Materiały źródłowe

• #1 Orf Viral Infection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562191/

  Orf viral infection, also known as ecthyma contagiosum or contagious pustular dermatitis, is an occupational disease primarily acquired from infected sheep and goats. […] Orf disease is generally self-limiting and does not necessitate specific treatment. However, early diagnosis is crucial to prevent worsening and further transmission, ultimately preserving productivity and reducing associated morbidity. […] Treatment may not be necessary for immunocompetent patients, as the disease usually resolves in 6 to 8 weeks. However, multiple treatments can be implemented to prevent the worsening of the disease in patients with immunosuppression. […] Orf viral infection, as a zoonotic host-switch illness, generally has a favorable prognosis. The lesions are self-limiting, and in immunocompetent patients, symptoms typically resolve spontaneously within a 4- to 6-week period.

• #1 Human orf

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5638474/

  Orf is one of the most widespread viral diseases worldwide and is caused by Parapoxvirus. It can be transmitted to humans from goats, deer, sheep, and cattle. Orf (also known as ecthyma contagiosum) can be transmitted to people who have direct contact with infected animals and it manifests as a erythematous maculopapular lesion. Human orf is usually self-limiting and no specific treatment is needed. Complications are due to misdiagnosis of this infection and, as a result, it being overtreated, specifically by surgical debridement. […] The diagnosis of orf was made based on the clinical findings: the history of exposure to goats and sheep, as well as the appearance of the typical cutaneous lesions. […] No treatment, including surgical debridement, is necessary, as the disease is self-limiting. The common approach to treat ulcers with surgical debridement is considered unnecessary in cases of human orf because it might cause scarring and prolong the recovery period. The lesion should be kept clean with antiseptic solution to avoid a secondary bacterial infection.

• #1 Orf Treatment & Management: Medical Care, Surgical Care, Prevention

  https://emedicine.medscape.com/article/1133450-treatment

  Although orf is a self-limited disease, symptomatic treatment with moist dressings, local antiseptics, and finger immobilization is helpful. Secondary bacterial infection of orf is not uncommon and must be treated with topical or systemic antibiotics. Several case reports describe orf successfully treated with topical imiquimod resulting in rapid regression of the lesions. Imiquimod has been effective in both immunocompetent and immunocompromised patients. Regimens range from once every other day to twice-daily application topically to the lesion. The use of interferon alfa-2a and 2b has also been reported in refractory giant orf lesions in immunocompromised patients. Reports also describe effective treatment of orf with cidofovir cream and cidofovir intravenously. […] Because of its self-limited nature, surgical procedures are usually reserved for immunocompromised patients who do not respond to conservative measures. Cryotherapy (liquid nitrogen) has been reported to speed the recovery process from orf treatment. Shave excision is a procedure that can be diagnostic and therapeutic for small orf lesions. For large exophytic orf lesions, dissection from the underlying dermis has been performed. If an orf lesion is persistent, curettage and electrodesiccation may be curative. Amputation should only be used as a last resort. Recurrences and delayed healing have been reported after surgical treatment. […] A case of human orf in an immunocompromised patient treated successfully with cidofovir cream.

• #1 About Orf Virus (Sore Mouth Disease) | Orf | CDC

  https://www.cdc.gov/orf-virus/about/index.html

  There is no specific treatment to cure orf virus infection. But it’s important to protect the sores from getting infected with other germs. […] Keep the sores dry and covered with a bandage. Use a bandage that keeps water out when working with animals or doing manual labor. If your sores are dry at bedtime, keep them uncovered while you sleep. If they are wet, cover sores loosely with a bandage. This will help them heal faster. […] See your doctor if you have pain, fever or if your sores are getting bigger or spreading. If this occurs, it could mean your sores are due to a different, more serious germ. Your doctor can help determine what’s going on.

• #1 Contagious Pustular Dermatitis (Orf)

  https://www.nadis.org.uk/disease-a-z/sheep/contagious-pustular-dermatitis-orf/

  Contagious pustular dermatitis virus most commonly results in proliferative lesions at the hoof/horn junction and on the lips/gums. […] Treatment is largely unsuccessful except for lambs with superficial secondary bacterial infection of scabs which show a good response to either intramuscular procaine penicillin or oxytetracycline injections and topical oxytetracycline spray for three to five consecutive days. […] Contagious pustular dermatitis is a significant problem in orphans lambs and other ill-thriven lambs, CPD is less of a problem in well-fed, well-thriven stock.

• #1 Severe Orf in Lambs: Clinical Description and Response to Treatment against Secondary Infection

  https://www.jscimedcentral.com/jounal-article-info/Journal-of-Veterinary-Medicine-and-Research/Severe-Orf-in-Lambs%3A-Clinical–Description-and-Response-to–Treatment-against-Secondary–Infection-9509

  In May 2014, severe disease affecting areas around the muzzle and the entire buccal mucosa was observed in two lambs from a flock of approximately 200 Highlander and Charolaise ewes. […] It was therefore deemed necessary to offer treatment against secondary infection. Both lambs responded very well to a combination of 200mg/kg procaine penicillin and 250mg/kg body weight dihydrostreptomycin sulphate and 1,5 pentanedial in petroleum based soft emollient cream administered once daily for three consecutive days. The treatment regime showed that secondary infection during severe orf cases can be treated with penicillin-streptomycin and petroleum based soft emollient cream in order to reduce losses associated with the disease. […] We therefore focused around the two lambs to try administering some treatment against secondary infection. To facilitate wound healing and treatment for secondary infection the two lambs were given an intramuscular injection of 200mg/kg body weight procaine penicillin and 250mg/kg body weight dihydrostreptomycin sulphate combined with 1,5 pentanedial in petroleum-based soft emollient cream once daily for three consecutive days.

