Diseases

Lumpy Skin Disease

Download as PDF Download as XLS Download summary

Chapter select

Global challenges

  • Commercial potential for diagnostic kits worldwide

    High given the recent spread of LSD into Asia, North-Africa and Europe.

Control Tools

  • Diagnostics availability

  • Commercial diagnostic kits available worldwide

    PCR-based tests are available

    A serological ELISAs for LSD was recently released.

    For all commercially available diagnostics: see link (Diagnostics for Animals).

  • Diagnostic kits validated by International, European or National Standards

    None.

  • Diagnostic method(s) described by International, European or National standards

    Routine methods are described in the OIE Manual of Diagnostic Tests and Vaccines. The most commonly used are:

    1. Identification of the agent

    1. Nucleic acid recognition (PCR)
    2. Virus isolation
    3. Immunohistochemistry
    4. Lateral flow antigen tests

    2. Serological

    1. Virus neutralisation
    2. ELISA

    GAPS

    Improved ELISAs to detect anti-capripoxvirus antibodies following vaccination.

    Validated sensitive lateral flow devices.

    Point of care molecular (LAMP) assays that can be easily run on farm.

    Multi-antigen strip tests for confirmation of ELISA test results.

  • DIVA tests required and/or available

    DIVA test for both antigen and antibody are described in scientific literature. DIVA PCR tests are commercially available. DIVA ELISA tests in combination with marker vaccines are not available, except from a recently launched Indian DIVA vaccine with associated DIVA ELISA (availability, sensitivity and specificity unclear).

  • Vaccines availability

  • Commercial vaccines availability (globally)

    Several (homologous and heterologous) live attenuated vaccines (LAVs) are available and have been sequenced. Homologous LAVs provide better protection than heterologous LAVs. Inactivated vaccines have been tested (but not clear whether these are commercially available).

    GAPS

    Use of LAV for mucosal administration.

  • Marker vaccines authorised in Europe

    None available.

  • Effectiveness of vaccines / Main shortcomings of current vaccines

    Effectiveness:

    • Poxviral diseases are traditionally relatively easy to protect against by using appropriate live attenuated vaccines.
    • Each capripoxvirus-based vaccine needs to be evaluated to ensure safety and immunogenicity are balanced.
    • Homologous LAVs provide better protection than heterologous LAVs.
    • “Neethling” based LSD vaccines have been shown to be effective both experimentally and in the field. Evidence shows they are on average >80% effective in prevention of disease, with some variation depending on the strain and production systems.
    • Duration of protective immunity of good quality LAV Neethling based vaccines has been shown to be at least 18 months.

    Shortcomings:

    • Side effects (commonly a local reaction at the vaccination site, fever, drop in milk production and, rarely, a generalized infection (Neethling disease)).
    • Sporadic detection of vaccine virus in swabs from vaccinated animals; animals having a Neethling disease regularly have a low level viremia and sporadically shed vaccine virus detectable in nasal swabs.
    • No commercial serological DIVA tests available that can distinguish between vaccinated and infected animals. (Except from an Indian DIVA vaccine)
    • Some vaccines are propagated on primary cells with inherent risk of contamination by adventitious agents.
    • Field trial demonstration of protection against different circulating LSDV strains.

    GAPS

    • A better understanding of the immune response to LSDV following vaccination
    • Correlates of protection are not known

  • Commercial potential for vaccines

    High: endemic regions in Africa, Russia, Asia; in case of (re)emergence: North-Africa, Europe.

    GAPS

    Difficulty in the use of LAVs for prevention prior to outbreaks in at risk (disease free) regions.

  • Regulatory and/or policy challenges to approval

    Bovivax LSD-N of Huvepharma, originally developed by MCI, has a been registered in Bulgaria and is authorized in Europe.Bovilis Lumpyvax E of MSD of MSD Animal Health is produced under EUGMP. Importance of independent quality control; how to deal with differences in GMP and associated quality between manufacturers.

    GAPS

    Regulatory approval for different countries to use LAVs for emergency use in the event of an outbreak.

  • Commercial feasibility (e.g manufacturing)

    With disease presence over a large geographic area, including Asia, Northern-Africa, and Europe higher demand for LSDV vaccines.

  • Opportunity for barrier protection

    Seemingly very effective in the recent European outbreaks.

    GAPS

    Zoning and compartmentalization requirements for LSD.

  • Pharmaceutical availability

  • Current therapy (curative and preventive)

    Apart from the use of antibiotics to control secondary infections there are no pharmaceutical products currently available for use directly against LSDV. Insecticides to reduce the abundance of vectors are available for use.

  • Future therapy

    Not a priority. Prevention of disease rather than treatment of disease is the aim of control programmes.

    GAPS

    Currently no therapeutics are available. CRISPR technology could possibly be used to reduce viral replication.

  • Commercial potential for pharmaceuticals

    None at present.

  • Regulatory and/or policy challenges to approval

    The EU has a policy of compulsory notification and slaughter therefore it is unlikely that regulatory approval for use in the EU would be granted.

    GAPS

    Possible use by farmers in an outbreak prior to vaccination to reduce viral replication in free regions or use in endemic regions.

  • Commercial feasibility (e.g manufacturing)

    Not currently applicable.

  • New developments for diagnostic tests

  • Requirements for diagnostics development

    Several conventional and real-time PCR methods have been developed and further refined for the detection of virus in different types of specimens such as skin biopsies, EDTA blood, semen and insects. Primers (and probes) have also been published for the differentiation of LSDV from the other capripoxvirus strains, and the differentiation of wildtype and Neethling-based vaccine strains. Further PCR-based developments are not a priority. A multiplex for immediate differentiation between classical (clade 1.2), recombinant (clade 2) or Neethling-based vaccine strains could be interesting.An antibody detection ELISA based on recombinant antigens has been brought to market by ID-VET. Development of ELISAs with increased sensitivity for detection of the humoral immune response to LSDV are required, to enable more sensitive identification of historical or subclinical infections and vaccinated animals, on an individual or herd basis, and therefore allowing disease surveillance and virus eradication programmes to be carried out. The usefulness of IGRA assays to identify LSDV vaccinated or infected animals is being evaluated.

