Foot-and-mouth disease

Foot-and-mouth disease
Classification and external resources

Foot-and-mouth disease virus-coating protein
ICD-10 B08.8 (ILDS B08.820)
ICD-9 078.4
DiseasesDB 31707
MeSH D005536

Foot-and-mouth disease, FMD or hoof-and-mouth disease (Aphtae epizooticae) is a highly contagious and sometimes fatal viral disease of cloven-hoofed animals, including domestic animals such as cattle, water buffalo, sheep, goats and pigs, as well as antelope, bison and other wild bovids, and deer. It is caused by foot-and-mouth disease virus.

In addition, hedgehogs [1] and elephants[2] are susceptible to the disease. The llama and alpaca may develop mild symptoms, but are resistant to the disease and will not pass it on to others of the same species.[2] In laboratory experiments, mice and rats and chickens have been successfully infected by artificial means, but it is not believed that they would contract the disease under natural conditions.[2]

Just as humans may spread the disease by carrying the germs on their clothes and body, animals that are not susceptible to the disease may still aid in spreading it. This was the case in Canada in 1952, when an outbreak flared up again after dogs had carried off bones from dead animals.[2] Wolves are thought to play a similar role in the former Soviet Union.[3]

Humans are very rarely affected. Foot-and-mouth disease virus (FMDV) is a picornavirus, the prototypic member of the Aphthovirus genus in the Picornaviridae family. It is a highly variable and transmissible virus.[4]

There are seven FMDV serotypes: O, A, C, SAT-1, SAT-2, SAT-3, and Asia-1. These serotypes show some regionality, and the O serotype is most common.

Contents

History

The cause of FMD was first shown to be viral in 1897 by Friedrich Loeffler. He passed the blood of an infected animal through a Chamberland filter and found that the fluid that was collected could still cause the disease in healthy animals.

FMD occurs throughout much of the world, and whilst some countries have been free of FMD for some time, its wide host range and rapid spread represent cause for international concern. After World War II, the disease was widely distributed throughout the world. In 1996, endemic areas included Asia, Africa, and parts of South America; as of August 2007, Chile is disease free,[5] and Uruguay and Argentina have not had an outbreak since 2001. North America and Australia have been free of FMD for many years. New Zealand has never had a case of foot and mouth disease.[6] Most European countries have been recognized as disease free, and countries belonging to the European Union have stopped FMD vaccination.

However, in 2001, a serious outbreak of FMD in Britain resulted in the slaughter of many animals, the postponing of the general election for a month, and the cancellation of many sporting events and leisure activities such as the Isle of Man TT. Due to strict government policies on sale of livestock, disinfection of all persons leaving and entering farms and the cancellation of large events likely to be attended by farmers, a potentially economically disastrous epizootic was avoided in the Republic of Ireland, with just one case recorded in Proleek, Co. Louth. In August 2007, FMD was found at two farms in Surrey, England. All livestock were culled and a quarantine erected over the area. There have since been two other suspected outbreaks, although these seem now not to be related to FMD. The only reported cases in 2010 were a false alarm from GIS Alex Baker, as proven false by the Florida Farm and Agricultural Department, and confirmed quarantine/slaughter of cows and pigs has been reported from Miyazaki prefecture in Japan in the month of June after three cows tested positive. A total of some 270,000 cattle have been ordered slaughtered following the disease's outbreak.

Clinical signs

The incubation period for foot-and-mouth disease virus has a range between 2 and 12 days.[7] The disease is characterised by high fever that declines rapidly after two or three days; blisters inside the mouth that lead to excessive secretion of stringy or foamy saliva and to drooling; and blisters on the feet that may rupture and cause lameness. Adult animals may suffer weight loss from which they do not recover for several months as well as swelling in the testicles of mature males, and in cows, milk production can decline significantly. Though most animals eventually recover from FMD, the disease can lead to myocarditis (inflammation of the heart muscle) and death, especially in newborn animals. Some infected animals remain asymptomatic, but they nonetheless carry FMD and can transmit it to others.

Ruptured oral vesicle in a cow with FMD

FMD can be transmitted in a number of ways including close contact animal to animal spread, long-distance aerosol spread and fomites or inanimate objects, typically fodder and motor vehicles. The clothes and skin of animal handlers such as farmers, standing water, and uncooked food scraps and feed supplements containing infected animal products can harbor the virus as well. Cows can also catch FMD from the semen of infected bulls. Control measures include quarantine and destruction of infected livestock, and export bans for meat and other animal products to countries not infected with the disease.