• #1 Farm Health Online – Animal Health and Welfare Knowledge Hub – Orf

  https://www.farmhealthonline.com/US/disease-management/sheep-diseases/orf/

  Orf is a highly contagious eruptive skin condition of sheep and goats, but various other ruminants and mammals have been reported to be infected as well. […] The orf virus primarily affects the skin around the mouth, and under normal circumstances is resolved in 4 to 6 weeks. […] Orf is a contagious virus that usually causes scabs and lesions in the mouth and gums of the infected animal. It mainly affects animals in the first year of their life, however, infected lambs can transmit the virus to the ewes udders while suckling. […] At present there is no practical means of killing the virus once it is established in the animal, although there is some experimental evidence of a reduction in lesion severity with an antiviral drug. However, orf is a self-limited disease and symptomatic treatment with dressings and local antiseptics are very helpful.

• #1 Orf | Infonet Biovision Home.

  https://infonet-biovision.org/animal-health-and-disease/young-animals-lamb-and-kids-problems-new/orf

  Orf is caused by a virus that can be found wherever sheep and goats are kept. There is no specific treatment against Orf. […] The most important treatment measure is to assist Orf lambs/kids with suckling and bottle feed them if necessary until they resume suckling milk. The second most important treatment measure is to provide a clean and dry environment for sick lambs/kids, this reduces the risk of bacteria infecting the Orf lesions. The third measure is to treat Orf lesions infected by bacteria by putting wound ointment (antibiotic creme or iodine) on the lesions to support the healing improves. In severe cases (weak lambs/kids) it becomes necessary to inject Penicillin to stop bacteria from infecting the lesions and making them worse. […] Complete healing of the lesions takes a few weeks. Older lambs and kids will infect the younger ones and an Orf outbreak in a lambing herd can last for 6 8 weeks.

• #1 Farm Health Online – Animal Health and Welfare Knowledge Hub – Orf

  https://www.farmhealthonline.com/US/disease-management/sheep-diseases/orf/

  Live orf vaccines are available, which are prepared from infectious scab material. These vaccines are applied by scarification and cause mild Orf lesions. However, protection is not lasting, although outbreaks that follow vaccination are milder and of short duration. […] Treatment of the scabby lesions with herbal remedies may help. Of these, plant oils obtained from sesame, castor, juice of Calotropis procera and Euphorbia spp. have been found to be effective in the treatment of orf infection in India and African subcontinents. […] Orf can affect sheep of all ages and has serious welfare implications. It causes scabs and lesions usually in the mouth area, but can affect udders and feet as well. There isn’t a cure to get rid of the virus once it has become established in the animal; however, the secondary infections can be treated. […] If there is a known problem with orf on the farm measures have to be taken to eliminate the disease from the flock as part of the overall flock health plan.

• #1 Scabby mouth (orf) | Sheep diseases | Animal diseases | Biosecurity | Agriculture Victoria

  https://agriculture.vic.gov.au/biosecurity/animal-diseases/sheep-diseases/scabby-mouth-orf

  The disease in sheep and goats is normally self-limiting and clears without treatment within 3 to 4 weeks. […] Early manual removal of scabs will delay healing. […] Antibiotics are not necessary unless secondary bacterial infection occurs. […] A scabby mouth vaccine is readily available and provides good protection from the disease. […] The recommended program for a property with continuing scabby mouth problems is to vaccinate each year’s drop of lambs. This can be done at marking and will provide protection for up to 18 months.

• #1 Soremouth (Orf) in Small Ruminants | OSU Small Ruminant Team

  https://u.osu.edu/sheep/2019/04/23/soremouth-orf-in-small-ruminants/

  The vaccine should not be used on farms where soremouth has never been known to occur, as it will introduce the disease to the premises and necessitate annual re-vaccination. […] Pregnant females can be vaccinated two months prior to lambing or kidding to prevent natural soremouth from occurring during the nursing period. […] In herds where buying or showing of animals occurs regularly, vaccination helps to prevent occurrence of a soremouth outbreak during the show season.

• #1 Orf Virus in Humans: Case Series and Clinical Review | MDedge

  https://blogs.the-hospitalist.org/content/orf-virus-humans-case-series-and-clinical-review

  Vaccinations are available for animals to prevent the spread of infection in the flock, but there are no formulations of vaccines for human use. Prevention of spread to humans can be done through animal vaccination, careful handling of animal products while wearing nonporous gloves, and proper sanitation techniques. […] Orf has an excellent long-term prognosis in immunocompetent patients, as the virus is epitheliotropic, and inoculation does not lead to viremia. […] Although lesions typically are asymptomatic in most patients, complications can occur, especially in immunosuppressed individuals. These complications include systemic symptoms, giant persistent lesions prone to infection or scarring, erysipelas, lymphadenitis, and erythema multiforme. […] Long-term prognosis is still good in these patients with appropriate disease recognition and treatment. Reinfection is not uncommon with repeated exposure to the source, but lesions are less severe and resolve faster than with initial infection.

