Orf is a virus infection of the skin contracted from sheep and goats.
Orf is caused by a virus called the parapox virus, which infects mainly young lambs and goats who contract the infection from one another or possibly from persistence of the virus in the pastures. Human lesions are caused by direct inoculation of infected material.
Orf is not uncommon among sheep farmers, shearers, freezing workers, vets and farmers' wives or their children who bottle-feed lambs. Children may also acquire it from playing on infected pasture. Butchers, meat porters and housewives are sometimes infected from carcasses, especially sheep heads. A similar condition, caused by a related virus, occurs in dairy farmers and is called Milkers' Nodule.
After an incubation period of 5 or 6 days a small, firm, red or reddish-blue lump enlarges to form a flat-topped, blood-tinged pustule or blister. The fully developed lesion is usually 2 or 3 cm in diameter but may be as large as 5 cm. Characteristically, although there appears to be pus under the white skin, incising this will reveal firm, red tissue underneath. The orf lesion is sometimes irritable during the early stages and is often tender. Orf lesions are generally solitary or few in number. They occur most commonly on the fingers, hands or forearms but can appear on the face. Red streaks up the lymph channels with enlargement of the lymph glands on the inner side of the elbow and/or under the arm are not uncommon. There may be a mild fever.
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