Ruptured blisters on the feet of a pig with FMD

Foot-and-mouth disease is caused by FMDV, an Aphthovirus of the viral family Picornaviridae. The members of this family are small (25-30 nm), nonenveloped icosahedral viruses that contain single-stranded RNA (ribonucleic acid). When such a virus comes in contact with a host cell, it binds to a receptor site and triggers a folding-in of the cell membrane. Once the virus is inside the host cell, its protein coat dissolves. New viral RNA and components of the protein coat are then synthesized in large quantities and assembled to form new viruses. After assembly, the host cell lyses (bursts) and releases the new viruses.

Foot-and-mouth disease infecting humans

Humans can be infected with foot-and-mouth disease through contact with infected animals, but this is extremely rare. Some cases were caused by laboratory accidents. Because the virus that causes FMD is sensitive to stomach acid, it cannot spread to humans via consumption of infected meat, except in the mouth before the meat is swallowed. In the UK, the last confirmed human case occurred in 1966[8][9], and only a few other cases have been recorded in countries of continental Europe, Africa, and South America. Symptoms of FMD in humans include malaise, fever, vomiting, red ulcerative lesions (surface-eroding damaged spots) of the oral tissues, and sometimes vesicular lesions (small blisters) of the skin. According to a newspaper report, FMD killed two children in England in 1884, supposedly due to infected milk.[10]

There is another viral disease with similar symptoms, commonly referred to as "hand, foot and mouth disease", that occurs more frequently in humans, especially in young children; the cause, Coxsackie A virus, is different from FMDV. Coxsackie A also belongs to the Picornaviridae family . Coxsackie viruses belong to the Enteroviruses within the Picornaviridae.

Because FMD rarely infects humans, but spreads rapidly among animals, it is a much greater threat to the agriculture industry than to human health. Farmers around the world can lose huge amounts of money during a foot-and-mouth epizootic, when large numbers of animals are destroyed and revenues from milk and meat production go down.

Vaccination

Plum Island Animal Disease Center

Seven main types of FMDV are believed to exist[11]. Like other viruses, the FMD virus continually evolves and mutates, thus one of the difficulties in vaccinating against FMD is the huge variation between and even within serotypes. There is no cross-protection between serotypes (meaning that a vaccine for one serotype will not protect against any others) and in addition, two strains within a given serotype may have nucleotide sequences that differ by as much as 30% for a given gene. This means that FMD vaccines must be highly specific to the strain involved. Vaccination only provides temporary immunity that lasts from months to years.

Currently, the World Organisation for Animal Health recognizes countries to be in one of three disease states with regards to FMD: FMD present with or without vaccination, FMD-free with vaccination, and FMD-free without vaccination. Countries that are designated FMD-free without vaccination have the greatest access to export markets, and therefore many developed nations, including Canada, the United States, and the UK, work hard to maintain their current FMD-free without vaccination status.

There are several reasons cited for restricting export from countries using FMD vaccines. The most important is probably that routine blood tests, relying on antibodies, cannot distinguish between an infected and a vaccinated animal.[12] This would severely hamper screening of animals used in export products, risking a spread of FMD to importing countries. A widespread preventive vaccination would also conceal the existence of the virus in a country. From there, it could potentially spread to countries without vaccine programs. Lastly, an animal that is infected shortly after being vaccinated can harbour and spread FMD without showing symptoms itself, hindering containment and culling of sick animals as a remedy.

Many early vaccines used dead samples of FMDV to inoculate animals. However, those early vaccines sometimes caused real outbreaks. In the 1970s, scientists discovered that a vaccine could be made using only a single key protein from the virus. The task was to produce such quantities of the protein that could be used in the vaccination. On June 18, 1981, the U.S. government announced the creation of a vaccine targeted against FMD; this was the world's first genetically engineered vaccine.

The North American FMD Vaccine Bank is housed at the United States Department of Agriculture's (USDA) Foreign Animal Disease Diagnostic Laboratory (FADDL) at Plum Island Animal Disease Center. The Center, located 1.5 miles (2.4 km) off the coast of Long Island, NY, is the only place in the United States where scientists can conduct research and diagnostic work on highly contagious animal diseases such as FMD. Because of this limitation US companies working on FMD usually use facilities in other countries where such diseases are endemic.

