 10.3390/ani13182962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/11/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
Contagious ecthyma is a highly transmissible eruptive viral disease of the skin and mucosa of sheep and goats distributed worldwide. The treatment of orf lesions is usually based on the use of antiseptics and antibiotics for the management of presumptive secondary infections, increasing risks of antimicrobial resistance. The wound dressing formulation Tri-Solfen® (TS) containing two local anaesthetics (lignocaine and bupivacaine), adrenaline and an antiseptic (cetrimide) in a gel formulation has been demonstrated to reduce suffering and enhance recovery in cattle and buffalo with oral and skin lesions due to foot-and-mouth disease virus infection and reduced the orf viral load in lambs. In the present study, experimental infection with the orf virus was conducted in 50 newborn lambs and 25 animals were treated after the presence of the first lesions with TS and repeated three days later. Daily clinical examination, haematological, serological, biomolecular and post-mortem analyses were conducted during 34 days after treatment. Results indicated that treatment had no effect on weight gain and clinical progression of the lesions. It was determined that seroconversion after experimental infection occurs 34 days after infection and suggested that the deep basal epithelial location of the orf lesions may have prevented the therapy from having altered the clinical course.
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Affiliation(s)
- Delia Lacasta
- Animal Pathology Department, Instituto Agroalimentario de Aragón-IA2 (Universidad de Zaragoza-CITA), Veterinary Faculty of Zaragoza, C/Miguel Servet 177, 50013 Zaragoza, Spain; (M.R.); (M.R.d.A.); (A.O.); (J.J.R.); (S.V.-S.); (H.R.); (M.B.); (A.G.); (T.N.)
| | - Marina Ríos
- Animal Pathology Department, Instituto Agroalimentario de Aragón-IA2 (Universidad de Zaragoza-CITA), Veterinary Faculty of Zaragoza, C/Miguel Servet 177, 50013 Zaragoza, Spain; (M.R.); (M.R.d.A.); (A.O.); (J.J.R.); (S.V.-S.); (H.R.); (M.B.); (A.G.); (T.N.)
| | - Marta Ruiz de Arcaute
- Animal Pathology Department, Instituto Agroalimentario de Aragón-IA2 (Universidad de Zaragoza-CITA), Veterinary Faculty of Zaragoza, C/Miguel Servet 177, 50013 Zaragoza, Spain; (M.R.); (M.R.d.A.); (A.O.); (J.J.R.); (S.V.-S.); (H.R.); (M.B.); (A.G.); (T.N.)
| | - Aurora Ortín
- Animal Pathology Department, Instituto Agroalimentario de Aragón-IA2 (Universidad de Zaragoza-CITA), Veterinary Faculty of Zaragoza, C/Miguel Servet 177, 50013 Zaragoza, Spain; (M.R.); (M.R.d.A.); (A.O.); (J.J.R.); (S.V.-S.); (H.R.); (M.B.); (A.G.); (T.N.)
| | - Juan José Ramos
- Animal Pathology Department, Instituto Agroalimentario de Aragón-IA2 (Universidad de Zaragoza-CITA), Veterinary Faculty of Zaragoza, C/Miguel Servet 177, 50013 Zaragoza, Spain; (M.R.); (M.R.d.A.); (A.O.); (J.J.R.); (S.V.-S.); (H.R.); (M.B.); (A.G.); (T.N.)
| | - Sergio Villanueva-Saz
- Animal Pathology Department, Instituto Agroalimentario de Aragón-IA2 (Universidad de Zaragoza-CITA), Veterinary Faculty of Zaragoza, C/Miguel Servet 177, 50013 Zaragoza, Spain; (M.R.); (M.R.d.A.); (A.O.); (J.J.R.); (S.V.-S.); (H.R.); (M.B.); (A.G.); (T.N.)
| | - María Teresa Tejedor
- Anatomy, Embryology and Animal Genetics Department, CIBER CV (Universidad de Zaragoza-IIS), Veterinary Faculty of Zaragoza, C/Miguel Servet 177, 50013 Zaragoza, Spain;
| | - Héctor Ruiz
- Animal Pathology Department, Instituto Agroalimentario de Aragón-IA2 (Universidad de Zaragoza-CITA), Veterinary Faculty of Zaragoza, C/Miguel Servet 177, 50013 Zaragoza, Spain; (M.R.); (M.R.d.A.); (A.O.); (J.J.R.); (S.V.-S.); (H.R.); (M.B.); (A.G.); (T.N.)