• #1 Orf (ecthyma contagiosum, scabby mouth [in animals]) – Dermatology Advisor

  https://www.dermatologyadvisor.com/home/decision-support-in-medicine/dermatology/orf-ecthyma-contagiosum-scabby-mouth-in-animals/

  No special management is required in patients with normal immune systems. They should be counseled about using gloves and proper hand hygiene when handling infected animals in the future (patients can get reinfected). […] If systemic symptoms (fever, rigors, poor appetite), or a sudden worsening of local symptoms (spreading erythema, pain, lymphadenopathy) develop, suspicion for bacterial superinfection should be heightened and coverage for staphyloccocal and streptococcal pathogens should be initiated. […] Giant orf, which is progressive in nature and found in patients with poor immune function, requires medical, and possibly surgical, intervention. As described above, the use of imiquimod, intralesional cidofovir, and/or surgical debridement may be necessary.

• #1 Giant Orf with Prolonged Recovery in a Patient with Psoriatic Arthritis Treated with Etanercept | HTML | Acta Dermato-Venereologica

  https://www.medicaljournals.se/acta/content/html/10.2340/00015555-1514

  Orf, also known as contagious ecthyma or contagious pustular dermatitis, is a viral skin infection caused by a parapoxvirus. […] In immunocompromised patients the infection many cause lesions with excessive growth and be long-lasting and difficult to treat. […] Several cases of orf have been reported in patients using immunosuppressive medications, such as glucocorticoids, cyclosporine, mycophenolate and tacrolimus, after transplantations, but to our knowledge this is the first report of giant orf in a patient treated with a tumour necrosis factor (TNF) inhibitor. […] As only a few cases of giant orf have been reported in immunosuppressed patients, management of this patient category has not been clearly established. […] In single cases, treatment with topical cidofovir or imiquimod has been successful, and the use of cryotherapy and surgical excision has also been described.

• #1 Orf disease in a patient with rheumatoid arthritis | MJR – Mediterranean Journal of Rheumatology

  https://www.mjrheum.org/june-2018/newsid792/128/showfulltext792/1

  Orf disease is a viral infection, affecting patients being involved in the care of livestock either professionally or habitually. […] The patient was successfully treated with doxycycline, while immunosuppressive treatment was discontinued. […] The diagnosis of Orf disease in an immunocompromised patient was made in a patient with a history of occupational exposure to sheep. […] In the case of our patient, discontinuation of immunosuppressive drugs was enough for the cure of Orf disease. […] Orf disease is benign and self-limiting, but the administration of immunosuppressive therapy can lead to chronicity with the risk of secondary bacterial infection.

• #1 Orf Virus: A New Class of Immunotherapy Drugs | IntechOpen

  https://www.intechopen.com/chapters/64011

  Orf is one of the most widespread viral diseases worldwide, usually benign and self-limiting, and mainly affects not only sheep and goats, but also various other ruminants and mammals. […] Currently, ORFV has been developed as vaccines in veterinary field. The unique host immune escape ability obtained by ORFV has made it one of the important candidates for prevention and treatment of various diseases (including chronic viral diseases, tumor, and liver fibrosis). […] The treatment for human orf is often focused on secondary infection. Previous reports have described speeding up the healing process with topical imiquimod and the antiviral cidofovir cream. Cryotherapy has also been used successfully to treat orf cases, especially in immunocompromised patients. […] In veterinary medicine, ORFV is widely used as a new type of preventive and immunomodulatory preparation. Activated or inactivated ORFV preparations have a dose-dependent immunomodulatory function.

• #1 Development of attenuated Orf virus as a safe oncolytic viral vector for nasopharyngeal carcinoma treatment | Virology Journal | Full Text

  https://virologyj.biomedcentral.com/articles/10.1186/s12985-025-02672-3

  Orf virus (ORFV) is gaining attention as a promising viral vector for cancer therapy because of its unique properties. Recent studies have shown that ORFV could be effective against various cancers, particularly nasopharyngeal carcinoma. This research explores the ability of wild-type ORFV and recombinant ORFVs, which lack specific virulence factors, to kill NPC cells and modulate the immune response. […] ORFV, particularly the wild-type and CBP-deleted variants, has significant potential as an oncolytic viral vector for NPC therapy. It induces cell death via pyroptosis and enhances immune-mediated tumor cell destruction through NK cells. The attenuated CBP-deleted ORFV offers a safer and effective option for cancer treatment, making it a promising candidate for future therapeutic applications.