Epizootics

US, 1914-1929

The US has had 9 FMD outbreaks since 1870. The most devastating outbreak happened in 1914. It originated from Michigan, but it was its entry into the stockyards in Chicago that turned it into an epizootic. About 3,500 livestock herds were infected across the US, totaling over 170,000 cattle, sheep and swine. The eradication came at a cost of 4.5 million 1914 USD. A 1924 outbreak in California resulted not only in the slaughter of 109,000 farm animals, but also 22,000 deer. The US saw its latest FMD outbreak in Montebello, California in 1929. This outbreak originated in hogs that had eaten infected meat scraps from a tourist steamship that had stocked meat in Argentina. Over 3,600 animals were slaughtered and the disease was contained in less than a month.[13][14]

United Kingdom, 1967

In October 1967, a farmer in Shropshire reported a lame sow, which was later diagnosed with FMD. The source was believed to be remains of legally-imported infected lamb from Argentina and Chile. The virus spread and in total, 442,000 animals were slaughtered and the outbreak had an estimated cost of £370 million.

Taiwan, 1997

Taiwan had previous epidemics of FMD in 1913-14 and 1924-29, but had since been spared epidemics [15], and considered itself free of FMD as late as in the 1990s. On the 19th of March 1997, a sow at a farm in Hsinchu prefecture, Taiwan was diagnosed with a strain of FMD which only infects swine. Mortality was high, nearing 100% in the infected herd. The cause of the epidemic was not determined, but the farm was near a port city known for its pig-smuggling industry and illegal slaughterhouses. Smuggled swine or contaminated meat are thus likely sources of the disease.

The disease spread fast among swine herds in Taiwan, with 200-300 new farms being infected daily. Causes for this include the high swine density in the area, with up to 6,500 hogs per square mile, feeding of pigs with untreated garbage and the farm's proximity to slaughterhouses. Other systemic issues such as lack of laboratory facilities, slow response and initial lack of a vaccination program contributed. It is also alleged that farmers intentionally introduced FMD to their flocks, because the payment offered to farmers for culled swine was at a time higher than the market value of the swine.

A complicating factor is the endemic spread of swine vesicular disease (SVD) in Taiwan. The symptoms are indistinguishable from FMD, which may have led to previous misdiagnosing of FMD as SVD. Laboratory analysis was seldom used for diagnosis and FMD may thus have gone unnoticed for some time in Taiwan.

The swine depopulation was a massive undertaking, with the military contributing substantial manpower. At peak capacity, 200,000 hogs per day were disposed of, mainly by electrocution. Carcasses were disposed of by burning and burial, but burning was avoided in water resource protection areas. In April, industrial incinerators were running around the clock to dispose of the carcasses.

Initially, 40,000 combined vaccines for the strains O-1, A-24 and Asia-1 were available and administered to zoo animals and valuable breeding hogs. At the end of March, half a million new doses of vaccines for O-1 and Asia-1 were made available. On the 3rd of May, 13 million doses of O-1 vaccine arrived, and both the March and May shipments were distributed free of charge. There was a danger of vaccination crews spreading the disease; therefore, trained farmers were allowed to administer the vaccine under veterinary supervision.

Taiwan had previously been the major exporter of pork to Japan, and among the top 15 pork producers in the world in 1996. During the outbreak, over 3.8 million swine were destroyed at a cost of $6.9 billion USD. The Taiwanese pig industry was devastated as a result, and the export market was in ruins.[13][16] In 2007, Taiwan was considered free of FMD, but were still conducting a vaccination program, which restricts the export of meat from Taiwan.

