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Medicine for the Outdoors

Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.

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Parapoxvirus Infection in Deer Hunters

By Paul S. Auerbach, MD | Published Feb 24, 2011

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Just when you thought it was safe to go out in the woods comes a report from Amira Roess and colleagues (New England Journal of Medicine 363;27:2621-7) about a poxvirus that one can contract from handling infected deer. After an incubation period of three to seven days, a person can develop a reddish-purple nodule in infected skin that may become large and painful. Although these may resolve, they may require removal by a surgeon, and may recur, presumably because of residual virus.

This report is based on incidents when hunters nicked or cut their fingers while dressing deer, so the exposures were presumably from deer blood. As noted by the authors, lesions commonly occur on fingers, hands, and other areas that come in contact with infected lesions. Smallpox immunization does not provide immunity; neither does previous infection. Most infections are a single lesion.

Parapoxvirus infections occur in other animals, such as reindeer, but clinical illness in animals and human infections are rare. However, the presentation can be confused with serious diseases such as anthrax. With tens of millions of deer and deer hunters crossing paths in the U.S. alone, there will undoubtedly be more cases. Prevention involves wearing personal protective equipment, and in particular, gloves.