This article is more than 5 years old. Information may no longer be current.
Girl infected with orf virus at skin graft site
Click Here to Manage Email Alerts
A girl in rural Iran with thermal burns on much of her body developed orf virus infection at the site of a skin graft harvest — the first reported case of its kind, according to researchers from the CDC and several other institutions.
“In humans, orf virus infections, or contagious ecthyma, are commonly associated with contact with infected animals, usually goats and sheep, or infected fomites,” the investigators wrote in The Journal of Infectious Diseases.
The patient, aged 4 years, suffered third-degree burns from hot water on 35% of her body in December 2015 while playing in her family’s kitchen in rural Iran. Seven days later, she underwent a skin graft harvest from her right thigh to her left arm and leg. Four days after that, she developed about 10 nodular lesions on the graft site and approximately 100 pustular/papular lesions on the burn sites on her trunk and left arm and leg.
While the patient’s father bred sheep and cattle near their home, none of the animals had a history of being sick, and the patient did not have a history of contact with them, according to her family.
One week after her skin graft, biopsies taken from two lesions on the harvest site were sent to the CDC. Biopsies were not taken from the burn sites because they were still being treated, and the lesions in both areas were determined to be from a similar cause.
The lesions tested positive for parapoxvirus and negative for orthopoxvirus. Orf virus DNA signatures were amplified by real-time PCR from formalin-fixed paraffin embedded biopsy specimens, and the researchers determined the virus most closely resembled an isolate from India from 2006.
A negative-stained transmission electron micrograph image depicting the ultrastructural details of an orf virus.
Source: CDC/Cynthia Goldsmith
They noted that the majority of the patient’s lesions resolved “spontaneously” after 3 weeks with no further complications, and that cryotherapy was used on three remaining lesions 1 week later with no scarring observed.
“This is the first documented report of orf virus infection in a thermal burn patient at the skin-graft harvest site,” the researchers wrote. “Though no biopsy was taken from the affected recipient burn site, orf virus infection was strongly suggested due to the timing and characteristic dermatologic presentation occurring concurrently with the orf virus infection at the skin-graft harvest site.
“Transmission through confirmed infectious fomites has been a cause in previous documented orf virus infection cases associated with burn patients; however, in the case of this burn patient, it is unknown if the infection of the harvest and burn sites were due to concurrent infection from a common animal or fomite source, or if virus transmission was the direct result of the grafting process.” – by Gerard Gallagher
Click Here to Manage Email Alerts