    GAPS

    An understanding of the immune response to LSDV infection.

  • Time to develop new or improved diagnostics

    In general, the development of tests is much faster and less expensive than developing vaccines. Real-time PCR and ELISA-based diagnostic tests for LSD have appeared on the market in recent years and the pace of development of these tests has increased in response to the outbreaks of LSD in Europe and Asia.

    GAPS

    Ready access to well characterised samples for test development and validation (as per the WOAH assay development and validation pathways).

  • Cost of developing new or improved diagnostics and their validation

    Potentially significant. The development and validation of new tests is time consuming, labour intensive and costly. Costs cannot be specified as they will depend on the nature of the test and the cost of producing reagents and supplying reading or processing machines if necessary.

  • Research requirements for new or improved diagnostics

    Knowledge requirements:

    • The ability to identify infected herds at the population level is required to demonstrate freedom from disease (disease surveillance).

    • A serological test able to detect exposure to the virus in individual animals is required in order to detect subclinically infected cattle.

    • A test to differentiate infected from vaccinated cattle is required to complement virus eradication programmes.

    Research requirements:

    • A more comprehensive understanding of the immune response to LSDV infection, including temporal changes and inter-animal variability.

    • A comparative study of the immune response to vaccinated vs infected cattle.

    GAPS

    An understanding of the immune response to LSDV infection.

    Determination of the immunodominant antigens from LSDV.

  • Technology to determine virus freedom in animals

    A commercial test to differentiate infected from vaccinated cattle in combination with a marker vaccine is required to complement virus eradication programmes.

    GAPS

    The protective antigen(s) for LSDV are not currently known.

    Once the protective antigen(s) are known different vaccine platforms such as mRNA and subunit can be assessed.

    Having vaccines based on protective antigen(s) will allow for companion DIVA diagnostic ELISA tests to be developed.

  • New developments for vaccines

  • Requirements for vaccines development / main characteristics for improved vaccines

    The live-attenuated vaccines currently on the market are effective and have played an important role in controlling the 2015-2017 and 2025 epidemic in Europe. However, the use of live vaccines results in the loss of disease free status and therefore trade opportunities, causing substantial financial penalties. WOAH recently included the possibility to define a zone with LSDV vaccination, enabling the rest of the country to maintain its LSDV free status. It is also difficult to develop a DIVA test for live attenuated vaccines. Marker, inactivated, subunit or mRNA vaccines would therefore be more suited to LSDV outbreaks in Europe, if they can be shown to be safe and effective, and in combination with DIVA diagnostic tests.

    GAPS

    LAV cannot be used without losing trade status due to lack of a DIVA test as well as the vaccine being a live virus.

    The protective antigen(s) for LSDV are not currently known.Once the protective antigen(s) are known different vaccine platforms such as mRNA and subunit can be assessed.Having vaccines based on protective antigen(s) will allow for companion DIVA diagnostic ELISA tests to be developed. These vaccines will take time to develop.

  • Time to develop new or improved vaccines

    Significant

  • Cost of developing new or improved vaccines and their validation

    Expensive

  • Research requirements for new or improved vaccines

    Better understanding of the LSDV immune response in order to facilitate development of DIVA assays, as well as inactivated and subunit vaccines.

    Better understanding of the pathogenesis of LSD in order to limit post-vaccinal reactions.

    Improved heat-stability of vaccines.

    GAPS

    Determining the role of specific antigens in inducing antibody responses and virus neutralization responses is needed to identify antigens responsible for virus neutralization.

    Correlates of protection are not known

  • New developments for pharmaceuticals

  • Requirements for pharmaceuticals development

    There is unlikely to be any pharmaceutical development that could impact this disease.

    GAPS

    Identifying CRISPR technology to interfere with virus replication.

  • Time to develop new or improved pharmaceuticals

    Significant.

  • Cost of developing new or improved pharmaceuticals and their validation

    Expensive.

  • Research requirements for new or improved pharmaceuticals

    Demonstration of clinical efficacy of the treatment in LSDV experimentally infected cattle.

Disease details

  • Description and characteristics

  • Pathogen

    Lumpy skin disease virus (LSDV), together with sheeppox virus (SPPV) and goatpox virus (GTPV), comprise the genus Capripoxvirus in the family Poxviridae, subfamily Chordopoxvirinae. Although very closely related genetically, the viruses can be distinguished by genome analysis but cannot be differentiated serologically unless a specific monoclonal antibody is used to differentiate LSDV from SPPV and GTPV (Chang et al, 2025, Int J Biol Macromol).

    GAPS

    Understanding the genes responsible for restricting host range of LSDV to cattle and buffalo compared to SPPV and GTPV

  • Variability of the disease

    LSDV causes disease in all breeds of cattle and Asian water buffalo. Also yaks were shown to be susceptible to LSDV infection. Lumpy skin disease (LSD) presence is reported in most African countries, the Middle East, Caucasus, Russia, Kazakhstan, South and South-East Asia.

    Europe (except for Italy, France and Spain), North and South America, and Oceania are currently free of LSDV.

    The historical LSDV strains in South-Africa belonged to clade 1.1. These evolved to clade 1.2 strains which are currently mainly present in Africa, the Middle-East and India.

    Recombinant strains emerged in the field in 2018 after Kazakhstan used a contaminated vaccine without proper quality control from the company Kevevapi. Virulent LSDV strains resulting from recombination between Neethling and KSGP vaccine strains during the vaccine manufacturing process were present in the vaccine and released in the field when used for vaccination of cattle. These recombinant strains cluster separately in a clade 2 in a phylogeny based on whole genome sequences. One specific group of recombinant strains (clade 2.5) have exhibited increased virulence and have spread via Russia into South-East Asia.

