Vesicular Stomatitis Virus · What It Is, Transmission, Signs and Symptoms, and More

Published: Apr 15, 2025

Author: Emily Miao, PharmD, MD•

Editor: Alyssa Haag, MD•

Editor: Lily Guo, MD•

Editor: Kelsey LaFayette, DNP, ARNP, FNP-C

Illustrator: Jessica Reynolds, MS

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What is vesicular stomatitis virus?

Vesicular stomatitis virus also known as Indiana vesiculovirus, is a type of enveloped RNA virus that was first identified in Kinney County, Texas in 2019. The virus belongs to the Rhabdoviridae family and Vesiculovirus genus. Vesicular stomatitis is a zoonotic viral disease (i.e., can be transmitted from animals to humans) that affects livestock, primarily cattle and horses, and occasionally pigs, sheep, goats, llamas, and alpacas. Vesicular stomatitis is endemic to warmer regions of North, Central, and South America, where sporadic outbreaks are often reported.

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How is vesicular stomatitis virus transmitted?

While vesicular stomatitis virus mainly affects livestock (e.g., cattle, horses), the virus can also be transmitted from livestock to humans if humans come into contact with an infected animal’s bodily fluids (e.g., saliva, nasal discharge, vesicular lesions) or fomites (i.e., objects likely to carry infection like clothing, utensils, furniture). The reservoir for vesicular stomatitis virus is currently unknown. It is thought that animals become infected with vesicular stomatitis through the facilitation of insect vectors (e.g., sandflies, midges) and through direct contact (i.e., viral shedding) with animal bodily fluids or lesions. Then, close contact between humans and infected animals leads to zoonotic disease transmission.

What signs and symptoms does vesicular stomatitis virus infection cause?

Vesicular stomatitis virus infection is often less severe in humans than in animals and most individuals are either asymptomatic or experience flu-like symptoms including fever, malaise, myalgias, fatigue, loss of appetite, and lethargy. Rarely, severe clinical signs and symptoms may include blister-like or vesicular lesions distributed around the mouth and nose. Vesicular stomatitis has an incubation period ranging from 2 to 8 days, which is the time between coming into contact with the virus and the first appearance of symptoms.

In animals, there may be more specific signs such as blister-like or vesicular lesions around the coronary bands (i.e., the junction between the hair-producing skin of an animal's lower limb and the hoof wall), and udders. The lesions seen in animals are clinically indistinguishable from those observed in foot and mouth disease, one of the most economically devastating viral diseases of livestock. Other specific symptoms in livestock may also include lethargy, drooling and/or frothing near the mouth, and lameness (i.e., inability to properly use one or more limbs and is often associated with pain and/or soft tissue injury).

How is a vesicular stomatitis virus infection diagnosed and treated?

Diagnosis of vesicular stomatitis virus infection begins with a thorough review of symptoms, risk factors (e.g., occupational exposure), and medical history. Overall, a physical examination focused on the face and oral cavity may help identify any vesicular lesions, ulcers, or blisters. Additionally, examination of the hooves and udders in animals can help identify these lesions. The diagnosis is confirmed through a throat or nasal swab or sampling of a lesion, followed by reverse transcriptase polymerase chain reaction (RT-PCR), a sequencing method that detects the genetic material of a pathogen (e.g., RNA from vesicular stomatitis virus) and subsequently produces a genetic code (i.e., DNA) of the detected pathogen. Complement fixation, a serologic test that detects the presence of specific antibodies or antigens of vesicular stomatitis virus in the blood, can also be used. In complement fixation, an infected individual or animal’s serum is mixed with a known antigen isolated from the virus. If specific antibodies from the individual or animal’s serum begin to clump with the viral antigen (i.e., complement fixation) forming immune complexes, that confirms that the individual or animal has been exposed and/or infected with the virus.

To date, there is no specific treatment for vesicular stomatitis virus and management is mainly aimed at supportive care measures to improve symptom burden. Supportive care measures include adequate rest and hydration with oral fluids; and over-the-counter pain medications like acetaminophen and ibuprofen to reduce fever and alleviate pain. Topical medications like lidocaine can be used to soothe blisters and ulcers in the mucosal area. While few cases of human vesicular stomatitis virus have been described, most of these cases were self-resolving, lasting anywhere from 3 to 5 days. In animals, the disease usually resolves within two weeks and animals usually recover completely without long-term sequelae.

Individuals who work closely with animals, especially in regions where vesicular stomatitis virus is prevalent (e.g., warmer regions of North, Central, and South America) should take preventative measures to minimize risks by using protective equipment and implementing good hand hygiene, both of which may help reduce the risk of disease exposure. If vesicular stomatitis is suspected, one may contact the local State Animal Health Official for further testing and confirmation.

What are the most important facts to know about vesicular stomatitis virus?

Vesicular stomatitis virus also known as Indiana vesiculovirus, is a type of enveloped RNA virus that was first identified in Kinney County, Texas in 2019. The virus belongs to the Rhabdoviridae family and Vesiculovirus genus. It is thought that animals become infected with vesicular stomatitis through insect vectors (e.g., arboviruses, sandflies, midges), and through direct contact (i.e., viral shedding) with animal’s bodily fluids and/or lesions. Then, close contact between humans and infected animals leads to zoonotic disease transmission. Clinical signs and symptoms of vesicular stomatitis virus infection in horses include blister-like or vesicular lesions distributed around the mouth, nose, coronary bands, and/or udders. The vesicular lesions seen in animals are clinically indistinguishable from foot and mouth disease. Diagnosis is confirmed using serologic tests including RT-PCR or complement fixation. Treatment is mainly supportive care measures aimed at reducing symptom burden, which include adequate rest, hydration, antipyretics, and pain relievers.

References

Animal and Plant Health Inspection Service: United States Department of Agriculture. https://www.aphis.usda.gov/aphis/ourfocus/animalhealth/animal-disease-information/equine/vsv/vesicular-stomatitis#:~:text=Vesicular%20stomatitis%20(VS)%20is%20a,this%20is%20a%20rare%20event.

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Centers for Disease Control and Prevention: Vesicular Stomatitis, Indiana Serotype.
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Stallknecht DE, Greer JB, Murphy MD, Mead DG, Howerth EW. Effect of strain and serotype of vesicular stomatitis virus on viral shedding, vesicular lesion development, and contact transmission in pigs. Am J Vet Res. 2004;65(9):1233-1239. doi:10.2460/ajvr.2004.65.1233