United Kingdom, 2001

The epidemic of foot-and-mouth disease in the United Kingdom in the spring and summer of 2001 was caused by the "Type O pan Asia" strain of the disease[17]. This episode resulted in more than 2,000 cases of the disease in farms throughout the British countryside. Around seven million sheep and cattle were killed in an eventually successful attempt to halt the disease. The county of Cumbria was the worst affected area of the country, with 843 cases. By the time the disease was halted by October 2001, the crisis was estimated to have cost Britain £8bn ($16bn) in costs to the agricultural and support industries, and to the outdoor industry. What made this outbreak so serious was the amount of time between infection being present at the first outbreak loci, and the time when countermeasures were put into operation against the disease, such as transport bans and detergent washing of both vehicles and personnel entering livestock areas. However, the extreme overkill of many disease-free animals (80% of culled livestock were clean) was a result of inappropriate poor mathematical modelling that did not reflect the epidemiology of the epidemic.[18] The epidemic was probably caused by pigs which had been fed infected garbage that had not been properly heat-sterilized. It is further believed that the garbage contained remains of infected meat which had been illegally imported to Britain.[19]

China, 2005

In April 2005, an Asia-1 strain of FMD appeared in the eastern provinces of Shandong and Jiangsu. During April and May, it spread to suburban Beijing, the northern province of Hebei, and the Xinjiang autonomous region in northwest China. On 13 May, China reported the FMD outbreak to the World Health Organization and the OIE. This was the first time China has publicly admitted to having FMD. [20] [21] China is still reporting FMD outbreaks. In 2007, reports filed with the OIE documented new or ongoing outbreaks in the provinces of Gansu, Qinghai and Xinjiang. This included reports of domestic yak showing signs of infection. [22]

United Kingdom, 2007

An infection of foot-and-mouth disease in the United Kingdom was confirmed by the Department for Environment, Food and Rural Affairs, on 3 August 2007, on farmland located in Normandy, Surrey.[23][24] All livestock in the vicinity were culled on 4 August. A nationwide ban on the movement of cattle and pigs was imposed, with a 3 km (1.9 mile) protection zone placed around the outbreak sites and the nearby virus research and vaccine production establishments, together with a 10 km (6.2 mile) increased surveillance zone.[25]

On 4 August, the strain of the virus was identified as an "01 BFS67-like" virus, one linked to vaccines and not normally found in animals, and isolated in the 1967 outbreak.[26] The same strain was used at the nearby Institute for Animal Health and Merial Animal Health Ltd at Pirbright, 2½ miles (4 km) away which is an American/French owned research facility, and was identified as a possible source of infection.[27]

On 12 September, a new outbreak of the disease was confirmed in Egham, Surrey, 19 km (12 miles) from the original outbreak[28], with a second case being confirmed on a nearby farm on 14 September.[29]

These outbreaks caused a cull of all at-risk animals in the area surrounding Egham, including two farms near to the famous 4-star Hotel Great Fosters.

These outbreaks also caused the closure of Windsor Great Park due to the park containing deer; the park remained closed for three months.

On 19 September 2007, there was a suspected case of FMD in Solihull, where a temporary control zone was set up by Defra.

Japan and the Republic of Korea, 2010

In April 2010, a report of three incursions of foot-and-mouth disease in Japan and the Republic of Korea led the United Nations Food and Agriculture Organization (FAO) to issue a call for increased global surveillance. Japan veterinary authorities confirmed an outbreak of type O FMD virus, currently more common in Asian countries where FMD is endemic.

The Republic of Korea was hit by the rarer type A FMD in January and then suffered type O infection in April.[30]

Economic and ethical issues

Epidemics of FMD have resulted in the slaughter of millions of animals, despite this being a frequently nonfatal disease for adult animals (2-5% mortality), though young animals can have a high mortality. The Taiwan outbreak that only affected pigs also showed a high mortality for adults. The destruction of animals is primarily to halt further spread, as growth and milk production may be permanently affected, even in animals that have recovered. Due to international efforts to eradicate the disease, infection would also lead to trade bans being imposed on affected countries. Critics of current policies to cull infected herds argue that the financial imperative needs to be balanced against the killing of many animals[31], especially when a significant proportion of infected animals, most notably those producing milk, would recover from infection and live normal lives, albeit with reduced milk production. On the ethical side, one must also consider that FMD is a painful disease for the affected animals.[32] The vesicles/blisters are painful in themselves, and restrict both eating and movement. Through ruptured blisters, the animal is at risk from secondary bacterial infections [32] and, in some cases, permanent disability.

Warning notice

This notice is posted where FMD is suspected and a temporary control zone has been set up by Defra:

Failure to comply with this Declaration may be an offence under section 72 or 73 of the Animal Health Act 1981
Note – The declaration of a Temporary Control Zone takes precedence over the previously declared Restricted Zone measures for its duration. A map is attached for ease of reference.

