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'''For patient information, click [[Sore mouth infection (patient information)|here]]'''
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{{Sore mouth infection}}
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'''''Related Key Words and Synonyms:''''' Orf virus, scabby mouth, or contagious ecthyma.
{{SK}} Orf virus; scabby mouth; contagious ecthyma


== Epidemiology and Demographics ==
==[[Sore mouth infection overview|Overview]]==
Geographically, “sore mouth” infection is commonly found throughout the world. According to the United States Department of Agriculture Animal and Plant Health Inspection Service's National Animal Health Monitoring System (USDA APHIS NAHMS) 2001 sheep survey, 40 percent of U.S. operations reported sore mouth infecting their flocks in the previous three years.


Sore mouth is generally found only in sheep and goats. Other ruminants that are occasionally infected include musk oxen and gazelles.
==[[Sore mouth infection pathophysiology|Pathophysiology]]==


== Risk Factors ==
==[[Sore mouth infection causes|Causes]]==
Since sore mouth is primarily an illness of sheep or goats, people who handle these animals are at greatest risk of infection. Specific activities that may put you at risk of infection include:


*Bottle feeding, tube feeding, or shearing animals (i.e., sheep or goats)
==[[Sore mouth infection differential diagnosis|Differentiating Sore mouth infection from other Diseases]]==
*Petting or having casual contact with infected animals
*Handling infected equipment
*Working with animals when you have an open cut or skin sore
*Being bitten by an infected animal


== Pathophysiology & Etiology==
==[[Sore mouth infection epidemiology and demographics|Epidemiology and Demographics]]==
[[Image:S. mouth in sheep farmers.jpg|left|thumb|280px|Sore mouth in sheep farmers.]]
“Sore mouth,” also known as “scabby mouth,” or contagious ecthyma, is a viral infection caused by a member of the '''poxvirus group (specifically orf virus)''' and is an infection primarily of sheep and goats. The scabs of infected animals contain virus, can fall off, remain in the environment and serve as a source of infection to susceptible animals.  A flock can become infected through contaminated bedding, feed or trucks, or by direct contact with infected animals (e.g. replacements brought onto the operation or at shows). 


Animals may become infected with sore mouth more than once in their lifetime although infections are likely to occur years apart. Young animals will have the most visible disease because they have not likely been exposed to the virus before and because their immune systems are still developing.
==[[Sore mouth infection risk factors|Risk Factors]]==


'''Can people become infected with sore mouth?'''
==[[Sore mouth infection natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


Yes, people can become infected with the virus that causes sore mouth. A person who comes into contact with virus from an infected animal or equipment (such as a harness that has rubbed the animal's sores) can potentially get infected. People often develop sores on their hands (see photos). The sore may be painful and can last for 2 months. People do not infect other people.  Sores usually heal without scarring.
==Diagnosis==


== Molecular Biology ==
[[Sore mouth infection history and symptoms|History and Symptoms]] | [[Sore mouth infection physical examination|Physical Examination]] | [[Sore mouth infection laboratory findings|Laboratory Findings]] | [[Sore mouth infection other diagnostic studies|Other Diagnostic Studies]]
[[Image:Orf virus.jpg|left|thumb|Orf virus--Image provide by Wikipedia]]


=== Differential Diagnosis ===
==Treatment==
Foot-and-mouth disease (FMD) is a serious disease that does resemble sore mouth and can affect sheep, goats, cattle, swine, and other "cloven-hoofed" animals.  Although FMD has not occurred in the United States since 1929, if there are symptoms you observe in your animals that appear more serious than sore mouth, immediately report it to your veterinarian, to State or Federal animal disease control officials, or to your county agricultural agent.


== Diagnosis ==
[[Sore mouth infection medical therapy|Medical Therapy]] | [[Sore mouth infection prevention|Prevention]] | [[Sore mouth infection cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Sore mouth infection future or investigational therapies|Future or Investigational Therapies]]


=== History and Symptoms ===
==Case Studies==
*Early in the infection [[sores]] appear as blisters and then become crusty scabs. 
[[Sore mouth infection case study one|Case #1]]
*[[Sores]] are typically found on the lips, muzzle, and in the mouth.
*Sheep and goats may get similar [[sores]]/[[scabs]] on the lower legs and the teats, especially when ewes or does are nursing infected lambs or kids.
*Except in rare cases, animals recover completely from sore mouth infections within a month.
*Young animals may have difficulty nursing/feeding and may require bottle or tube feeding. Nursing ewes may abandon their lambs, and older animals may also require nutritional support. 
*Particular breeds (e.g. Boer goats) may be especially susceptible and have severe infections. 


== Risk Stratification and Prognosis==
{{WH}}
Can an animal become infected with sore mouth more than once?
{{WS}}
Yes, animals may become infected more than once in their lifetime but repeat infections usually occur after a year's time and are usually less severe.
 
=== Primary Prevention ===
 
'''Is there a vaccination for sore mouth?'''
 
Currently, there are commercially available preparations of live virus marketed as vaccines. According to the 2001 NAHMS sheep survey, approximately 5 percent of operators reported using a vaccination for sore mouth in replacement or breeding ewes. More operators (14.0 percent) reported vaccinating their nursing lambs for orf.
 
'''There are measures that may help lessen the risk of infection. These include:'''
 
*Reduce the likelihood of mouth/muzzle cuts (e.g. remove thistle or harsh brush from grazing areas)
*Quarantine new animals until sore mouth can be ruled out
*Avoid bringing animals with sore mouth to public events such as fairs and shows
 
The sore mouth virus survives in soil, and carrier animals may not show symptoms; as a result it is difficult to prevent infection, but using the measures above may assist in prevention.
 
Sore mouth may be transmitted through saliva. Some owners choose to assist the judges at shows by opening their own animal's mouth. While there is no evidence to prove that this will prevent sore mouth, it is a logical measure to decrease the spread of sore mouth by indirect contact (i.e. from infected animal to judge’s hand to uninfected animal).
 
=== Secondary Prevention ===


What should I keep in mind when using a vaccine?
[[Category:Disease]]


Producers considering using an orf vaccine product in their flock should consult a veterinarian. Vaccination practices vary depending on breed and geographic location. Use of a vaccine is only suggested for previously infected flocks since the vaccination will cause an orf infection in the animals and lead to contamination of the operation with virus-containing scabs. Studies conducted by experts in Scotland suggest that if a vaccine product is used in a flock, it may decrease the severity of illness.
[[Category:Viral diseases]]
 
 
==References==
#http://www.cdc.gov/ncidod/dvrd/orf_virus/large_images/orf_kid.html
#http://en.wikipedia.org/wiki/Orf_%28animal_disease%29
 
== Acknowledgements ==
The content on this page was first contributed by: C. Michael Gibson, M.S., M.D.
 
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[[Category:Infectious disease]]
 
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Latest revision as of 19:05, 18 September 2017

For patient information, click here

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Orf virus; scabby mouth; contagious ecthyma

Overview

Pathophysiology

Causes

Differentiating Sore mouth infection from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

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Case #1

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