Potentially pathogenic orthopoxviruses (OPVs) persist in nature and re-emerge for reasons we do not fully understand. New information pertaining to Orthopoxvirus (OPV) persistence in nature would significantly improve surveillance and control programs. In a recent investigation of a Camelpox virus (CMLV) outbreak in Eastern Saudi Arabia, atypical minute pox-like skin lesions (AMPL) persisted on 42.9% of convalescent camels (8.8% of herd) for more than a year after the onset of clinical signs. In order to investigate whether AMPL were related to CMLV infection, AMPL homogenates were inoculated on the chorioallantoic membranes (CAM) of specific-pathogen-free (SPF) embryonating chicken eggs (ECE). Live CMLV was recovered from AMPL homogenates. The sequences of the ATIP gene of viruses isolated in the beginning of the outbreak, and one year later from AMPL were identical, and similar to the Kazakhstan isolate CMLV M-96. Virus identity was confirmed by sequence analysis of the CMLV A33R, A27L, B5R, and L1R orthologue genes. Uninfected adult camels that came in contact with animals showing AMPL became infected within two weeks. Since AMPL were easily missed by veterinarians and camel drivers, it was concluded that CMLV survival in persistent skin lesions may be a key mechanism in maintaining the virus in previously infected camel herds during inter-epizootic periods.
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