• #1 Human Orf Virus Infection from Household Exposures — United States, 2009–2011

  https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6114a3.htm

  Orf, also known as contagious ecthyma, is a zoonotic infection caused by a dermatotropic parapoxvirus that commonly infects sheep and goats; it is transmitted to humans through contact with an infected animal or fomites. […] Cases lacking these exposure histories might be misdiagnosed, leading to unnecessary treatment of orf lesions, which do not usually require any specific treatment. […] Orf should be included in the differential diagnosis of patients with clinically compatible skin lesions and a history of household meat processing or animal slaughter. […] Treatment consists of basic wound care, but case reports suggest that topical imiquimod might facilitate healing, especially in immunocompromised patients. […] Orf virus infection should be included in the differential diagnosis of patients with clinically compatible skin lesions and a history of household meat processing or animal slaughter.

• #2 Orf (disease) – Wikipedia

  https://en.wikipedia.org/wiki/Orf_(disease)

  Orf is a farmyard pox, a type of zoonosis. It causes small pustules in the skin of primarily sheep and goats, but can also occur on the hands of humans. A pale halo forms around a red centre. It may persist for several weeks before crusting and then either resolves or leaves a granuloma. There is usually only one non-painful lesion, but there can be more. Lymph nodes may also become swollen. […] Generally, once infected, treatment options are limited. Injecting the lesion with cidofovir or applying imiquimod has been studied. However, it is sometimes required to excise the pustules. The vaccine used in sheep to prevent orf is live and has been known to cause disease in humans. […] While orf is usually a benign self-limiting illness which resolves in 3-6 weeks, in the immunocompromised it can be very progressive and even life-threatening. One percent topical cidofovir has been successfully used in a few patients with progressive disease. Serious damage may be inflicted on the eye if it is infected by orf, even among otherwise healthy patients.

• #2 Human Orf with Immune-Mediated Reactions: A Systematic Review

  https://www.mdpi.com/2076-2607/11/5/1138

  Orf is a highly contagious zoonosis caused by Orf virus (ORFV), which is endemic in sheep and goats worldwide. Human Orf is usually a self-limiting disease, but potential complications, including immune-mediated reactions, may occur. A total of 12 (27.3%) patients received a local or systemic treatment for primary lesions. Surgical removal of primary lesion was described in two cases (4.5%). Orf-immune-mediated reactions were treated in 22 cases (50.0%), mostly with topical corticosteroids (12, 70.6%). Clinical improvement was reported for all cases. The main highlight of our work is the presentation of complicated Orf from an infectious diseases specialist’s point of view. A better understanding of the disease and its complications is essential to achieve the correct management of cases.

• #2

  https://dermnetnz.org/topics/orf

  No specific treatment is necessary in most cases, as orf usually clears up by itself in about 6 weeks. The lesion should be covered to prevent contaminating the environment or other people, although person-to-person spread is very uncommon. […] Imiquimod cream has been reported to be effective in a few cases of orf.

• #2 About Orf Virus (Sore Mouth Disease) | Orf | CDC

  https://www.cdc.gov/orf-virus/about/index.html

  There is no specific treatment to cure orf virus infection. But it’s important to protect the sores from getting infected with other germs. […] Keep the sores dry and covered with a bandage. Use a bandage that keeps water out when working with animals or doing manual labor. If your sores are dry at bedtime, keep them uncovered while you sleep. If they are wet, cover sores loosely with a bandage. This will help them heal faster. […] See your doctor if you have pain, fever or if your sores are getting bigger or spreading. If this occurs, it could mean your sores are due to a different, more serious germ. Your doctor can help determine what’s going on.

• #2 Human orf

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5638474/

  Orf is one of the most widespread viral diseases worldwide and is caused by Parapoxvirus. It can be transmitted to humans from goats, deer, sheep, and cattle. Orf (also known as ecthyma contagiosum) can be transmitted to people who have direct contact with infected animals and it manifests as a erythematous maculopapular lesion. Human orf is usually self-limiting and no specific treatment is needed. Complications are due to misdiagnosis of this infection and, as a result, it being overtreated, specifically by surgical debridement. […] The diagnosis of orf was made based on the clinical findings: the history of exposure to goats and sheep, as well as the appearance of the typical cutaneous lesions. […] No treatment, including surgical debridement, is necessary, as the disease is self-limiting. The common approach to treat ulcers with surgical debridement is considered unnecessary in cases of human orf because it might cause scarring and prolong the recovery period. The lesion should be kept clean with antiseptic solution to avoid a secondary bacterial infection.

• #2 Vet Times: Latest Veterinary News, Jobs & Clinical Resources

  https://www.vettimes.com/news/vets/livestock/diagnosis-andtreatment-of-orf

  When I used to do a meat inspection for an hour each week, I came across a case of orf in one of the slaughtermen. […] I always advise clients to wear rubber gloves when dealing with the disease. […] Philip Scott, reader in division of veterinary clinical sciences at the University of Edinburgh, has done some excellent evidence based medicine that shows the beneficial effects of intramuscular injections of procaine penicillin in severe cases of orf. […] Clinicians should beware. The main concern would be in mixed sheep flocks and goat herds. If orf is seen in small mixed groups on hobby farms, aggressive antibiotic therapy should be implemented. […] I always advise procaine penicillin in severe cases of orf. […] I normally suggest Battles Summer Fly Cream, but other treatments have exhibited success.

