Eid Al Adha and Orf virus infections: Take extra caution while selecting animals for sacrifice during Bakrid

Sheep-to-Human Transmission of Orf Virus during Eid al-Adha Religious Practices

Five persons in France were infected with Orf virus after skin wounds were exposed to infected sheep tissues during Eid al-Adha, the Muslim Feast of Sacrifice. Infections were confirmed by electron microscopy, PCR, and sequence analysis. Prevention and control of this underdiagnosed disease can be achieved by educating physicians, slaughterhouse workers, and persons participating in Eid al-Adha.

Although human Orf virus infections have typically been associated with occupational animal contact, they also have been linked to Muslim religious practices and, more globally, to household meat processing or animal slaughter, reports senior researcher Antoine Nougairede in Emerging Infectious Diseases of the CDC.

Our findings show that clinical microbiology laboratories (other than national reference centers) can accurately detect and identify poxviruses by using EM and broad-spectrum PCR. Our results also suggest that PCR is highly sensitive for detection of poxviruses, and they show that samples obtained by Virocult swab are well-suited for detection of Orf virus by EM or PCR and could replace more invasive methods (e.g., skin biopsy).

The finest, unblemished animals (e.g., cows, goats, sheep) were initially reserved for the ritual sacrifice during Eid al-Adha. Today, however, Muslims in developed countries (especially in cities) mostly buy lambs, which are cheaper and more plentiful but also highly susceptible to Orf virus infections. This change in buying practices has created a large market for possibly infected animals and an associated potential health risk for persons who butcher and prepare the animals.

The cases reported here stress the need for using appropriate measures to prevent animal-to-human transmission of pathogens. Public health officials should educate persons with occupational or household exposure to animals about the possibility for disease transmission and ways to avoid infection.

Persons at increased risk for exposure to Orf virus include livestock owners, slaughterhouse workers, and persons who prepare animals at home for religious practices. Persons who handle animals should wear nonpermeable gloves, avoid exposure of open wounds, and meticulously wash skin wounds with soap and water after handling animals.

In addition, slaughterhouses should verify that all animals to be sold or butchered are in good health; animals with Orf virus lesions should be disposed of in a safe manner. Physicians, including dermatologists, should be informed of the potential for Orf virus infection, a heretofore underdiagnosed disease, and suspected infections should be confirmed by microbiology laboratories. The first 3 cases presented here were rapidly diagnosed, and emergency department physicians were promptly advised of the cases, enabling rapid detection and confirmation of the subsequent cases.