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Abstract
We report a case of atypical cowpox virus infection in France in 2016. The patient sought care for thoracic lesions after injury from the sharp end of a metallic guardrail previously stored in the ground. We isolated a cowpox virus from the lesions and sequenced its whole genome. The patient reported that he had been previously vaccinated against smallpox. We describe an alternative route of cowpox virus infection and raise questions about the immunological status of smallpox-vaccinated patients for circulating orthopoxviruses.
Highlights
We report a case of atypical cowpox virus infection in France in 2016
We report an atypical cowpox virus human infection in France in 2016, in which the patient had a pustular lesion on the laterothoracic area, but reported no direct contact with infected domestic or wild animals
We are aware that rats, mice, raccoons, and field and bank voles are all recognized as susceptible to cowpox virus, and some of these animals can be associated with human cowpox virus infections
Summary
We report a case of atypical cowpox virus infection in France in 2016. Cowpox virus infection in humans causes local cutaneous pustular affections, which may in some cases disseminate and become fatal in immunocompromised patients. Since the 2000s, cowpox virus infections in humans have been frequently associated with direct contact between patients and rodents [18,19,20,21], causing lesions mainly on the hands, arms, face, and neck. Human infection can occur through intermediate hosts, notably by domestic cats, which are commonly infected with cowpox virus through contact with rodents [22]. We report an atypical cowpox virus human infection in France in 2016, in which the patient had a pustular lesion on the laterothoracic area, but reported no direct contact with infected domestic or wild animals. We present our analysis of this novel viral strain, cowpox virus France Amiens 2016, describe its complete genome, review some morphological aspects of its infectious cycle, and discuss the probable way of transmission
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