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  1. Fulltext The interplay of climate, intervention and imported cases as determinants of the 2014 dengue outbreak in Guangzhou
    Cheng Q, Jing Q, Spear RC, Marshall JM, Yang Z, Gong P
    PLoS Negl Trop Dis, 2017 Jun;11(6):e0005701.
    PMID: 28640895 DOI: 10.1371/journal.pntd.0005701
    Dengue is a fast spreading mosquito-borne disease that affects more than half of the population worldwide. An unprecedented outbreak happened in Guangzhou, China in 2014, which contributed 52 percent of all dengue cases that occurred in mainland China between 1990 and 2015. Our previous analysis, based on a deterministic model, concluded that the early timing of the first imported case that triggered local transmission and the excessive rainfall thereafter were the most important determinants of the large final epidemic size in 2014. However, the deterministic model did not allow us to explore the driving force of the early local transmission. Here, we expand the model to include stochastic elements and calculate the successful invasion rate of cases that entered Guangzhou at different times under different climate and intervention scenarios. The conclusion is that the higher number of imported cases in May and June was responsible for the early outbreak instead of climate. Although the excessive rainfall in 2014 did increase the success rate, this effect was offset by the low initial water level caused by interventions in late 2013. The success rate is strongly dependent on mosquito abundance during the recovery period of the imported case, since the first step of a successful invasion is infecting at least one local mosquito. The average final epidemic size of successful invasion decreases exponentially with introduction time, which means if an imported case in early summer initiates the infection process, the final number infected can be extremely large. Therefore, dengue outbreaks occurring in Thailand, Singapore, Malaysia and Vietnam in early summer merit greater attention, since the travel volumes between Guangzhou and these countries are large. As the climate changes, destroying mosquito breeding sites in Guangzhou can mitigate the detrimental effects of the probable increase in rainfall in spring and summer.
    Matched MeSH terms: Disease Outbreaks/statistics & numerical data*
  2. Fulltext Passengers' destinations from China: low risk of Novel Coronavirus (2019-nCoV) transmission into Africa and South America
    Haider N, Yavlinsky A, Simons D, Osman AY, Ntoumi F, Zumla A, et al.
    Epidemiol Infect, 2020 02 26;148:e41.
    PMID: 32100667 DOI: 10.1017/S0950268820000424
    Novel Coronavirus (2019-nCoV [SARS-COV-2]) was detected in humans during the last week of December 2019 at Wuhan city in China, and caused 24 554 cases in 27 countries and territories as of 5 February 2020. The objective of this study was to estimate the risk of transmission of 2019-nCoV through human passenger air flight from four major cities of China (Wuhan, Beijing, Shanghai and Guangzhou) to the passengers' destination countries. We extracted the weekly simulated passengers' end destination data for the period of 1-31 January 2020 from FLIRT, an online air travel dataset that uses information from 800 airlines to show the direct flight and passengers' end destination. We estimated a risk index of 2019-nCoV transmission based on the number of travellers to destination countries, weighted by the number of confirmed cases of the departed city reported by the World Health Organization (WHO). We ranked each country based on the risk index in four quantiles (4th quantile being the highest risk and 1st quantile being the lowest risk). During the period, 388 287 passengers were destined for 1297 airports in 168 countries or territories across the world. The risk index of 2019-nCoV among the countries had a very high correlation with the WHO-reported confirmed cases (0.97). According to our risk score classification, of the countries that reported at least one Coronavirus-infected pneumonia (COVID-19) case as of 5 February 2020, 24 countries were in the 4th quantile of the risk index, two in the 3rd quantile, one in the 2nd quantile and none in the 1st quantile. Outside China, countries with a higher risk of 2019-nCoV transmission are Thailand, Cambodia, Malaysia, Canada and the USA, all of which reported at least one case. In pan-Europe, UK, France, Russia, Germany and Italy; in North America, USA and Canada; in Oceania, Australia had high risk, all of them reported at least one case. In Africa and South America, the risk of transmission is very low with Ethiopia, South Africa, Egypt, Mauritius and Brazil showing a similar risk of transmission compared to the risk of any of the countries where at least one case is detected. The risk of transmission on 31 January 2020 was very high in neighbouring Asian countries, followed by Europe (UK, France, Russia and Germany), Oceania (Australia) and North America (USA and Canada). Increased public health response including early case recognition, isolation of identified case, contract tracing and targeted airport screening, public awareness and vigilance of health workers will help mitigate the force of further spread to naïve countries.
