Zoonotic vaccinia virus outbreaks in Brazil

Abstract

The vaccinia virus (VACV) was used as a live vaccine during the WHO-led smallpox eradication campaign in the second half of the 20th century. The program culminated with the obliteration of the disease, one of the most important achievements in modern medicine. Interestingly, one of the key factors in the successful vaccination campaign – the VACV itself – is poorly understood in relation to its natural reservoirs, evolutionary history and origins, being frequently considered extinct as a naturally occurring virus. Nevertheless, orthopoxviruses other than variola virus have been known to circulate in Brazil since the early 1960s. More specifically, VACV has been associated with naturally acquired infections in humans, cattle and possibly other reservoirs since 1999, when bovine vaccinia outbreaks started to be consistently described year after year. In this article, we list and discuss the most important VACV outbreaks that have occurred in Brazil in the last 20 years. Phylogenetic issues are considered, as the latest studies point to large genetic variance among isolates. Clinical and epidemiological data, both published and new, are presented.