Cow pox

Last Updated: 2020-11-19

Author(s): Anzengruber F., Navarini A.

ICD11: -

Variola vaccinia

Zoonosis caused by the poxvirus bovis (orthopoxvirus). The main pathogen reservoir is rodents (e.g. rats), but humans, cats and cattle can be infected.

  • Risk groups: Atopic, immunosuppressed patients.

Transmission occurs via rodents and cattle, but mainly via cats. Skin lesions serve as entry ports. 

  • After erythema, papulovesicles and pustules occur, ulceration occurs (after approx. 2 weeks). In addition to local swelling, painful lymphadenitis is often seen. Sometimes a reduced general condition, febrile temperatures and eye involvement can be observed. 

Clinic, electron microscopy (negative contrast), serology, pathogen detection.

  • In almost 50% of cases the hands or fingers are affected, otherwise the face and neck.
  • Topically antiseptic 

  • Approved systemic drugs do not exist. Cidovir showed efficacy in studies, but its use is to be discussed due to potentially lethal side effects.

  1. McShane H, Pathan AA, Sander CR, et al. Recombinant modified vaccinia virus Ankara expressing antigen 85A boosts BCG-primed and naturally acquired antimycobacterial immunity in humans. Nature Medicine 2004;10:1240-4.
  2. Tack DM, Karem KL, Montgomery JR, et al. Unintentional transfer of vaccinia virus associated with smallpox vaccines: ACAM2000((R)) compared with Dryvax((R)). Hum Vaccin Immunother 2013;9:1489-96.
  3. Kroon EG, Mota BE, Abrahao JS, da Fonseca FG, de Souza Trindade G. Zoonotic Brazilian Vaccinia virus: from field to therapy. Antiviral Res 2011;92:150-63.
  4. Fleming SB, Wise LM, Mercer AA. Molecular genetic analysis of orf virus: a poxvirus that has adapted to skin. Viruses 2015;7:1505-39.
  5. Wienecke R, Wolff H, Schaller M, Meyer H, Plewig G. Cowpox virus infection in an 11-year-old girl. Journal of the American Academy of Dermatology 2000;42:892-4.
  6. Stolz W, ouml, tz A, et al. Characteristic but Unfamiliar – The Cowpox Infection, Transmitted by a Domestic Cat. Dermatology 1996;193:140-3.