    Matched MeSH terms: Disease Outbreaks*
  3. Fulltext Public perception and attitude towards dengue prevention activity and response to dengue early warning in Malaysia
    Zaki R, Roffeei SN, Hii YL, Yahya A, Appannan M, Said MA, et al.
    PLoS One, 2019;14(2):e0212497.
    PMID: 30818394 DOI: 10.1371/journal.pone.0212497
    An early warning system for dengue is meant to predict outbreaks and prevent dengue cases by aiding timely decision making and deployment of interventions. However, only a system which is accepted and utilised by the public would be sustainable in the long run. This study aimed to explore the perception and attitude of the Malaysian public towards a dengue early warning system. The sample consisted of 847 individuals who were 18 years and above and living/working in the Petaling District, an area adjacent to Kuala Lumpur, Malaysia. A questionnaire consisting of personal information and three sub-measures of; i) perception, ii) attitude towards dengue early warning and iii) response towards early warning; was distributed to participants. We found that most of the respondents know about dengue fever (97.1%) and its association with climate factors (90.6%). Most of them wanted to help reduce the number of dengue cases in their area (91.5%). A small percentage of the respondents admitted that they were not willing to be involved in public activities, and 64% of them admitted that they did not check dengue situations or hotspots around their area regularly. Despite the high awareness on the relationship between climate and dengue, about 45% of respondents do not know or are not sure how this can be used to predict dengue. Respondents would like to know more about how climate data can be used to predict a dengue outbreak (92.7%). Providing more information on how climate can influence dengue cases would increase public acceptability and improve response towards climate-based warning system. The most preferred way of communicating early warning was through the television (66.4%). This study shows that the public in Petaling District considers it necessary to have a dengue warning system to be necessary, but more education is required.
    Matched MeSH terms: Disease Outbreaks/prevention & control
  4. Fulltext View of Pakistani Residents toward Coronavirus Disease (COVID-19) during a Rapid Outbreak: A Rapid Online Survey
    Hayat K, Rosenthal M, Xu S, Arshed M, Li P, Zhai P, et al.
    Int J Environ Res Public Health, 2020 05 12;17(10).
    PMID: 32408528 DOI: 10.3390/ijerph17103347
    BACKGROUND: Coronavirus disease (COVID-19) is a deadly disease that is affecting most of the countries worldwide. Public understanding, including knowledge about signs and symptoms, mode of transmission, and hygiene of COVID-19, is vital for designing effective control strategies during a public health crisis. The current study is aimed at investigating the public's perspective about COVID-19, including their knowledge, attitude, and practices.

    METHODS: A rapid online survey comprising 22 items was administered during the rapid outbreak of COVID-19 in Pakistan. Questions were focused on the prevention, transmission, clinical features, and control of COVID-19. In addition, the attitudes and practices of the participants were explored. Descriptive statistics, Mann-Whitney tests, Kruskal-Wallis tests, and regression analysis were carried out during data analysis.

    RESULTS: A total of 1257 respondents participated in this study. Most of the respondents had good knowledge (good = 64.8%, average = 30.5%, poor = 4.7%) of COVID-19. Gender, marital status, education, and residence were observed to have a significant association with the knowledge score. A vast majority of the survey respondents (77.0%) believed that COVID-19 would be controlled successfully in Pakistan. The practices of wearing a mask (85.8%) and handwashing (88.1%) were common among the participants.