    LSDV was also introduced in India, and presence of clade 1.2 strains has been reported. Both presence of KSGP-like strains and strains more closely linked to European isolates have been reported.

    LSDV is thought to be primarily transmitted by blood feeding arthropods, although there is a growing body of field and experimental data showing that clade 2 strains can also efficiently be transmitted by direct and indirect vector-free transmission.

    GAPS

    • The genetic variability of LSDV.
    • The molecular determinants of host range and virulence.
    • Virus spread and which virus clade with dominant in areas where different clades co-exist such as India.
    • The minimal dose of LSDV to start an outbreak.
    • Role of different vectors for LSDV transmission with respect to transmission of LSDV in the field.

  • Stability of the agent/pathogen in the environment

    LSDV survives for long periods at ambient temperatures when present in organic matrices (for up to 6 months if protected from sunlight), especially in dried scabs (40 days). Virus is susceptible to high temperatures (inactivation is achieved by heating at 55ºC for 2 hours) and also to highly alkaline or acidic pH. LSDV is susceptible to sunlight but survives well at cold temperatures.

    GAPS

    • The infectiousness of the virus to cattle after weeks/months in the environment (including in insect and arthropod vectors) under different conditions.
    • The presence and survival of LSDV in animal products such as hides and meat, and the inactivation by transformation processes.
    • Dose overwintering of LSDV occur in regions with severe winter seasons?

  • Species involved

  • Animal infected/carrier/disease

    All cattle are susceptible.

    Clinical disease can vary from inapparent, characterised by viraemia but no clinical signs of disease (subclinical infection), to severe resulting in death of the animal.

    No carrier status occurs in cattle following infection with LSDV although live virus can be detected for up to 39 days in the skin of infected animals.

    LSDV is highly species specific. Like many other poxviruses it stimulates a protective immune response when inoculated into species other than cattle (such as sheep and goats) but does not cause disease.

    Large serological surveys of wildlife in areas of Africa where LSD is endemic have not found evidence of a wildlife reservoir, although there are occasional case reports of LSDV infection in wildlife species.

    GAPS

    How common is subclinical LSD (which was shown to be the source of onwards transmission and thus play a role in the epidemiology of the disease)?Understanding of the reasons for variability of disease ranging from no infection to subclinical to severe disease in outbreaks.

  • Human infected/disease

    Humans are not susceptible.

  • Vector cyclical/non-cyclical

    LSDV transmission by arthropod vectors has been proven under experimental conditions, mostly by biting flies like Stomoxys calcitrans, but also by mosquitoes, and ticks. Potentially also other blood feeding insects and ticks can transmit the disease.

    Transmission of the virus occurs by mechanical transmission.

    Epidemiological evidence from LSD outbreaks strongly supports an insect-borne method of spread of the virus.

    There is a growing body of evidence that the clade 2 recombinant strains can also spread efficiently in the absence of vectors.

    GAPS

    The competence and capacity of potential vectors of LSD. This is a key knowledge gap which greatly hampers efforts to control the disease. It is suggested to initiate integrated studies to determine the competence and capacity for various potential vectors. This would include distinguishing mechanical and biological transmission, and cover potential vectors present in different climates.

  • Reservoir (animal, environment)

    There is no carrier state for LSDV but the virus may survive for prolonged periods in the skin of severely infected animals or environment.

    GAPS

    • The infectiousness of LSDV to cattle after weeks/months in environment under different conditions.
    • The risk posed by a LSD-affected animal over time.

    • The presence of LSDV in the skin over time.

  • Description of infection & disease in natural hosts

  • Transmissibility

    Transmission is believed to be mediated primarily by arthropod vectors (insects and ticks). Clade 2 strains can also be efficiently transmitted in the absence of vectors.

    Virus is present at high levels in the cutaneous nodules of the skin of affected animals. It is present at lower levels in nasal and oral discharges. It is present at low levels and intermittently in the blood stream (viraemia). LSDV has been detected in the skin of subclinically affected animals, indicating the dermotropic nature of this virus. Onwards vector transmission from subclinically affected animals has been shown. LSDV has also been detected in semen of affected bulls.

    GAPS

    • Spread of LSD by fomites (vehicles, people, etc)
    • Spread of LSD by carcasses
    • Spread of LSD by semen
    • Comparative efficiency of non-vector transmission of clade 1 and clade 2 strains
    • Impact of non-vector transmission of clade 2 strains on LSDV epidemiology under field conditions

  • Pathogenic life cycle stages

    Not applicable.

  • Signs/Morbidity

    Clinical signs can range from inapparent to severe.

    • Fever may be transitory or last up to 2 weeks.
    • Enlargement of superficial lymph nodes is commonly observed.
    • Multifocal to coalescing, firm, well demarcated cutaneous nodules up to 5 cm in diameter develop, particularly on the head, neck, udder, perineum and limbs. In severe cases they may cover the majority of the animal. The nodules may extend through the dermis into the subcutaneous tissue and underlying musculature, and can develop necrotic centres, called “sitfasts” which form a nidus for secondary bacterial infections and myiasis.
    • Focal to multifocal, well demarcated erosions and ulcers may form in the mucus membranes of the respiratory and gastrointestinal tracts.
    • Animals may be depressed and reluctant to move.
    • Lactating animals may experience a sudden drop in milk yield and pregnant cattle may abort.
    • Bulls can experience temporary or permanent infertility.
    • Marked deterioration in body condition can occur, and recovery may be prolonged.

    It is estimated that up to 50% of infected cattle develop inapparent disease characterised only by a transient mild pyrexia with or without a mild lymphadenopathy.

    GAPS

    • The host, virus and environmental factors which determine the outcome of LSDV infection.