| | - Marta Borobia
- Animal Pathology Department, Instituto Agroalimentario de Aragón-IA2 (Universidad de Zaragoza-CITA), Veterinary Faculty of Zaragoza, C/Miguel Servet 177, 50013 Zaragoza, Spain; (M.R.); (M.R.d.A.); (A.O.); (J.J.R.); (S.V.-S.); (H.R.); (M.B.); (A.G.); (T.N.)
| | - Ramsés Reina
- Instituto de Agrobiotecnología, CSIC-Gobierno de Navarra, 31192 Mutilva, Spain;
| | - Alex Gómez
- Animal Pathology Department, Instituto Agroalimentario de Aragón-IA2 (Universidad de Zaragoza-CITA), Veterinary Faculty of Zaragoza, C/Miguel Servet 177, 50013 Zaragoza, Spain; (M.R.); (M.R.d.A.); (A.O.); (J.J.R.); (S.V.-S.); (H.R.); (M.B.); (A.G.); (T.N.)
| | - Teresa Navarro
- Animal Pathology Department, Instituto Agroalimentario de Aragón-IA2 (Universidad de Zaragoza-CITA), Veterinary Faculty of Zaragoza, C/Miguel Servet 177, 50013 Zaragoza, Spain; (M.R.); (M.R.d.A.); (A.O.); (J.J.R.); (S.V.-S.); (H.R.); (M.B.); (A.G.); (T.N.)
| | - Peter Andrew Windsor
- Sydney School of Veterinary Science, The University of Sydney, Camden, NSW 2570, Australia;
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Phillips CJC. Zoonotic Disease Risks of Live Export of Cattle and Sheep, with a Focus on Australian Shipments to Asia and the Middle East. Animals (Basel) 2022; 12:ani12233425. [PMID: 36496946 PMCID: PMC9738783 DOI: 10.3390/ani12233425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
The growing human and livestock populations in the world today and increased international transport of livestock is increasing the risk of both emerging and endemic zoonotic diseases. This review focuses on the potential for the live export trade to transmit zoonotic diseases. Both cattle and sheep are exposed to major stresses during the transport process, which are described, together with the impact of these stresses on the immune function of transported animals. Heat stress, overcrowding, inanition, ship and vehicle motion and accumulation of noxious gases are analysed for their ability to potentiate infectious diseases. The major zoonoses are described: pustular dermatitis, pneumonia, salmonellosis, as well as some common conditions, such as conjunctivitis, with specific reference to stressors associated with each disorder. Historical precedents exist for restriction of the trade based on disease risks. Finally, the economic and regulatory frameworks are considered to evaluate ways in which the spread of zoonotic diseases can be controlled.
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Affiliation(s)
- Clive J. C. Phillips
- Institute of Veterinary Medicine and Animal Sciences, Estonian University of Life Sciences, Kreutzwaldi 1, 51014 Tartu, Estonia;
- Curtin University Sustainability Policy (CUSP) Institute, Curtin University, Kent St., Bentley, WA 6102, Australia
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Hall LE, Reilly B, Blackie N. Surveying UK sheep farmers' vaccination techniques and the impact of vaccination training. Vet Rec 2022; 191:e1798. [PMID: 35860912 DOI: 10.1002/vetr.1798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 04/04/2022] [Accepted: 05/04/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Vaccines are commonly used in sheep farming. However, compliance with vaccination protocols and subsequent suboptimal vaccination techniques are concerns in the industry. METHODS An online survey containing 31 questions encompassing vaccination storage, technique and training was distributed to UK sheep farmers. Respondents were asked to mark on a sheep diagram where they would administer intramuscular (IM), intradermal, and subcutaneous (SC) vaccines. RESULTS Of 370 respondents, only 26.1% identified the correct location for SC, 38.0% for intradermal, and 7.7% for IM vaccination. Almost half (45.5%) stored their vaccines in a fridge specific to veterinary medicines, only 33.9% used a temperature logger, and 6.4% checked their fridge temperature daily. Almost half (45.5%) kept their vaccines 48 hours or longer after broaching, and 11.1% kept them until the next time. Significantly more respondents who had received training correctly identified the location for IM vaccination (p < 0.01). However, training had no significant influence on the the correct identification of the other vaccination sites, vaccine storage or administration. CONCLUSION Suboptimal vaccination techniques are not due to unwillingness to learn; 83.8% responded that they would consider taking a course to improve their use. However, the majority (73.9%) were unaware of the training courses available. Therefore, the industry needs to respond and promote courses.