    CONCLUSION: The participants demonstrated good knowledge and reasonable attitudes and practices toward most aspects of the COVID-19 outbreak. Improvements in certain areas could be made by mass-level education.

    Matched MeSH terms: Disease Outbreaks/prevention & control*
  5. Fulltext Emergence of Genotype I of Dengue Virus Serotype 3 during a Severe Dengue Epidemic in Sri Lanka in 2017
    Ngwe Tun MM, Muthugala R, Rajamanthri L, Nabeshima T, Buerano CC, Morita K
    Jpn J Infect Dis, 2021 Sep 22;74(5):443-449.
    PMID: 33642435 DOI: 10.7883/yoken.JJID.2020.854
    During the 2017 outbreak of severe dengue in Sri Lanka, dengue virus (DENV) serotypes 2, 3, and 4 were found to be co-circulating. Our previous study of 295 patients from the National Hospital Kandy in Sri Lanka between March 2017 and January 2018 determined that the dominant infecting serotype was DENV-2. In this study, we aimed to characterize the DENV-3 strains from non-severe and severe dengue patients from our previous study population. Patients' clinical records and previous laboratory tests, including dengue-specific nonstructural protein 1 antigen rapid test and IgM-capture and IgG enzyme-linked immunosorbent assays, were analyzed together with the present results of real-time reverse transcription polymerase chain reaction and next-generation sequencing of DENV-3. Complete genome analysis determined that DENV-3 isolates belonged to 2 different clades of genotype I and were genetically close to strains from Indonesia, China, Singapore, Malaysia, and Australia. There were 16 amino acid changes among DENV-3 isolates, and a greater number of changes were found in nonstructural proteins than in structural proteins. The emergence of DENV-3 genotype I was noted for the first time in Sri Lanka. Continuous monitoring of this newly emerged genotype and other DENV serotypes and genotypes is needed to determine their effects on future outbreaks and understand the molecular epidemiology of dengue.
    Matched MeSH terms: Disease Outbreaks*
  6. Fulltext Outbreak of vaccine-preventable diseases in Muslim majority countries
    Ahmed A, Lee KS, Bukhsh A, Al-Worafi YM, Sarker MMR, Ming LC, et al.
    J Infect Public Health, 2017 10 04;11(2):153-155.
    PMID: 28988775 DOI: 10.1016/j.jiph.2017.09.007
    The increase in Muslim parents' refusal and hesitancy to accept childhood vaccination was identified as one of the contributing factors in the increase of vaccine-preventable diseases cases in countries such as Afghanistan, Malaysia and Pakistan. The spread of inaccurate and irresponsible information by the anti-vaccination movement may inflict more harm than good on Muslim communities. To curb this issue, health authorities in Pakistan and Malaysia have resorted to imposing strict punishments on parents who refuse to allow their children to be vaccinated. Information addressing religious concerns such as the halal issue must be made priority and communicated well to the general public, encouraging not only the acceptance of vaccinations but motivating communities to play an active role in promoting vaccination. Local government of the affected region need to work towards creating awareness among Muslim parents that vaccinations are a preventative public health strategy that has been practised and acknowledged by many doctors of all faiths.
    Matched MeSH terms: Disease Outbreaks/prevention & control*
  7. Notes from the field: acute muscular sarcocystosis among returning travelers - Tioman Island, Malaysia, 2011
    Centers for Disease Control and Prevention (CDC)
    MMWR Morb Mortal Wkly Rep, 2012 Jan 20;61(2):37-8.