  • Incubation period

    In experimental models using needle inoculation of LSD there is an incubation period of 6-7 days before the animal develops a fever, followed 1-2 days later by the appearance of cutaneous nodules. There are reports of longer incubation times in older literature. LSDV transmission by vectors probably results in inoculation of low doses and can result in prolonged incubation periods up to 4 to 5 weeks.

    GAPS

    The interactions which occur between the virus and the host during the incubation period.

  • Mortality

    The mortality rates in affected herds in recent outbreaks in the Middle East and Europe have varied from 0.4% in Greece to 6.4% in Turkey. Morbidity varied form 8.7% in Greece to 17.9% in Iran and 26% in Jordan.

    GAPS

    Factors which contribute to higher morbidity and mortality rates.

  • Shedding kinetic patterns

    LSDV is present in cutaneous lesions for up to 39 days post-infection and likely longer. Virus is also shed in saliva, respiratory secretions, blood, milk and semen. Shedding in semen may be prolonged since the virus has been associated with necrotising and granulomatous orchitis and epididymitis in experimentally inoculated bulls, with virus isolated from the semen of one of these animals 42 days after inoculation.

    GAPS

    • Transmission of LSD via semen and embryos.

  • Mechanism of pathogenicity

    Pathogenicity of capripoxviruses is largely unstudied. Other poxviruses such as Vaccinia virus and Ectromelia virus have been studied in great detail. Poxviruses are characterised by their large (over 150kb) and complex double-stranded DNA genome, and their entirely cytoplasmic replication cycle, which is very unusual for a DNA virus. Poxviruses replicate initially at the site of infection before travelling to draining lymph nodes and then systemically. Poxviruses encode a wide array of immunomodulatory proteins which enable them to evade the host’s antiviral immune response.

    Poxviruses stimulate a strong immune response, including both cell mediated (T cell-based) and humoral (B cell-based) immunity. This has resulted in them being developed as vaccine vectors for a range of pathogens, and as oncolytic therapies.

    Protective immunity against a subsequent challenge with poxviruses is correlated with a strong and varied antibody response.

    GAPS

    Understanding of the pathogenesis and induced immune responses of capripoxvirus disease is in its infancy. Examples of areas which require investigation include:

    • The mechanisms of immune evasion by LSDV
    • Characterisation of a protective immune response against LSDV, including identification of immunodominant epitopes / proteins
    • The mechanisms underlying the narrow host range of LSDV.
    • Mechanisms of natural host resistance
    • Correlates of protection

  • Zoonotic potential

  • Reported incidence in humans

    LSDV is not zoonotic.

  • Risk of occurence in humans, populations at risk, specific risk factors

    N/A

  • Symptoms described in humans

    N/A

  • Likelihood of spread in humans

    N/A

  • Impact on animal welfare and biodiversity

  • Both disease and prevention/control measures related

    LSD undoubtably causes substantial and long term pain, harm and distress in cattle, particularly those severely affected.

    Control measures include vaccination, movement restrictions, and slaughter campaigns. Vaccination with live-attenuated LSDV strains can cause mild LSD-like symptoms. Movement restrictions and slaughter campaigns can result in mild to moderate negative impacts on animal welfare.

    During the recent LSD epidemic in the Balkans widespread and indiscriminate insecticide use was practiced in some areas, likely leading to loss of biodiversity.

    Slaughter campaigns, if extensive, have the propensity to reduce biodiversity, have a negative environmental impact and compromise people livelihoods.

    GAPS

    A better understanding of the pathogenesis and epidemiology of LSD is needed in order to enable focused and targeted control measures such as integrated vector management and vaccination. This will reduce the negative welfare and biodiversity impacts of these measures as currently used. It will also improve control, prevention and eradication of LSD, leading to reductions in the number of cattle suffering from the disease.

  • Endangered wild species affected or not (estimation for Europe / worldwide)

    There are limited case reports showing that LSDV can cause disease in wild species. There is however insufficient evidence to assume that wild species play an important role in LSDV epidemiology.

    GAPS

    Having a complete list of susceptible animal species to LSDV, several species in regions free of LSDV could be susceptible.

  • Slaughter necessity according to EU rules or other regions

    Compulsory slaughter is a recommended means of control in the animal health law, particularly in previously disease free countries. Current evidence suggests that if efficient vaccination is implemented, culling has only a minor additional effect for disease control.

    GAPS

    The impact of partial vs complete stamping out in LSD control programmes.

  • Geographical distribution and spread

  • Current occurence/distribution

    LSD occurs in most African countries with sporadic outbreaks in the Middle East. In 2012, the disease re-appeared in the northern part of Israel and then spread swiftly within the Middle East region and was reported in Lebanon, Palestinian Autonomous Territories and Jordan. It spread further in 2013 into Turkey, Kuwait, Saudi Arabia and Iraq. In 2014 LSD occurred in Iran and northern parts of Cyprus. In 2015 the disease spread into Saudi Arabia, Bahrain, Greece and into the Caucasus region including Azerbaijan, Georgia and Russia. In 2016, LSD continued to spread into Bulgaria, Serbia, Montenegro, Former Yugoslav Republic of Macedonia, Kosovo and Albania, and also spread to Iran, Iraq, Azerbaijan, Armenia, Georgia, Kazakhstan and the southern Caucasian parts of the Russian Federation. In 2018, vaccine-like recombinant LSDV strains originating from a badly produced LSDV vaccine were released in Kazakhstan, spread to Russia and subsequently spread throughout South-East Asia by 2023. Clade 1.2 LSDV was also introduced in India in 2019. Both presence of KSGP-like strains and strains more closely linked to European isolates have been reported. In 2024, LSDV was also introduced in Japan and Northern African countries like Libya, Tunisia and Algeria. In 2025, an outbreak of LSD occurred in Italy, likely due to vector spread from Northern Africa, and subsequently spread to France and Spain.

