Twelve separate outbreaks of confirmed cowpox, 10 involving humans, were reviewed. Six of the patients, including three children, had severe infections and five were admitted to hospital. In three outbreaks both people and cows were affected but it was not known how the infections entered the herds. In seven outbreaks no direct contact with cattle was established and clinical and serological examination failed to show evidence of cowpox in the bovine population. Comparison of these data with information about infections known to be enzootic in cattle leads to the suggestion that cows are not the natural reservoir of cowpox. This should be remembered when diagnosis is considered. The role of small wild animals as hosts and vectors of "cowpox" should be investigated.
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