    PMID: 22258418
    GeoSentinel (the surveillance program of the International Society of Travel Medicine and CDC) has identified 32 cases of suspected acute muscular sarcocystosis in travelers returning from Tioman Island off the east coast of peninsular Malaysia. All the patients traveled to Tioman Island during the summer of 2011. Within days or weeks of returning home, all experienced fever and muscle pain, often severe and prolonged. All had peripheral eosinophilia, and most had elevated serum creatinine phosphokinase levels. Most were tested for acute trichinosis and toxoplasmosis by serology, and all of these tests were negative. Approximately half of the patients were identified in Germany; others were reported elsewhere in Europe, and in North America and Asia. Muscle biopsy from two patients demonstrated organisms consistent with sarcocystosis, one from a group of five ill travelers and one from a group of three.
    Matched MeSH terms: Disease Outbreaks*
  8. Update: outbreak of Nipah virus--Malaysia and Singapore, 1999
    Centers for Disease Control and Prevention (CDC)
    MMWR Morb Mortal Wkly Rep, 1999 Apr 30;48(16):335-7.
    PMID: 10366143
    During March 1999, health officials in Malaysia and Singapore, in collaboration with Australian researchers and CDC, investigated reports of febrile encephalitic and respiratory illnesses among workers who had exposure to pigs. A previously unrecognized paramyxovirus (formerly known as Hendra-like virus), now called Nipah virus, was implicated by laboratory testing in many of these cases. Febrile encephalitis continues to be reported in Malaysia but has decreased coincident with mass culling of pigs in outbreak areas. No new cases of febrile illness associated with Nipah virus infection have been identified in Singapore since March 19, 1999, when abattoirs were closed. This report summarizes interim findings from ongoing epidemiologic and laboratory investigations in Malaysia and Singapore.
    Matched MeSH terms: Disease Outbreaks*
  9. Fulltext Investigation of hepatitis A outbreak in district of Manjung, Perak, Malaysia, October 2012
    Yusoff FA, Rahman RA, May LH, Budart SB, Sulaiman LH
    Western Pac Surveill Response J, 2015 May 27;6(2):27-31.
    PMID: 26306213 DOI: 10.5365/WPSAR.2015.6.1.012
    In September 2012, 10 cases suspected to be hepatitis A were notified to the Manjung District Health Department. An investigation was conducted to identify the possible mode of transmission, source of the outbreak and to recommend prevention and control measures.
    Matched MeSH terms: Disease Outbreaks*
  10. Fulltext Pandemic influenza A (H1N1) and its prevention: a cross sectional study on patients' knowledge, attitude and practice among patients attending primary health care clinic in Kuala Lumpur, Malaysia
    Latiff LA, Parhizkar S, Zainuddin H, Chun GM, Rahiman MA, Ramli NL, et al.
    Glob J Health Sci, 2012 Feb 29;4(2):95-102.
    PMID: 22980156 DOI: 10.5539/gjhs.v4n2p95
    The World Health Organization confirmed that the novel influenza A, H1N1 as a pandemic on 11 June 2009. After less than three months, 182 countries were affected by the pandemic accounting for about 150,000 infected cases and 3000 mortality. Successful H1N1 pandemic management strategies' shaped by making changes in health behavior. The aim of this study was to document patients' knowledge, attitudes and practices (KAP) regarding the pandemic influenza A (H1N1) and its prevention. We performed a cross-sectional study on knowledge, attitudes and practices (KAP) on preventive measures of Influenza A (H1N1) involving 322 patients attending Klinik Kesihatan Jinjang, a primary health care clinic in Kuala Lumpur, Malaysia from May 10 to 26, 2010 using a face to face interview with a structured pre-tested questionnaire. The majority of the respondents were females (56.8%), Malays (43.2%) aged between 18-27 years old (28.9%). There were significant association between knowledge on the complication of H1N1, effectiveness of the treatment, preventive measures of Influenza A (H1N1) and race (p<0.001) and educational level (p<0.001). There were also significant associations between attitude scores of these patients and their gender (p=0.03), and educational level (p=0.001). Practice scores related to H1N1 were found to be significantly associated with race (p<0.001) and educational level (p<0.001). The significant associations were observed between knowledge and attitude (p<0.001), knowledge and practices (p<0.001), as well as attitude and practices related to H1N1 (p<0.001). Knowledge has a crucial effect on patients' attitude and practice particularly in a pandemic spread. So health policy makers should attempt to disseminate information about preventive measures to community in order to improve their preventive practices during pandemics.