    GAPS

    The factors contributing to rapid and uncontrolled LSD spread.

    Distance that LSDV can be spread over oceans and seas.

  • Epizootic/endemic- if epidemic frequency of outbreaks

    Endemic in most African countries. Endemic in Turkey and probably other countries in the Middle East. Epidemic spread through South-East Asia between 2020 and 2023. Starting to become endemic in that region.

  • Speed of spatial spread during an outbreak

    In tropical climates the incidence of disease is highest in wet warm weather and decreases during the dry season (linked to possible insect vector occurrence/numbers). As LSDV spread into temperate climates, initial evidence suggests there may be several peaks; i.e. during the dry warm season, winter (in Mediterranean climate) and spring.

    GAPS

    • The correlation of certain climatic conditions with the occurrence of LSD.
    • The role of winter in slowing the spread of LSD in countries with different climates where it is spreading (ie Russia)
    • The impact of more efficient non-vector transmission (compared to clade 1.2 strains) on the epidemiology of clade 2 strains

  • Transboundary potential of the disease

    The 2012-2017 epidemic of LSD in the Middle East, Balkans and Caucasus clearly demonstrates the ability of LSDV to spread rapidly through political and geographic boundaries. This was confirmed by the rapid spread of LSDV over Russia and South-East Asia.

  • Route of Transmission

  • Usual mode of transmission (introduction, means of spread)

    Evidence suggests that transmission of LSDV occurs mechanically via arthropod vectors. Direct (cattle to cattle) transmission represents a very low to negligible risk for clade 1 strains. Recent field and experimental data indicate that clade 2 strains also spread between animals in the absence of vectors.

    Movement of infected cattle has been linked with long distance spread of LSDV, particularly in epidemic situations.

    GAPS

    • The risk of transmission of LSDV by different arthropod vectors.
    • Epidemiological importance under field conditions of non-vector transmission of clade 2 strains
    • Genomic background and changed virus-host interaction underlying the capacity for non-vector spread of clade 2 strains
    • Legal and illegal trade of infected animals and subclinically infected animals in spread.

  • Occasional mode of transmission

    Potential occasional modes of transmission of LSDV include sexual transmission, transmission via fomites, via carcasses or via animal products.A presence of live LSDV in semen of infected bulls has been demonstrated, however transmission of disease to naïve animals via infected semen has not been shown. LSDV is present at high levels in the cutaneous nodules of the skin of affected animals. It is present at lower levels in nasal and oral discharges. It is present at low levels and intermittently in the blood stream (viraemia). LSDV has been detected in the skin of subclinically affected animals. In addition to these potential means of virus shedding, LSDV is very resistant to certain environmental conditions (drying, temperature fluctuations etc).

    GAPS

    • The risk of transmission of LSD by indirect routes (fomites, carcasses, semen and embryos).

    • The risk of transmission of LSD by animal products (hides, meat, milk).

  • Conditions that favour spread

    On a local level warm wet weather and animal movement from endemic to non-endemic regions have been identified as risk factors associated with LSD outbreaks.On a regional level the spread of clade 1.2 LSDV strains throughout the Middle East, Russia, the Balkans and Causasus in 5 years (2012-2017) is unprecedented, just as rapid spread of the clade 2 recombinant strains over Russia and South-East Asia between 2018 and 2023. This provides opportunities to investigate the factors contributing to this rapid and unexpected spread of the virus.

    GAPS

    The influence of risk factors which contribute to the regional spread of LSDV such as:o Climatic conditionso Abundance of arthropod vectors.o Civil unresto Alterations in cattle trading patternso Lack of awareness of the disease in disease free countries. o Lack of emergency preparedness and ability to eradicate the disease using mass vaccination and testing.o Lack of veterinary services to control the disease.

  • Detection and Immune response to infection

  • Mechanism of host response

    Experimental and field studies have identified a cell mediated immune response (IFN-gamma production and CD4 T cell proliferation) and humoral immune response in naïve cattle infected with LSDV. Experimental studies indicate that protection against a secondary challenge with LSDV (for example post vaccination) is strongly correlated with rapid production of anti-LSDV antibodies, consistent with other poxviruses.

    GAPS

    • The protective components of an immune response to LSDV.

    • Immune evasion mechanisms employed by LSDV.

    • Mechanism/s by which antibodies provide protection against LSDV.

    • Immune response and correlated to protection in the field considering different production systems, management practices and presence of other pathogens in the area.

    • Protection following vaccination in the absence of detectable neutralizing antibodies.

  • Immunological basis of diagnosis

    There are no commercially available tests to measure the cell mediated immune response to LSDV. Under experimental conditions, IGRA tests have been shown to allow early detection of LSDV vaccinated and infected animals.

    The only validated test for measuring the antibody response to LSDV infection is the virus neutralisation test (VNT), as described in the WOAH manual. It has high specificity but low sensitivity, is expensive and time consuming and requires use of live virus.

    A commercial diagnostic ELISA (Innovative Diagnostics) is available on the market. Additional ELISAs from Biostone and Indical became recently available.

    Several different antigens have been identified and used in in- house ELISAs, which require further development, validation and commercialization.

    GAPS

    There are few LSD immunology-detection diagnostic tests available. This hampers identification of sub clinically infected cattle, tracking outbreaks of the disease, and proving freedom from disease after an outbreak. For example, a sensitive and specific diagnostic test to identify antibodies to LSDV is required. Ideally the test should be cheap, simple, and amenable to high throughput testing. In addition, it should be able to differentiate between infected and vaccinated animals.

    Determining the role of specific antigens in inducing antibody responses is needed to identify target antigens for diagnostic development.

  • Main means of prevention, detection and control

  • Sanitary measures

    Cleaning and disinfection of contaminated premises and equipment - LSDV is susceptible to highly alkaline or acidic pH, formalin (1%), sodium hypochlorite 3 %, Virkon 2%, some detergents (e.g., sodium dodecyl sulphate) and phenol (2%).

