Orf Virus Infection and Possible Secondary Human-to-Human Transmission

Figure

Photo: Gesundheitsamt Städteregion Aachen

A primary school-aged child presented to the dermatology department with a lesion on the finger (Figure a) 19 days after a visit to a sheep farm with the father. During close contact with the animals, a (likely infected) lamb had “nibbled” the child’s finger. Due to superinfection, surgical debridement and antibiotic therapy were performed. A similar lesion developed above the father’s upper lip 22 days after the visit to the sheep farm. Following manipulation, the lesion showed signs of superinfection (Figure b). Subsequent treatment consisted of acyclovir and intravenous antibiotic therapy. A sample from the father’s lesion tested positive for Orf virus in a species-specific qPCR assay. A further 10 days later, a painless lesion appeared on the nose of a sibling who had not had contact with the lambs. No further diagnostic assessment or specific treatment was undertaken. In all likelihood, this is a rare case of human-to-human transmission of Orf virus (ecthyma contagiosum), which often remains clinically inconspicuous. Lesions generally heal after several weeks without sequelae, as was the case with the individuals described here.

PD Dr. med. Monika Gube, Gesundheitsamt StädteRegion Aachen, Aachen, [e-mail]

Dr. med. Marc Fabian Juzek-Küpper, Zentralbereich für Krankenhaushygiene und Infektiologie, Universitätsklinikum Aachen (UKA), Aachen

PD Dr. med. vet. Donata Hoffmann, Institut für Virusdiagnostik, Friedrich-Loeffler-Institut, Greifswald – Insel Riems

Conflict of interest statement: The authors declare that no conflict of interests exists.

Translated from the original German by Christine Rye.

Cite this as: Gube M, Juzek-Küpper MF, Hoffmann D: Orf virus infection and possible secondary human-to-human transmission. Dtsch Arztebl Int 2026; 123: 225. DOI: 10.3238/arztebl.m2025.0236