    Matched MeSH terms: Disease Outbreaks*
  11. New virus emerges in Malaysia
    Caplan CE
    CMAJ, 1999 Jun 1;160(11):1607.
    PMID: 10374006
    Matched MeSH terms: Disease Outbreaks*
  12. Epidemiologic analysis of sporadic Salmonella typhi isolates and those from outbreaks by pulsed-field gel electrophoresis
    Thong KL, Cheong YM, Puthucheary S, Koh CL, Pang T
    J Clin Microbiol, 1994 May;32(5):1135-41.
    PMID: 7914202
    Pulsed-field gel electrophoresis (PFGE) was used to compare and analyze 158 isolates of Salmonella typhi from five well-defined outbreaks of typhoid fever in Malaysia and also isolates involved in sporadic cases of typhoid fever occurring during the same period. Digestion of chromosomal DNAs from these S. typhi isolates with the restriction endonucleases XbaI (5'-TCTAGA-3'), SpeI (5'-ACTAGT-3'), and AvrII (5'-CCTAGG-3') and then PFGE produced restriction endonuclease analysis (REA) patterns consisting of 11 to 24 DNA fragments ranging in size from 20 to 630 kbp. Analysis of the REA patterns generated by PFGE after digestion with XbaI and SpeI indicated that the S. typhi isolates obtained from sporadic cases of infection were much more heterogeneous (at least 13 different REA patterns were detected; Dice coefficient, between 0.73 and 1.0) than those obtained during outbreaks of typhoid fever. The clonal nature and the close genetic identities of isolates from outbreaks in Alor Setar, Penang, Kota Kinabalu, Johor Bahru, and Kota Bahru were suggested by the fact that only a limited number of REA patterns, which mostly differed by only a single band, were detected (one to four patterns; Dice coefficient, between 0.82 and 1.0), although a different pattern was associated with each of these outbreaks. Comparison of REA patterns with ribotyping for 18 S. typhi isolates involved in sporadic cases of infection showed a good correlation, in that 72% of the isolates were in the same group. There was no clear correlation of phage types with a specific REA pattern. We conclude that PFGE of s. typhi chromosomal DNA digested with infrequently cutting restriction endonucleases is a useful method for comparing and differentiating S. typhi isolates for epidemiological purposes.
    Matched MeSH terms: Disease Outbreaks*
  13. Fulltext Human adenovirus type 7 outbreak in Police Training Center, Malaysia, 2011
    Yusof MA, Rashid TR, Thayan R, Othman KA, Hasan NA, Adnan N, et al.
    Emerg Infect Dis, 2012 May;18(5):852-4.
    PMID: 22515984 DOI: 10.3201/eid1805.110865
    In March 2011, an outbreak of acute respiratory disease was reported at the Kuala Lumpur (Malaysia) Police Training Centre. Approximately 100 trainees were hospitalized and 5 were admitted to the intensive care unit. Three of these 5 trainees died. Human adenovirus type 7 was identified as the etiologic agent.
    Matched MeSH terms: Disease Outbreaks*
  14. Leptospirosis in "Eco-Challenge" athletes, Malaysian Borneo, 2000
    Sejvar J, Bancroft E, Winthrop K, Bettinger J, Bajani M, Bragg S, et al.
    Emerg Infect Dis, 2003 Jun;9(6):702-7.