  • Mechanical and biological control

    The three key control measures used against LSD are movement restrictions, slaughter campaigns, and vaccination.Animal movement restrictions are an important method of restricting spread of LSD, particularly in epidemic situations, however the width of an effective “quarantine” zone is difficult to define given the gap in knowledge over the insect vectors believed to transmit the disease.In disease-free countries in the EU complete stamping-out has been mandated for all LSDV-infected herds. Recent scientific evidence has called into question the efficacy of this expensive and often controversial method of control. Partial stamping out of only the clinically affected cattle within a herd has been suggested as an effective alternative. Total stamping out was shown to be effective only in very localized outbreaks in Israel in 1989, 2006 and 2007, while modified stamping out produced the same result. The existence of subclinically infected animals and their known capacity to allow onwards transmission of the virus by vectors challenges the usefulness of partial stamping out. A recent EFSA report used mathematical modelling to compare complete and modified stamping out policies. This found that, when combined with an effective vaccination campaign, a complete stamping out programme has only a minor additional effect for disease control, if any, compared to a modified stamping out programme.Vaccination with a live attenuated strain of LSDV in the recent outbreaks in Europe was shown to be very effective at restricting the spread of LSD. Vaccination is often the only effective method to stop an LSDV outbreak.

    GAPS

    • The length of time vaccination provides protection, although this was shown to be at least 18 months for homologous Neethling strain based live attenuated vaccines.

    • The impact of vector populations, geographic features (mountains, rivers), climatic conditions, and other factors on the required width of an effective “quarantine zone”.

    Methodological gaps:

    • Although vector-control can only play a secondary role in LSDV control and negatively impacts biodiversity if improperly used, studies towards specific, focused and effective methods of vector control can be useful.

  • Diagnostic tools

    LSD is often suspected based on the characteristic clinical signs and confirmed with a PCR-based assay.

    PCR-based tests which differentiate between LSDV, SPPV and GTPV have been published.

    PCR-based tests which differentiate between wildtype LSDV and the commonly used “Neethling” vaccine strain of LSDV have been published.

    Other methodology which can be used to diagnose LSD are described in the OIE manual.

    As described above there are few immunology-based diagnostic tests available which hampers control, eradication and prevention of LSD.

    Product gaps:

    • A highly sensitive and specific diagnostic test to identify antibodies to LSDV is required. Ideally the test should be cheap, simple, and amenable to a high throughput of testing. In addition, it should be able to differentiate between infected and vaccinated animals

    Methodological gaps:

    • Formal validation of LSD diagnostic tests to the standards set by the WOAH.

  • Vaccines

    Live-attenuated vaccines are recommended. Homologous (LSDV-based) and heterologous (SPPV or GTPV-based) live attenuated vaccines against LSD are available. Poxviruses exhibit within genus cross-protection. This has been proven experimentally and in the field with SPPV and GTPV – based vaccines as well as attenuated LSDV-based vaccines providing protection for cattle against LSDV. Comparative studies nevertheless showed that homologous LAVs provide better protection than heterologous LAVs.There is field and experimental evidence of variation in protection afforded by individual capripoxvirus vaccines. There is a very strong body of evidence that the attenuated “Neethling” LSDV strain vaccines are highly (around 80%) effective for prevention of LSD. There is firm evidence that RM-65 and other SPPV-based vaccines offer only partial protection against LSD. Several studies have shown that goat pox vaccines are protective against LSD (Gari et al. 2015, Capstick and Coackley, 1961) but field evidence from India also reports incomplete protection of GTPV vaccines against LSDV. The side effects of live-attenuated vaccines may include necrotic lesions at the site of inoculation, reduction in milk production, and occasionally induction of ‘Neethling’ disease, consisting of the presence of small nodules over the body which disappear within a few weeks after vaccination.Annual vaccinations with live attenuated vaccines are recommended by manufacturers. Experimental studies showed a duration of immunity of at least 18 months for a homologous Neethling based vaccine.Inactivated LSDV vaccines have been demonstrated to be effective in experimental settings. There are currently no subunit, viral-vectored, or mRNA vaccines available against LSD. A marker vaccine accompanied by a DIVA ELISA is reported to be present in Asia. Thorough information is nevertheless missing.

    GAPS

    • Correlates of protection for LSD.

    Product gaps:

    • Vaccines which facilitate differentiating vaccinated from infected cattle are required.

    • As LSD spread to Asia and South-East Asia the amount of (affordable yet high quality) vaccine required has massively increased, some countries experiencing shortage of vaccines to be able to vaccinate enough animals to develop herd immunity.

    • Demonstration of the ability to eradicate LSDV using GTPV LAV in the field.

    • Guidelines for the use of GTPV LAV in the field. Economic issues taking precedence over efficacy

  • Therapeutics

    There are no specific therapeutic products available to treat LSDV.

  • Biosecurity measures effective as a preventive measure

    Biosecurity measures, movement restrictions and slaughter are often ineffective in an LSD outbreak and need to be combined with vaccination programmes.

    GAPS

    • The impact of vector populations, geographic features (mountains, rivers), climatic conditions, and other factors on the required width of an effective “quarantine zone”.
    • The length of time LSDV can survive in the environment or vectors requires investigation in order to determine the length of time quarantine bans need to remain in place.
    • The mechanisms by which LSDV over-winters in temperate climate zones where vectors are not continuously present.

  • Border/trade/movement control sufficient for control

    LSD in a region is often a barrier for trade with LSD-free countries.

    Countries free of LSD should consider very carefully the risks associated with importation of livestock, carcases, hides and semen from LSD-affected regions. Rules associated with importing from LSD-affected countries are outlined in the WOAH Terrestrial Manual.