• #2 Severe Orf in Lambs: Clinical Description and Response to Treatment against Secondary Infection

  https://www.jscimedcentral.com/jounal-article-info/Journal-of-Veterinary-Medicine-and-Research/Severe-Orf-in-Lambs%3A-Clinical–Description-and-Response-to–Treatment-against-Secondary–Infection-9509

  The good prognosis to treatment did demonstrate that a combination of broad spectrum parenteral procaine penicillin and dihydrostreptomycin sulphate and topical application of 1,5 pentanedial in petrolatum based soft emollient cream is effective in the treatment against secondary infection during orf cases. […] This study established that parenteral procaine penicillin and dihydrostreptomycin sulphate and topical application of 1,5 pentanedial in petroleum based soft emollient cream is effective in the treatment against secondary infections that followed during an orf outbreak in lambs.

• #2 Orf Viral Infection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562191/

  Most cases rarely require anything more than reassurance and expectant care. However, in immunocompromised hosts, Orf can grow to several centimeters, and the resultant morphology may mimic those of tumors and pyogenic granuloma, which may require further management. […] Because Orfviridae utilizes a novel viral form of DNA-dependent RNA polymerase, topical cidofovir (a potent blocker of this enzyme) has found almost ubiquitous use as first-line antiviral therapy, along with mechanical eradication (eg, cryotherapy, imiquimod) if needed. […] Clinicians have employed systemic interferon- to treat immunocompromised patients. […] Additionally, proposed effective treatments include antiviral agents that inhibit nucleoside. […] A review of therapeutic options for orf virus, among other poxviruses, found multiple medications that may be considered treatment options for the infection.

• #2 A Review on Human Orf: A Neglected Viral Zoonosis | RRTM

  https://www.dovepress.com/a-review-on-human-orf-a-neglected-viral-zoonosis-peer-reviewed-fulltext-article-RRTM

  Orf or EC is generally assumed to be self-limiting among immunocompetent humans with no scarring after about 8 weeks and there is no specific choice of therapy. In most cases, the prognosis of Orf is excellent. Supportive therapy typically consists of local antiseptics and dressings are applied to minimize secondary bacterial infections as needed. Sometimes if the lesion appears on a finger, it may be important to immobilize the affected finger and antibiotics may be recommended to prevent bacterial infections. […] Orf has been reported resolving with only supportive care in burn patients. Cryotherapy using liquid nitrogen facilitates recovery from Orf. Mortality from Orf has not been reported in humans. […] For diagnostic as well as therapeutic purposes, shave excision technique may be employed to remove portions of Orf lesions. For large, out-growing lesions, surgical dissection from the underlying dermis has been described. If the lesion is persistent and refractory, curettage and electro-desiccation can be employed as curative operations. In severe Orf cases on the fingers, amputation may be performed. However, it is only advised as a last chance remedy. In certain instances, the lesion is outsized with ulceration and necrosis that may become refractory to treatments and require amputation. Recurrences and delayed healing have been reported after surgical treatment. Generally, surgical procedures are usually reserved for immunocompromised patients who do not have the capacity to respond to more conservative measures.

• #2 Human orf

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5638474/

  Human orf is a benign infection and its diagnosis can be based on clinical findings to avoid unnecessary expensive testing and invasive treatment. The disease is self-limiting and clears without treatment within several weeks. Surgical debridement should be avoided because it can lead to scarring and prolong the recovery period. The lesion should be kept clean with antiseptic solution to avoid a secondary bacterial infection.

• #2 Farm Health Online – Animal Health and Welfare Knowledge Hub – Orf

  https://www.farmhealthonline.com/US/disease-management/sheep-diseases/orf/

  Live orf vaccines are available, which are prepared from infectious scab material. These vaccines are applied by scarification and cause mild Orf lesions. However, protection is not lasting, although outbreaks that follow vaccination are milder and of short duration. […] Treatment of the scabby lesions with herbal remedies may help. Of these, plant oils obtained from sesame, castor, juice of Calotropis procera and Euphorbia spp. have been found to be effective in the treatment of orf infection in India and African subcontinents. […] Orf can affect sheep of all ages and has serious welfare implications. It causes scabs and lesions usually in the mouth area, but can affect udders and feet as well. There isn’t a cure to get rid of the virus once it has become established in the animal; however, the secondary infections can be treated. […] If there is a known problem with orf on the farm measures have to be taken to eliminate the disease from the flock as part of the overall flock health plan.

• #2 Orf | Infonet Biovision Home.

  https://infonet-biovision.org/animal-health-and-disease/young-animals-lamb-and-kids-problems-new/orf

  Orf is caused by a virus that can be found wherever sheep and goats are kept. There is no specific treatment against Orf. […] The most important treatment measure is to assist Orf lambs/kids with suckling and bottle feed them if necessary until they resume suckling milk. The second most important treatment measure is to provide a clean and dry environment for sick lambs/kids, this reduces the risk of bacteria infecting the Orf lesions. The third measure is to treat Orf lesions infected by bacteria by putting wound ointment (antibiotic creme or iodine) on the lesions to support the healing improves. In severe cases (weak lambs/kids) it becomes necessary to inject Penicillin to stop bacteria from infecting the lesions and making them worse. […] Complete healing of the lesions takes a few weeks. Older lambs and kids will infect the younger ones and an Orf outbreak in a lambing herd can last for 6 8 weeks.

