Uncommon cutaneous manifestations in buffalopox

Abstract

Context: Buffalopox is a zoonotic disease caused by buffalopox virus. The natural host being buffaloes, it has been known to infect cows and humans as well. Recent trends suggest that increasing numbers of outbreaks in the Indian subcontinent are being recorded, but awareness about diagnosis, treatment and preventive measures in humans is much less. Aim: To report the rare occurrence of lesions in humans at atypical sites like face and eyes and also indirectly involving non-milkers. Methods and Material: The study was carried out in Dhule, Maharashtra where twenty-eight patients were diagnosed with the condition based on history and clinical examination. The diagnosis was confirmed by viral nucleotide sequencing by polymerase chain reaction. Results: Total twenty-eight patients were diagnosed with buffalopox with a male predominance. Most of them were milkers but two children who were not directly involved in milking were also affected. Lesions were mostly present over hands and forearms. We found involvement of atypical sites like face and eyes in some patients. Prophylactic antibiotic treatment was given, draining of pus and debridement done and hygienic practices like use of gloves were promoted. Conclusions: Early interventions in such conditions help limit the disease itself; however, the involvement of children and presentation of atypical sites may indicate increased virulence of the virus. This may lead to a severe epidemic in the future. Atypical presentations, and new sites of development of clinical lesions should be kept in mind. Awareness should be created regarding the emergence of poxvirus infections in future.