Buffalopox is an emerging viral zoonotic disease caused by the buffalopox virus (BPXV), endemic in Southeast Asia. BPXV is a member of the Orthopoxvirus genus, along with smallpox and mpox, and a close variant of the vaccinia virus. It is thought that waning cross-immunity against smallpox since its eradication contributes to the increasing risk of human infections. Animal hosts may include buffaloes, cows, and rabbits.

Zoonotic outbreaks of BPXV have been reported in India, Pakistan, Bangladesh, Russia, Indonesia, and Egypt. Human cases have been reported in India and Pakistan. The virus is transmitted from animal hosts to humans by direct contact with skin lesions of infected animals and fomites. Milking affected animals is a common route of transmission. Food-borne transmission through contaminated milk has also been reported. Buffalo fat, which may be applied as a remedy for burns in certain communities, is a possible source of infection. Occupational exposure in a laboratory worker handing BPXV virus has also been reported. In 2022, human-to-human spread was suspected in a dermatologist who took care of affected patients.

Patients present with progressive stages of erythematous macules, papules, vesicles, and pustules that become necrotic over 3-6 weeks after an incubation period of 3-19 days. Lesions most commonly appear on the hands and wrists (due to direct contact with the infected animal while milking), and less commonly on the forearms, face, neck, legs, feet, and genitalia, from self-inoculation. Secondary bacterial infection may also occur. Patients may report prodromal symptoms including fevers, malaise, and lymphadenopathy. BPXV is typically self-limiting with low mortality but some morbidity.