• #2 Farm Health Online – Animal Health and Welfare Knowledge Hub – Orf in Goats

  https://www.farmhealthonline.com/US/disease-management/goat-diseases/orf-in-goats/

  Orf (also known as contagious ecthyma, scabby mouth, contagious pustular dermatitis, or sore mouth) is a viral skin and mucosae disease which causes scabby lesions usually around the area of the mouth, lips and nose (Spyrou and Valiakos, 2015). […] Orf is a global pathogen which causes significant financial losses in livestock production as the lesions often jeopardize optimum productivity, and reduce the market value of meat. Severe lesions can interfere with feeding, or if the teats and/or udder are infected, it may lead to abandonment of offspring (Nandi et al., 2011). […] If orf is a problem then vaccination is possible to reduce the severity of the disease. Orf vaccine contains live virus so must be administered with extra care. […] There is no treatment available for orf as it is a primary viral infection. However treatment with local antiseptics and pain relief can be helpful for secondary infections. […] Few traditional herbal therapies have been attempted in orf virus infection including plant oils from sesame, juice from Euphorbia spp., and in France and the Netherlands common holly plant (Ilex aquifolium) is used for curing and preventing orf (Nandi et al., 2011).

• #2

  https://111.wales.nhs.uk/Orf/

  Orf is a skin infection you can get from infected sheep or goats. It usually clears up without treatment in about 6 weeks. […] There’s no specific treatment for orf. […] The blister on your skin should clear up in around 6 weeks. Cover it with a waterproof dressing to keep it clean and dry and stop it getting infected. […] If it becomes infected, you may need antibiotics. […] Rarely, minor surgery may be needed to remove the affected area of skin if it does not clear up by itself.

• #2 Better orf control

  https://www.lamlac.co.uk/resources/lambing-advice/view,better-orf-control_70.htm

  In addition to vaccinating lambs against orf, flock managers who have previously seen the disease on their farm should consider ewe vaccination not less than seven weeks before lambing to help avoid poor lamb growth rates and increased mastitis. […] Its led to the conclusion that, ideally, both ewes and lambs should be vaccinated. […] Where orf has been confirmed in a flock, vaccination of lambs and ewes offers sheep producers an effective disease management approach when administered correctly. […] Pregnant ewes should not be vaccinated less than seven weeks before housing or lambing. This will allow them to develop sufficient immunity while preventing contamination of the environment from virus-infected scabs that may be shed. […] Immunity develops within four to eight weeks after vaccination, but the vaccine does not offer long-term protection so ewes need to be boosted annually. […] Lambs are born nave to the disease so always need to be vaccinated themselves from one day old.

• #2 Giant Orf with Prolonged Recovery in a Patient with Psoriatic Arthritis Treated with Etanercept | HTML | Acta Dermato-Venereologica

  https://www.medicaljournals.se/acta/content/html/10.2340/00015555-1514

  Therefore, surgical removal was chosen as initial treatment, being fully aware that some degree of scarring could be expected at the site of surgery. […] Three weeks after surgery there were signs of progression of the finger lesion, and 6 satellite tumours had appeared in the temporal region. […] Therefore, cryotherapy was also applied here, and treatment with imiquimod was started on all lesions. […] Over this period the lesions gradually diminished, until they finally disappeared 17 weeks after start of therapy, i.e. 30 weeks after the patient had discovered the first tumour. […] This suggests that etanercept both increased the susceptibility of orf and contributed to the excessive growth of the tumour in our patient. […] Moreover, this case demonstrates the effect of an integrated treatment consisting of tumour excision, cryotherapy and imiquimod. […] However, even though intensive therapy was started and the etanercept was swiftly discontinued, the recovery phase was remarkably prolonged.

• #2 Orf Virus: A New Class of Immunotherapy Drugs | IntechOpen

  https://www.intechopen.com/chapters/64011

  The ORFV has significant antifibrous activity in CCL4-mediated liver fibrosis. The inactivated ORFV agents with a low dose (only 500,000 virus particles) are more effective in transgenic mice than the standard 3TC for HBV infection; thus, it can be used as the candidate antiviral agent for the treatment of human HBV. […] Live or inactivated ORFV induces antitumor immune responses in multiple tumor models. […] Therefore, ORFV has been used in veterinary medicine as preventive and therapeutic immunomodulatory agents. Moreover, live or inactivated ORFV preparations exhibit immunomodulatory effects, with therapeutic efficacy demonstrated for various diseases, including infectious diseases and tumors.

• #2 Orf Virus in Humans: Case Series and Clinical Review | MDedge

  https://blogs.the-hospitalist.org/content/orf-virus-humans-case-series-and-clinical-review

  A patient presenting with a hand pustule is a phenomenon encountered worldwide requiring careful history-taking. […] Recognizing orf virus as the etiology of a cutaneous hand pustule in patients is important, as misdiagnosis can lead to unnecessary invasive testing and/or treatments with suboptimal clinical outcomes. […] Because of the self-resolving nature of orf, treatment usually is not needed in immunocompetent patients with a solitary lesion. However, wound care is essential to prevent secondary infections of the lesion. If secondarily infected, topical or oral antibiotics may be prescribed. Immunocompromised individuals are at increased risk for developing large persistent lesions and sometimes require intervention for successful treatment. Several successful treatment methods have been described and include intralesional interferon injections, electrocautery, topical imiquimod, topical cidofovir, and cryotherapy.

