Images in Clinical Tropical Medicine: Vaccinia Virus in Humans and Cattle in Southwest Region of São Paulo State, Brazil

Abstract

A new outbreak of Vaccinia virus was observed in Southwest region of Sao Paulo State, Brazil. The disease was observed in small dairy farms with manual milking. Lesions in cattle were observed on teats and udder (Figure 1) characterized by vesicules and ulcers. Milkers presented lesions on hands and one child, 11 years of age, presented lesions in mouth and nose. Age of the milkers ranged from 22 to 63 years of age. Three of them were previously vaccinated against smallpox. Lymphadenopathy, headache, and fever were reported, varying in severity and persisting for ∼2–5 days. Lesions in the ocular region were observed in one milker, 22 years of age, correlated with several lesions on the hands (Figure 2). Although several reports of Vaccinia virus outbreaks have been occurring in Brazil, 1,2 it was not yet reported in this region. The disease in persons previously vaccinated and not vaccinated against smallpox reinforces the absence of immunity and the risk to the human health.