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Affiliation(s)
- Lauren E Hall
- Pathobiology and Population Sciences, Royal Veterinary College, Hatfield, UK
| | - Beth Reilly
- Pathobiology and Population Sciences, Royal Veterinary College, Hatfield, UK
| | - Nicola Blackie
- Pathobiology and Population Sciences, Royal Veterinary College, Hatfield, UK
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Bukar AM, Jesse FFA, Abdullah CAC, Noordin MM, Lawan Z, Mangga HK, Balakrishnan KN, Azmi MLM. Immunomodulatory Strategies for Parapoxvirus: Current Status and Future Approaches for the Development of Vaccines against Orf Virus Infection. Vaccines (Basel) 2021; 9:1341. [PMID: 34835272 PMCID: PMC8624149 DOI: 10.3390/vaccines9111341] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 08/25/2021] [Accepted: 08/25/2021] [Indexed: 11/17/2022] Open
Abstract
Orf virus (ORFV), the prototype species of the parapoxvirus genus, is the causative agent of contagious ecthyma, an extremely devastating skin disease of sheep, goats, and humans that causes enormous economic losses in livestock production. ORFV is known for its ability to repeatedly infect both previously infected and vaccinated sheep due to several immunomodulatory genes encoded by the virus that temporarily suppress host immunity. Therefore, the development of novel, safe and effective vaccines against ORFV infection is an important priority. Although, the commercially licensed live-attenuated vaccines have provided partial protection against ORFV infections, the attenuated viruses have been associated with major safety concerns. In addition to safety issues, the persistent reinfection of vaccinated animals warrants the need to investigate several factors that may affect vaccine efficacy. Perhaps, the reason for the failure of the vaccine is due to the long-term adaptation of the virus in tissue culture. In recent years, the development of vaccines against ORFV infection has achieved great success due to technological advances in recombinant DNA technologies, which have opened a pathway for the development of vaccine candidates that elicit robust immunity. In this review, we present current knowledge on immune responses elicited by ORFV, with particular attention to the effects of the viral immunomodulators on the host immune system. We also discuss the implications of strain variation for the development of rational vaccines. Finally, the review will also aim to demonstrate future strategies for the development of safe and efficient vaccines against ORFV infections.
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Affiliation(s)
- Alhaji Modu Bukar
- Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia; (M.M.N.); (Z.L.); (H.K.M.); (K.N.B.)
- Department of Science Laboratory Technology, School Agriculture and Applied Sciences, Ramat Polytechnic Maiduguri, Maiduguri 1070, Borno, Nigeria
| | - Faez Firdaus Abdullah Jesse
- Department of Veterinary Clinical Studies, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia;
| | | | - Mustapha M. Noordin
- Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia; (M.M.N.); (Z.L.); (H.K.M.); (K.N.B.)
| | - Zaharaddeen Lawan
- Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia; (M.M.N.); (Z.L.); (H.K.M.); (K.N.B.)
| | - Hassana Kyari Mangga
- Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia; (M.M.N.); (Z.L.); (H.K.M.); (K.N.B.)
| | - Krishnan Nair Balakrishnan
- Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia; (M.M.N.); (Z.L.); (H.K.M.); (K.N.B.)
| | - Mohd-Lila Mohd Azmi
- Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia; (M.M.N.); (Z.L.); (H.K.M.); (K.N.B.)
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Struzik J, Szulc-Dąbrowska L. NF-κB as an Important Factor in Optimizing Poxvirus-Based Vaccines against Viral Infections. Pathogens 2020; 9:pathogens9121001. [PMID: 33260450 PMCID: PMC7760304 DOI: 10.3390/pathogens9121001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/24/2020] [Accepted: 11/27/2020] [Indexed: 11/16/2022] Open
Abstract
Poxviruses are large dsDNA viruses that are regarded as good candidates for vaccine vectors. Because the members of the Poxviridae family encode numerous immunomodulatory proteins in their genomes, it is necessary to carry out certain modifications in poxviral candidates for vaccine vectors to improve the vaccine. Currently, several poxvirus-based vaccines targeted at viral infections are under development. One of the important aspects of the influence of poxviruses on the immune system is that they encode a large array of inhibitors of the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), which is the key element of both innate and adaptive immunity. Importantly, the NF-κB transcription factor induces the mechanisms associated with adaptive immunological memory involving the activation of effector and memory T cells upon vaccination. Since poxviruses encode various NF-κB inhibitor proteins, before the use of poxviral vaccine vectors, modifications that influence NF-κB activation and consequently affect the immunogenicity of the vaccine should be carried out. This review focuses on NF-κB as an essential factor in the optimization of poxviral vaccines against viral infections.
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