• #2 Human Orf Virus Infection from Household Exposures — United States, 2009–2011

  https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6114a3.htm

  Most infections are self-limited, resolving in 4-8 weeks without scarring. […] Rapid diagnosis is critical for preventing unwarranted psychological stress, unnecessary surgeries, and inappropriate antibiotic use. […] Histopathology and microscopy can support a diagnosis of a parapoxvirus infection. PCR can definitively identify orf virus and is available at CDC.

• #3 Orf

  https://www.nhs.uk/conditions/orf/

  There’s no specific treatment for orf. […] The blister on your skin should clear up in around 6 weeks. Cover it with a waterproof dressing to keep it clean and dry and stop it getting infected. […] If it becomes infected, you may need antibiotics. […] Rarely, minor surgery may be needed to remove the affected area of skin if it does not clear up by itself.

• #3 Vet Times: Latest Veterinary News, Jobs & Clinical Resources

  https://www.vettimes.com/news/vets/livestock/diagnosis-andtreatment-of-orf

  The immunity obtained by the actual disease is very protective animals infected naturally are highly resistant to further infection. […] Nowadays, there is a worthwhile vaccine that involves scarification of the skin in the axillary region with a live vaccine. […] I would also advise against its use in pregnant animals, not because the vaccine would cause abortion, but because if young lambs become infected with the virus from the vaccine on their mouths, they may cause lesions on the udders of the ewes. […] I treat these cases very aggressively I give five days of intramuscular injections of procaine penicillin and streptomycin combination with a topical treatment of Battles Summer Fly Cream for the prepuce. […] It is sensible to warn farmers that sheepdogs can contract the disease from very close direct contact; the infection will go eventually, but the dogs suffer a very painful condition for two to three weeks.

• #3 Orf Viral Infection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562191/

  Cidofovir has demonstrated activity against multiple orthopox and parapox viruses. Animal models revealed its effectiveness in reducing the development of Orf lesions in lambs and rescuing mice with orf lesions. This agent has been used in humans for recalcitrant cases, primarily in immunocompromised patients.

• #3 Giant Orf with Prolonged Recovery in a Patient with Psoriatic Arthritis Treated with Etanercept | HTML | Acta Dermato-Venereologica

  https://www.medicaljournals.se/acta/content/html/10.2340/00015555-1514

  Orf, also known as contagious ecthyma or contagious pustular dermatitis, is a viral skin infection caused by a parapoxvirus. […] In immunocompromised patients the infection many cause lesions with excessive growth and be long-lasting and difficult to treat. […] Several cases of orf have been reported in patients using immunosuppressive medications, such as glucocorticoids, cyclosporine, mycophenolate and tacrolimus, after transplantations, but to our knowledge this is the first report of giant orf in a patient treated with a tumour necrosis factor (TNF) inhibitor. […] As only a few cases of giant orf have been reported in immunosuppressed patients, management of this patient category has not been clearly established. […] In single cases, treatment with topical cidofovir or imiquimod has been successful, and the use of cryotherapy and surgical excision has also been described.

• #3 Orf – MSD Animal Health Republic of Ireland

  https://www.msd-animal-health.ie/species/sheep/orf/

  Orf is a contagious disease of sheep caused by a pox virus. […] The vaccine is useful in reduction of clinical disease. […] Treatment and segregation of clinical cases: Sheep farmers can apply antibiotic sprays on to larger lesions, while ensuring infected lambs receive sufficient milk and separating out the infected stock to slow down disease transmission to healthy animals is very important.

• #3 Best treatment for Orf? | The Farming Forum

  https://thefarmingforum.co.uk/index.php?threads/best-treatment-for-orf.227778/

  Yes – agree with @rancher, I’d be inclined to say make up a salt solution and spray it on once a week/fortnight which is a huge amount of work but better than the purple spray or an antibiotic treatment you don’t need. […] Interesting and simple solutions, thanks both. I use salty water to bathe cuts and grazes, but thought orf sores would need more oomph. Agree that orf hardly ever needs antibiotics.

• #3 Orf | Infonet Biovision Home.

  https://infonet-biovision.org/animal-health-and-disease/young-animals-lamb-and-kids-problems-new/orf

  Orf vaccine is available from KEVEVAPI and can be used in lambs as early as 3 days after birth. The vaccine is applied by scarification of the skin, not by injection. Wear gloves to protect your hands during vaccination. If the vaccine accidentally gets into the human skin through scratches / small wounds, it can cause a painful lesion. The vaccine cannot contain all types of Orf virus. Depending on the type of Orf that is present in your herd it may work well or be less effective.