    PMID: 12781010
    Adventure travel is becoming more popular, increasing the likelihood of contact with unusual pathogens. We investigated an outbreak of leptospirosis in "Eco-Challenge" multisport race athletes to determine illness etiology and implement public health measures. Of 304 athletes, we contacted 189 (62%) from the United States and 26 other countries. Eighty (42%) athletes met our case definition. Twenty-nine (36%) case-patients were hospitalized; none died. Logistic regression showed swimming in the Segama River (relative risk [RR]=2.0; 95% confidence interval [CI]=1.3 to 3.1) to be an independent risk factor. Twenty-six (68%) of 38 case-patients tested positive for leptospiral antibodies. Taking doxycycline before or during the race was protective (RR=0.4, 95% CI=0.2 to 1.2) for the 20 athletes who reported using it. Increased adventure travel may lead to more frequent exposure to leptospires, and preexposure chemoprophylaxis for leptospirosis (200 mg oral doxycycline/week) may decrease illness risk. Efforts are needed to inform adventure travel participants of unique infections such as leptospirosis.
    Matched MeSH terms: Disease Outbreaks*
  15. Fulltext Nipah virus infection in dogs, Malaysia, 1999
    Mills JN, Alim AN, Bunning ML, Lee OB, Wagoner KD, Amman BR, et al.
    Emerg Infect Dis, 2009 Jun;15(6):950-2.
    PMID: 19523300 DOI: 10.3201/eid1506.080453
    The 1999 outbreak of Nipah virus encephalitis in humans and pigs in Peninsular Malaysia ended with the evacuation of humans and culling of pigs in the epidemic area. Serologic screening showed that, in the absence of infected pigs, dogs were not a secondary reservoir for Nipah virus.
    Matched MeSH terms: Disease Outbreaks*
  16. Fulltext Enterovirus 71 outbreak, Brunei
    AbuBakar S, Sam IC, Yusof J, Lim MK, Misbah S, MatRahim N, et al.
    Emerg Infect Dis, 2009 Jan;15(1):79-82.
    PMID: 19116058 DOI: 10.3201/eid1501.080264
    Enterovirus 71 (EV71) outbreaks occur periodically in the Asia-Pacific region. In 2006, Brunei reported its first major outbreak of EV71 infections, associated with fatalities from neurologic complications. Isolated EV71 strains formed a distinct lineage with low diversity within subgenogroup B5, suggesting recent introduction and rapid spread within Brunei.
    Matched MeSH terms: Disease Outbreaks*
  17. Fulltext Severe Pediatric Adenovirus 7 Disease in Singapore Linked to Recent Outbreaks across Asia
    Ng OT, Thoon KC, Chua HY, Tan NW, Chong CY, Tee NW, et al.
    Emerg Infect Dis, 2015 Jul;21(7):1192-6.
    PMID: 26079293 DOI: 10.3201/eid2107.141443
    During November 2012-July 2013, a marked increase of adenovirus type 7 (Ad7) infections associated with severe disease was documented among pediatric patients in Singapore. Phylogenetic analysis revealed close genetic links with severe Ad7 outbreaks in China, Taiwan, and other parts of Asia.
    Matched MeSH terms: Disease Outbreaks*
  18. Genetic characterization of Nipah virus, Bangladesh, 2004
    Harcourt BH, Lowe L, Tamin A, Liu X, Bankamp B, Bowden N, et al.
    Emerg Infect Dis, 2005 Oct;11(10):1594-7.
    PMID: 16318702
    Until 2004, identification of Nipah virus (NV)-like outbreaks in Bangladesh was based on serology. We describe the genetic characterization of a new strain of NV isolated during outbreaks in Bangladesh (NV-B) in 2004, which confirms that NV was the etiologic agent responsible for these outbreaks.
    Matched MeSH terms: Disease Outbreaks*
  19. Unusual, neurological and severe dengue manifestations during the outbreak in Sri Lanka, 2017
    Ngwe Tun MM, Muthugala R, Nabeshima T, Rajamanthri L, Jayawardana D, Attanayake S, et al.
    J Clin Virol, 2020 04;125:104304.