    GAPS

    • The risks posed by different animal products from LSD-affected areas
    • The efficacy of “border vaccination” to prevent introduction of LSD into a new areas.
    • Evidence-based regulations governing a declaration of “freedom from LSD”.

  • Prevention tools

    In endemic countries minimising mixing of cattle with other herds, minimising buying in of cattle, and vaccination are the most effective means of prevention.

    In disease-free countries, prohibiting the importation of livestock and their products from countries where LSD is endemic reduces the risk of LSD occurring. However in the past 5 years LSD has spread rapidly across the Middle East and into Europe, Asia, and Russia, highlighting the difficulty of preventing the spread of this disease even in the face of movement and trade restrictions.

    Methodological gaps

    • Additional management actions which may help prevent LSD outbreaks.

  • Surveillance

    Lumpy skin disease is classified as notifiable by the World Organization for Animal Health (OIE). A presumptive diagnosis is usually based on characteristic clinical signs, but the diagnosis must be confirmed by laboratory testing.

    Lack of sensitive serological tests hamper efforts at disease surveillance.

    Lack of serological tests which differentiate infected and vaccinated animals hamper post-outbreak disease surveillance.

    Product gaps:

    • A highly sensitive and specific diagnostic test to identify antibodies to LSDV is required. Ideally the test should be cheap, simple, and amenable to a high throughput of testing. In addition, it should be able to differentiate between infected and vaccinated animals.

    Methodological gaps:

    • Scientifically valid, standardised recommendations for effective surveillance for LSD in post-outbreak situations.

  • Past experiences on success (and failures) of prevention, control, eradication in regions outside Europe

    To date eradication and prevention measures have proved ineffective in Africa and the Middle East. Europe successfully eradicated LSDV after the introduction in the Balkan regions thanks to a mass vaccination campaign with homologous Neethling based vaccines. Also in 2025, vaccination in 50km radius zones around outbreaks in Italy, France and Spain stopped further virus spread.

    Only implementing a slaughter policy combined with strict movement controls were shown to be insufficient to stop LSDV spread when it was introduced into the Balkans in 2015-16.

    GAPS

    • A comprehensive retrospective evaluation of the different control measures undertaken in the 2012-2017 epidemic to allow lessons to be learnt.

    Methodological gaps:

    • Improved and novel methods for eradicating LSD from endemic areas

  • Costs of above measures

    Some analysis of the economic impact of LSDV outbreaks in Europe (Balkans) and Asia have been reported, covering different production types (Casal et al., 2018; Chouhan, et al., 2022, Saqib et al., 2023; WOAH, 2004, Modethed et al., 2025). Estimates of the cost of the outbreaks in the Balkans are many millions of euros.

    Methodological gaps:

    • Adapting existing frameworks to enable an estimation of costs and other impacts of an outbreak of LSD as well as the estimation of potential economic benefits of viable control measures in different settings (endemic, LSDV emergence) and production systems (e.g subsistence (backyard and transhumance) and commercial) is urgently required
    • A cost-benefit analysis of mass LSDV vaccination campaigns (with and without other control measures) in both endemic and at risk countries, and countries confronted with an LSDV incursion.
    • Cost benefit analysis of preventative vaccination and surveillance in at risk regions for next generation vaccines.

  • Disease information from the WOAH

  • Disease notifiable to the WOAH

    Yes. Full list of notifiable diseases is here.

  • Socio-economic impact

  • Zoonosis: impact on affected individuals and/or aggregated DALY figures

    LSD is endemic in many low and middle income countries in Africa, and probably the same will occur in South and South-East Asian countries that were recently confronted with LSDV incursions. On a farm level LSD reduces productivity through reduced milk production, reduced weight gain, loss of body condition, and the death of cattle. These impacts are particularly significant for subsistence farmers as their animals provide high quality protein food source (meat and milk), skins for clothing, a means of accumulating capital and a ready source of emergency funds as well as socio-cultural wealth. LSD therefore contributes to instability of income and animal protein for subsistence farmers and rural poverty.

  • Zoonosis: cost of treatment and control of the disease in humans

    N/A

  • Direct impact (b) cost of private and public control measures

    Few studies on the economic impact of LSD have been published. In the study in Ethiopia mentioned above https://pubmed.ncbi.nlm.nih.gov/21852008/">(https://pubmed.ncbi.nlm.nih.gov/21852008/) the financial benefits of an annual vaccination programme in Ethiopia were examined. A vaccination programme was estimated to enable the financial costs due to LSD to be reduced by 17% per head in local zebu herds and 31% per head in HF/crossbred herds.

    The cost of control programmes in the Balkans in 2015-2016 (vaccination, movement control, trade losses, slaughter campaigns) are estimated at many millions of euros (Casal et al., 2018).

    GAPS

    A thorough study of the economic impact of LSD at different scales is required including implementation of different control measures, and barriers to control LSD and different level of subsides for LSD control to farmers.

  • Indirect impact

    No studies on the indirect impact of LSD have been published.

    GAPS

    A thorough study of the economic impact of LSD is required.

  • Trade implications

  • Impact on international trade/exports from the EU

    High impact. Standards for movement are specified in the WOAH Terrestrial Animal Health Code. Trade of live cattle and embryo and semen exports are banned from countries with LSD to countries free of the disease.

  • Impact on EU intra-community trade

    High impact. Standards for movement are specified in the Animal Health Law. Trade of live cattle and embryo and semen exports are banned from countries with LSD. This has significantly impacted the EU countries recently affected by LSD including Greece and Bulgaria.

  • Impact on national trade

    High impact. Standards for movement are specified in the WOAH Terrestrial Animal Health Code. Trade of cattle and specified cattle products are banned from an infected zone to an uninfected zone within a country.

  • Links to climate

    Seasonal cycle linked to climate

    Evidence would suggest this is the case.

  • Distribution of disease or vector linked to climate

    There is a close correlation, although exceptions do occur.