• #3 A Review on Human Orf: A Neglected Viral Zoonosis | RRTM

  https://www.dovepress.com/a-review-on-human-orf-a-neglected-viral-zoonosis-peer-reviewed-fulltext-article-RRTM

  As ORFV is a DNA virus, it has a DNA dependent RNA polymerase. This enzyme serves as a target of antiviral drugs such as cidofovir. Cidofovir is a nucleotide analog that selectively inhibits viral DNA production in cytomegalovirus and other herpes viruses. The drug has been found almost ubiquitously used as a first-line antiviral therapy, along with mechanical excision of the Orf lesion. Cidofovir in cream and intravenous preparations were used in severe Orf cases, even though it is not approved for this use. The apparently successful use of cidofovir to treat a giant non-resolving ORFV infected lesion has been reported in an immunocompromised patient. The use of topical cidofovir cream has also been described due to its apparent benefit, despite the lack of controlled clinical trials to support this. Other reports described that Orf has been successfully treated with topical imiquimod application including in immunocompromised cases with very large Orf lesions. However, imiquimod, which is an immune response modifier, is not approved for treating ORFV infections. The product may induce secretions of interferon alpha and other cytokines where the mechanisms of action are not well elucidated. Generally, topical cidofovir or imiquimod have been particularly employed in patients with nonhealing or proliferative lesions, and immunocompromised. Interferon alpha-2a is another immune response modifier used rarely in Orf cases. It has antiviral, antiproliferative, and antiangiogenic properties and by so doing, it may stimulate the immune defense mechanism.

• #4 Severe Orf in Lambs: Clinical Description and Response to Treatment against Secondary Infection

  https://www.jscimedcentral.com/jounal-article-info/Journal-of-Veterinary-Medicine-and-Research/Severe-Orf-in-Lambs%3A-Clinical–Description-and-Response-to–Treatment-against-Secondary–Infection-9509

  In May 2014, severe disease affecting areas around the muzzle and the entire buccal mucosa was observed in two lambs from a flock of approximately 200 Highlander and Charolaise ewes. […] It was therefore deemed necessary to offer treatment against secondary infection. Both lambs responded very well to a combination of 200mg/kg procaine penicillin and 250mg/kg body weight dihydrostreptomycin sulphate and 1,5 pentanedial in petroleum based soft emollient cream administered once daily for three consecutive days. The treatment regime showed that secondary infection during severe orf cases can be treated with penicillin-streptomycin and petroleum based soft emollient cream in order to reduce losses associated with the disease. […] We therefore focused around the two lambs to try administering some treatment against secondary infection. To facilitate wound healing and treatment for secondary infection the two lambs were given an intramuscular injection of 200mg/kg body weight procaine penicillin and 250mg/kg body weight dihydrostreptomycin sulphate combined with 1,5 pentanedial in petroleum-based soft emollient cream once daily for three consecutive days.

• #4 A Review on Human Orf: A Neglected Viral Zoonosis | RRTM

  https://www.dovepress.com/a-review-on-human-orf-a-neglected-viral-zoonosis-peer-reviewed-fulltext-article-RRTM

  As ORFV is a DNA virus, it has a DNA dependent RNA polymerase. This enzyme serves as a target of antiviral drugs such as cidofovir. Cidofovir is a nucleotide analog that selectively inhibits viral DNA production in cytomegalovirus and other herpes viruses. The drug has been found almost ubiquitously used as a first-line antiviral therapy, along with mechanical excision of the Orf lesion. Cidofovir in cream and intravenous preparations were used in severe Orf cases, even though it is not approved for this use. The apparently successful use of cidofovir to treat a giant non-resolving ORFV infected lesion has been reported in an immunocompromised patient. The use of topical cidofovir cream has also been described due to its apparent benefit, despite the lack of controlled clinical trials to support this. Other reports described that Orf has been successfully treated with topical imiquimod application including in immunocompromised cases with very large Orf lesions. However, imiquimod, which is an immune response modifier, is not approved for treating ORFV infections. The product may induce secretions of interferon alpha and other cytokines where the mechanisms of action are not well elucidated. Generally, topical cidofovir or imiquimod have been particularly employed in patients with nonhealing or proliferative lesions, and immunocompromised. Interferon alpha-2a is another immune response modifier used rarely in Orf cases. It has antiviral, antiproliferative, and antiangiogenic properties and by so doing, it may stimulate the immune defense mechanism.

• #4 Giant Orf with Prolonged Recovery in a Patient with Psoriatic Arthritis Treated with Etanercept | HTML | Acta Dermato-Venereologica

  https://www.medicaljournals.se/acta/content/html/10.2340/00015555-1514

  Therefore, surgical removal was chosen as initial treatment, being fully aware that some degree of scarring could be expected at the site of surgery. […] Three weeks after surgery there were signs of progression of the finger lesion, and 6 satellite tumours had appeared in the temporal region. […] Therefore, cryotherapy was also applied here, and treatment with imiquimod was started on all lesions. […] Over this period the lesions gradually diminished, until they finally disappeared 17 weeks after start of therapy, i.e. 30 weeks after the patient had discovered the first tumour. […] This suggests that etanercept both increased the susceptibility of orf and contributed to the excessive growth of the tumour in our patient. […] Moreover, this case demonstrates the effect of an integrated treatment consisting of tumour excision, cryotherapy and imiquimod. […] However, even though intensive therapy was started and the etanercept was swiftly discontinued, the recovery phase was remarkably prolonged.

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