Page content: Victorian statutory requirement | Infectious agent | Identification | Incubation period | Public health significance & occurrence | Reservoir | Mode of transmission | Period of communicability | Susceptibility & resistance | Control measures | Outbreak measures | Additional sources of information

Victorian statutory requirement

Notification and school exclusion are not required.

Infectious agent

Molluscipoxvirus is a member of the pox virus (Poxviridae) family.

Identification

Clinical features
This is a viral disease of the skin that produces firm, smooth, spherical, pearly white papules with a central dimple. Most papules are 2–5 mm in diameter, although papules may coalesce to form larger lesions.

Lesions in adults are more common on the lower abdomen, genitalia or inner thighs. In children lesions are more common on the face, trunk, and limbs. Lesions may disseminate more widely in patients with HIV infection.

Molluscum contagiosum may persist for six months to two years without treatment. Lesions may resolve spontaneously or possibly as a result of inflammatory responses secondary to bacterial infection or trauma.

Method of diagnosis
The virus has not yet been cultivated. Diagnosis can be confirmed by microscopy (the core of the lesion is expressed onto a slide then stained), by histology or by visualisation of the vesicle fluid by electron microscopy.

Incubation period

The incubation period is unknown. Clinical reports suggest a range from seven days to six months.

Public health significance & occurrence

Molluscum contagiosum infection occurs worldwide. Surveys in other countries suggest peak incidence occurs during childhood.

Lesions typically resolve without complication. Molluscum contagiosum may be more severe and more persistent in immunosuppressed patients and particularly in patients with HIV/AIDS.

Reservoir

Humans.

Mode of transmission

Molluscum is transmitted by direct contact, fomites or sexual contact. Autoinoculation through scratching is also suspected.

Period of communicability

The period of communicability is unknown but probably as long as the lesions persist.

Susceptibility & resistance

Any age may be affected although infection is more common in children. Infection is more common and more severe in the immunosuppressed.

It is unknown whether prior infection confers any protection against subsequent exposures.

Control measures

Preventive measures
Avoid close contact with the lesions of affected persons. Avoid sharing baths and spas with patients with lesions, and do not share face or bath towels.

Control of case
Isolation of case is not required. Infected children should either avoid contact sports or ensure lesions are adequately covered during play. No school exclusion is required.

Transmission through warm water is only very rarely observed. The risk of transmission through public swimming pool contact is very low and exclusion is rarely if ever necessary.

Many treatments are cited in the literature with destruction of the lesions as their common goal but there is minimal evidence to support them. Watchful waiting may still be the best option for many patients. Phenol ablation may produce significant scarring. Other topical preparations are under investigation.

Control of contacts
Not required.

Control of environment
Not required.

Outbreak measures

Consider suspending direct contact and sporting activities.

Additional sources of information

Australian College of Dermatologists