    GAPS

    The correlation of climatic conditions (and associated changes in vector populations) with the incidence of LSD. Potential difference between clade 1.2 and clade 2 strains.

  • Outbreaks linked to extreme weather

    This has not been studied.

    GAPS

    Association of LSD with extreme weather.

  • Sensitivity of disease or vectors to the effects of global climate change (climate/environment/land use)

    This has not been studied in detail.

    GAPS

    The role of specific arthropod vectors in transmission of disease, and associated alterations in vector distribution and dynamics caused by climate change.

  • Main perceived obstacles for effective prevention and control

    Inability to eradicate the disease from a region once it has become endemic, unless a combination of control measures including movement controls and mass vaccination with homologous Neethling based vaccines are implemented.

    GAPS

    • Lack of knowledge of LSD transmission and epidemiological importance of non-vector transmission of clade 1 and clade 2 LSDV strains
    • Rapid and accurate serological diagnosis
    • Ability to differentiate infected and vaccinated animals
    • Lack of understanding of the pathogenesis of the disease, and difference between clade 1 and clade 2 strains
    • Lack of understanding of the protective components of the immune response to LSDV infection
    • Lack of an effective veterinary infrastructure in some developing countries.
    • Lack of DIVA vaccines, preferentially based on other than attenuated vaccine platforms
    • Lack of international research funding for capripoxviruses, despite the recent increasing geographic spread and associated economic losses.
    • Lack of awareness of the impact of the disease in free regions.

  • Main perceived facilitators for effective prevention and control

    • Effective and safe live attenuated vaccines
    • Specific and sensitive PCR-based diagnostic tests
    • Specific and sensitive ELISA-based serodiagnostic tests
    • Sequencing of full genomes of multiple strains of capripoxvirus
    • Standardisation of an experimental model of LSD

    GAPS

    • Lack of DIVA vaccines, preferentially based on mRNA or subunit platforms.

Global challenges

  • Antimicrobial resistance (AMR)

  • Digital health

  • Climate change

  • Preparedness

  • Diagnostic platforms

    Limited serology diagnostics.

  • Mathematical modelling

    Limited modelling approaches for LSDV risk assessment and transmission patterns.

  • Communication strategies

    EUFMD courses on LSDV

    GAPS

    Lack of stakeholders understanding of LSDV compared to foot-and-mouth disease virus.

Risk

  • LSD occurs in most African countries with sporadic outbreaks in the Middle East. In 2012, the disease re-appeared in the northern part of Israel and then spread swiftly within the Middle East region and was reported in Lebanon, Palestinian Autonomous Territories and Jordan. It spread further in 2013 into Turkey, Kuwait, Saudi Arabia and Iraq. In 2014 LSD occurred in Iran and northern parts of Cyprus. In 2015 the disease spread into Saudi Arabia, Bahrain, Greece and into the Caucasus region including Azerbaijan, Georgia and Russia. In 2016, LSD continued to spread into Bulgaria, Serbia, Montenegro, Former Yugoslav Republic of Macedonia, Kosovo and Albania and also spread to Iran, Iraq, Azerbaijan, Armenia, Georgia, Kazakhstan and the southern Caucasian parts of the Russian Federation. LSD currently represents an immediate threat to central parts of Russia, Ukraine, Afghanistan and Pakistan.

    Warm wet weather appears to favour outbreaks and therefore spread of the disease. The incubation period of LSD is approximately 6-7 days, during which time infected animals could travel a considerable distance thereby contributing to disease spread.

    LSD virus is a potential agriterrorist agent as it (i) causes morbidity and mortality in susceptible animals, (ii) has potential for rapid or silent spread,(iii) has potential to cause serious economic losses and (iv) is of major importance in the international trade of cattle and cattle products.

Main critical gaps

  • Knowledge gaps:

    • Lack of knowledge of LSD transmission
    • Lack of understanding of the pathogenesis of the disease, including differences between clade 1 and clade 2 strains
    • Lack of understanding of the protective components of the immune response to LSDV infection

    Methodological gaps:

    • Lack of “roadmap” defining the stages to eradication of the disease from a region
    • Lack of regulations for determining proof of disease freedom
    • Inability to differentiate between infected and vaccinated animals
    • Lack of an effective veterinary infrastructure in some developing countries

    Product gaps:

    • Rapid and accurate serological diagnosis on a herd and animal level
    • Safe DIVA vaccines and associated DIVA tests

Conclusion

  • Much has been learnt from the recent LSD epidemics in the Middle East, Europe, Russia, and Asia. This temporarily led to increased research funding for development of new diagnostic and disease control tools but funding waned after LSDV was eradicated from Europe. Future research should focus on (i) characterizing both vector- and non-vector-borne transmission of LSDV, (ii) developing improved immune-based diagnostic assays to support disease surveillance and eradication activities, and (iii) understanding the fundamental immunology and pathology of LSDV in order to underpin development of future novel disease control tools like DIVA vaccines.

Sources of information

  • Expert group composition

    Dr. Nick De Regge, Sciensano – [Leader]

    Dr. Andy Haegeman, Sciensano

    Dr. Nina Kresic, Sciensano

    Dr Georgina Limon-Vega, The Pirbright Institute, UK

    Dr Shawn Babiuk, National Centre for Foreign Animal Disease, Canadian Food Inspection Agency, Canada

    Dr Tim Bowden, CSIRO, Australia

    Chriche du Plessis, Intergovernmental Veterinary Health, Merck Animal Health

    John Atkinson, Intergovernmental Veterinary Health, Merck Animal Health

    Recommended citation:

    De Regge N., Haegeman A., Kresic N., Limon-Vega G., Babiuk S., Bowden T., du Plessis C., Atkinson J., 2026. DISCONTOOLS chapter on Lumpy Skin Disease. https://www.discontools.eu/database/86-lumpy-skin-disease.html

  • Date of submission by expert group

    29 May 2026

  • References

    N/A