    PMID: 32145478 DOI: 10.1016/j.jcv.2020.104304
    BACKGROUND: Sri Lanka experienced its largest dengue outbreak in 2017 with more than 185,000 dengue cases including at least 250 fatalities.

    OBJECTIVES: Our study aimed to characterize the clinical, immunological and virological features of confirmed dengue patients in Sri Lanka during the outbreak in 2017 when unusual manifestations of severe dengue were observed.

    STUDY DESIGN: Sera from 295 patients who were admitted to Teaching Hospital Kandy, Kandy, Sri Lanka between March 2017- January 2018 were subjected to NS1 antigen, IgM and IgG ELISAs, virus isolation, conventional and real time RT-PCR and next generation sequencing.

    RESULTS: Primary and secondary infections were detected in 48.5 % and 51.5 % of the study population, respectively. Two hundred twenty five DENV strains were isolated (219 DENV-2, one DENV-3, two DENV-4, two mixed infections of DENV-2 and -3 and one mixed infection of DENV-2 and -4). Unusual and severe manifestations such as encephalitis, encephalopathy, liver failure, kidney failure, myocarditis, Guillain-Barré syndrome and multi-organ failure were noted in 44 dengue patients with 11 deaths. The viraemia levels in patients with primary infection and unusual manifestations were significantly higher compared to those in patients with secondary infection. A new clade of DENV-2 Cosmopolitan genotype strains was observed with the strains closely related to those from China, Malaysia, Indonesia, Singapore and Taiwan.

    CONCLUSIONS: The new clade of DENV-2 cosmopolitan genotype observed in Sri Lanka in 2017 caused an unprecedented, severe dengue outbreak. The emergence of DENV-3 and DENV-4 in the 2017 outbreak might cause future outbreaks in Sri Lanka.

    Matched MeSH terms: Disease Outbreaks/prevention & control; Disease Outbreaks/statistics & numerical data
  20. The re-emerging of orf virus infection: A call for surveillance, vaccination and effective control measures
    Bala JA, Balakrishnan KN, Abdullah AA, Mohamed R, Haron AW, Jesse FFA, et al.
    Microb Pathog, 2018 Jul;120:55-63.
    PMID: 29709684 DOI: 10.1016/j.micpath.2018.04.057
    Orf disease is known to be enzootic among small ruminants in Asia, Africa, and some other parts of the world. The disease caused by orf virus is highly contagious among small ruminant species. Unfortunately, it has been neglected for decades because of the general belief that it only causes a self-limiting disease. On the other hand, in the past it has been reported to cause huge cumulative financial losses in livestock farming. Orf disease is characterized by localized proliferative and persistent skin nodule lesions that can be classified into three forms: generalized, labial and mammary or genitals. It can manifest as benign or malignant types. The later type of orf can remain persistent, often fatal and usually causes a serious outbreak among small ruminant population. Morbidity and mortality rates of orf are higher especially in newly infected kids and lambs. Application of antibiotics together with antipyretic and/or analgesic is highly recommended as a supportive disease management strategy for prevention of subsequent secondary microbial invasion. The presence of various exotic orf virus strains of different origin has been reported in many countries mostly due to poorly controlled cross-border virus transmission. There have been several efforts to develop orf virus vaccines and it was with variable success. The use of conventional vaccines to control orf is a debatable topic due to the concern of short term immunity development. Following re-infection in previously vaccinated animals, it is uncommon to observe the farms involved to experience rapid virus spread and disease outbreak. Meanwhile, cases of zoonosis from infected animals to animal handler are not uncommon. Despite failures to contain the spread of orf virus by the use of conventional vaccines, vaccination of animals with live orf virus is still considered as one of the best choice. The review herein described pertinent issues with regard to the development and use of potential effective vaccines as a control measure against orf virus infection.
    Matched MeSH terms: Disease Outbreaks/prevention & control*; Disease Outbreaks/veterinary
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