Department of Dermatology, Ghent University, Ghent University Hospital, Ghent, Belgium.
Department of General Internal Medicine and Infectious Diseases, Ghent University, Ghent University Hospital, Ghent, Belgium.
Acta Clin Belg. 2023 Apr;78(2):180-184. doi: 10.1080/17843286.2022.2090181. Epub 2022 Jun 22.
Human cowpox virus infection is a rare zoonotic disease. Cowpox virus is a member of the Orthopoxvirus genus, like smallpox. Over the last years records of cowpox virus transmission from pet cats and pet rats to humans in Europe have increased. This observation may result from the loss of cross-immunity against orthopoxviruses after discontinuation of routine smallpox vaccination in the 1980s.
We report the first case of a human cowpox infection in an unvaccinated Belgian citizen. This 19-year-old student presented with multiple necrotic skin lesions on the chin, the scalp and the pubic region, and with cervical lymphadenopathy and flu-like symptoms. The diagnosis of human cowpox was based on electron microscopic findings and PCR examination performed on a skin biopsy of the pubic lesion. Close contact with cats (her domestic cats or cats from a local shelter) was probably the source of transmission. Spreading of the lesions was likely the result of autoinoculation. After six months all lesions spontaneously healed with atrophic scars.
To enhance awareness of this rare viral zoonosis and to verify the suspected increase in incidence and symptom severity after cessation of smallpox vaccination, one could argue whether human cowpox should become a notifiable disease.
人类牛痘病毒感染是一种罕见的人畜共患病。牛痘病毒是正痘病毒属的一员，与天花病毒相似。近年来，在欧洲，有记录表明宠物猫和宠物鼠将牛痘病毒传播给人类的情况有所增加。这种观察结果可能是由于 20 世纪 80 年代常规天花疫苗接种停止后，针对正痘病毒的交叉免疫力丧失所致。
我们报告了首例在未接种疫苗的比利时公民中发生的人类牛痘感染病例。这位 19 岁的学生出现下巴、头皮和会阴部多个坏死性皮肤损伤，伴有颈部淋巴结病和流感样症状。人牛痘的诊断基于电子显微镜检查结果和对会阴部皮肤活检进行的 PCR 检查。与猫（她的家猫或当地收容所的猫）的密切接触可能是传播的来源。病变的扩散可能是自身接种的结果。六个月后，所有病变均自行愈合，留下萎缩性瘢痕。
为了提高对这种罕见的病毒性人畜共患病的认识，并验证天花疫苗接种停止后发病率和症状严重程度疑似增加的情况，人们可以争论是否应将人类牛痘病列为应报告的疾病。
