Buffalopox outbreak in humans and animals in Western Maharashtra, India.

An outbreak of febrile illness with rash was reported in humans and buffaloes with pox lesions in some villages of Solapur and Kolhapur districts of Maharashtra state, India. Detailed clinico-epidemiological investigations were done with collection of blood, vesicular fluid and scab from humans and animals. A total of 166 suspected human cases from Kasegaon village in Solapur district and 185 cases were reported from 21 different villages from Kolhapur district. The attack rate in humans in Kasegaon village was 6.6% while in Kolhapur district the attack rate for buffaloes was 11.7%. Pox-like lesions were associated with fever, malaise, pain at site of lesion and axillary and inguinal lymphadenopathy in the humans. Infected buffaloes had lesions on teats, udders, external ears and eyelids. Laboratory investigations included detection of Buffalopox virus (BPXV) by electron microscopy (EM), virus isolation and polymerase chain reaction (PCR). Presence of BPXV was confirmed in 7 human cases and one buffalo in Kasegaon and 14 human cases from Kolhapur. The virus was isolated from 3 clinical specimens and Orthopoxvirus (OPXV) particles could be observed in EM. Thus, BPXV was identified as the etiological agent of the outbreak among both humans and buffaloes. Phylogenetic analysis based on the ATI and C18L gene revealed that a single strain of virus is circulating in India. Re-emergence of OPXV like BPXV is a real danger and contingency planning is needed to define prophylactic and therapeutic strategies to prevent or stop an epidemic. Considering the productivity losses caused by buffalopox infection and its zoonotic impact, the importance of control measures in reducing the economic and public health impact cannot be underestimated.