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Rare sheep virus with parallels to coronavirus put boy in emergency care

Brychan Edwards mum did not leave his bedside for five days and four nights as he lay in hospital.

She massaged the 15-year-old’s hands and feet with an emollient to soothe the angry red weals and welts that were erupting across his body.

She also applied ice packs across his hands to relieve the itchiness that prevented him from sleeping for 96 hours.

Meanwhile medical staff scratched their heads about a condition that’s rarely seen in hospitals but which is all too familiar to farmers.

North Wales Live reported that Brychan had a severe case of Orf, a viral illness in sheep which can be passed to humans.

It’s likely he caught the virus feeding pet lambs at Tywysog, his family farm in Conwy near Henllan.

“He felt as if his hands and feet were on fire,” said his mum Ffion Clwyd Edwards

“It looked like he’d been burnt all over.

“A skin condition is not usually an emergency but in my son’s case it was.”

Brychan Clwyd Edwards, 15, back home at Tywysog farm with mum Ffion

In desperation, as Brychan’s condition deteriorated, his family issued a Facebook appeal for information.

It was shared 43,000 times and prompted scores of suggested remedies from around the world, including from the family’s relatives from Patagonia.

The consensus was to let the illness run its course without intervention.

“We couldn’t believe the response,” said Ffion, a farmer’s wife and PR consultant.

“So many strangers were so kind, considerate and helpful.”

Ffion feels her son’s five-day hospital nightmare at Ysbyty Glan Clwyd, Bodelwyddan,could have been avoided if there had been greater awareness, and understanding, of the condition.

Muddying the medical waters was Covid-19: in most of the 100 or so severe cases involving teenagers, they too have developed rashes.

“Brychan recovered only when he was taken off the treatment he was receiving,” said Ffion.

“In hospital we were told Orf is an extremely rare condition. However we were contacted by dozens of farmers – and vets – who have suffered from it, or know someone who has.

“Most people tend to deal with it themselves, rather than visit their GP or hospital, so there is less awareness of the condition than there should be.”

The family’s nightmare began in early May when Brychan developed an itchy rash on both hands.

Mum Ffion applied antiseptic and gauze so that he could return to his part-time milking job on a nearby farm. Antibiotics and anti-fungal tablets were also prescribed.

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But within five days hives spread from his hands to his elbows, knees, ankles and feet.

Although GP practices were closed on VE Day, Ffion managed to get hold of her family doctor.

Dr Dyfan Rhys Jones, of the Bronyffynnon Surgery, Denbigh, insisted on opening his surgery to see the condition for himself.

He quickly identified Orf and, within an hour of seeing him, Brychan was in hospital.

Dr Jones knew what to look for as his own father – who farmed near Tywysog – had been hospitalised with the disease in the 1990s.

“The condition is probably more common than widely supposed in the medical profession,” he said.

“No doubt you can find it in the fine print of medical texts, but it certainly wasn’t part of my training.

“This was the first time I’ve ever admitted a patient to hospital needing to explain what the condition was.”

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At Ysbyty Glan Clwyd, Brychan was put on a drip.

As no dermatology consultants were on duty over the Bank Holiday weekend, it fell to the on-duty medical team to find solutions.

Staff even contacted specialists at Alder Hey Hospital and the Liverpool School of Tropical Medicine.

“They worked around the clock to support my son,” said Ffion.

“By Saturday night all the nurses on the ward were online researching Orf. They were wonderful!

“Some were farmer’s daughters and wives, but they had never seen it before. Everyone was intrigued.”

All the while Brychan was treated with antibiotics, antihistamines, steroid creams and eczema creams. Ffion also applied iced water and ice packs – but it made little difference.

As his condition deteriorated, Brychan was moved to the red (Covid) ward in the children’s wing. For this he needed a Covid-19 swab, for which he tested negative.

Under Covid measures only one parent can attend hospital with a child. Dad Rhodri and Brychan’s older brother, Tomos, were forced to wait at home for news.

During her stay, Ffion never felt threatened by the virus: she said families shouldn’t hesitate to access hospital care if their children are unwell.

“The Covid-19 safeguards in place at Glan Clwyd were brilliant,” she said.

“We felt extremely safe on both wards we attended.”

It was only after the weekend, with paediatric and dermatology consultants back on call, that all treatments were withdrawn. Brychan’s condition quickly improved.

“Later my 72-year-old father, who farms in the Conwy Valley, told me you should never treat Orf, as it will only aggravate the condition,” said Ffion.

In fact her own husband, Rhodri, had been hospitalised with Orf 10 years earlier.

And it was clear from responses to the family’s Facebook post that these were not isolated examples.

“Cases in sheep seem to be high in the Vale of Clwyd this season,” said Ffion.

Each year Dr Dyfan Rhys Jones usually sees two or three patients with suspect Orf.

Many more cases probably go undetected because the majority of people show mild or no symptoms, he said.

As most doctors are trained at urban facilities, relatively obscure rural conditions like Orf are rarely on curricula.

Most cases can be self-treated. However some individuals develop complications, including infected lessons or systemic problems.

In these situations, medical advice should be sought.

Dr Jones drew parallels with coronavirus.

“Like Covid-19 only a minority of patients develop severe symptoms,” he said.

“The majority recover without intervention.

“And like Covid-19, best advice is always to wash your hands properly when handling infected animals, and to wear gloves.”

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