Annex 1

The Zone comprises that part of England contained within a circle with a radius of 3 kilometres centred on grid reference SP 1752681268. The grid reference is a British National Grid Reference.

Annex 2

1. No person shall move any susceptible animal into or out of the Zone except where the movement is –
(a) through the Zone without stopping under a licence authorising movement within the Restricted Zone, granted before the creation of the Zone; or
(b) necessary to complete a journey started under a licence authorising movement within the Restricted Zone, granted before the creation of the Zone.
2. No person shall move any susceptible animal from or to premises in the Zone (without leaving the Zone) except to complete a journey started before the creation of the Zone, under the authority of a licence authorising movement within the Restricted Zone granted before the creation of the Zone.
3. The keeper of a susceptible animal in the Zone shall take all such steps as are necessary to prevent it from straying from the premises on which it is kept.

Derivative word uses

Sometimes "has foot-in-the-mouth disease" is used humorously to mean "says something inappropriate": this is derived from misinterpreting the pronoun "it" in the sentence "Every time he opens his mouth [to talk], he puts his foot in it [= does something silly]."[1]

See also

References

  1. ↑ J. D. McLauchlan, W. M. Henderson 'The Occurrence of Foot-and-Mouth Disease in the Hedgehog under Natural Conditions', The Journal of Hygiene, Vol. 45, No. 4 (Dec., 1947), pp. 474-479
  2. ↑ 2.0 2.1 2.2 2.3 Canadian Food Inspection Agency - Animal Products - Foot-and-Mouth Disease Hazard Specific Plan
  3. ↑ Graves, Will (2007). Wolves in Russia: Anxiety throughout the ages. pp. 222. ISBN 1550593323. http://www.wolvesinrussia.com/. 
  4. ↑ Martinez-Salas E, Saiz M, Sobrino F (2008). "Foot-and-Mouth Disease Virus". Animal Viruses: Molecular Biology. Caister Academic Press. pp. 1–38. ISBN 978-1-904455-22-6. http://www.horizonpress.com/hsp/abs/absavir.html. 
  5. ↑ (PDF) Foot and Mouth Disease. Washington State Department of Health. March 2002. http://www.doh.wa.gov/ehp/ts/zoo/foot-and-mouth-disease.pdf. Retrieved 2007-08-05. 
  6. ↑ http://www.biosecurity.govt.nz/pests/surv-mgmt/surv/freedom, official government press release, New Zealand's Freedom From Foot And Mouth Disease, Biosecurity New Zealand, accessdate = 2007-08-06
  7. ↑ "Foot and Mouth Symptom Guide". Farmers Weekly. 2007-08-04. http://www.fwi.co.uk/Articles/2007/08/04/105713/foot-and-mouth-symptoms.html. Retrieved 2007-08-06. 
  8. ↑ "Foot and Mouth Disease update: further temporary control zone established in Surrey". Defra. 2007-08-14. http://www.defra.gov.uk/news/2007/070814c.htm. Retrieved 2007-08-14. 
  9. ↑ Jeffery, Simon (2001-11-23). "Foot and Mouth Disease". London: The Guardian. http://www.guardian.co.uk/footandmouth/story/0,,604980,00.html. Retrieved 2007-08-14. 
  10. ↑ Jeffery, Simon (2001-11-23). "Foot and mouth 'killed people in 1800s'". London: The Guardian. http://www.guardian.co.uk/footandmouth/story/0,,604980,00.html. Retrieved 2007-08-14. 
  11. ↑ http://copus.org.uk/page.asp?id=1253 Foot and Mouth Virus Information
  12. ↑ Canadian Food Inspection Agency Q&A, question 20. http://www.inspection.gc.ca/english/anima/heasan/disemala/fmdfie/questionse.shtml
  13. ↑ 13.0 13.1 EDEN http://www.eden.lsu.edu/Issues_View.aspx?IssueID=5f3b1efb-d295-4d8e-9cab-8e3bba3c3824
  14. ↑ CRS Report for Congress - Foot and Mouth Disease: A Threat to U.S. Agriculture, Segarra, Rawson. http://www.nationalaglawcenter.org/assets/crs/RS20890.pdf
  15. ↑ Foot-and-mouth virus: A global dilemma http://archives.cnn.com/2001/WORLD/europe/02/27/farming.world/index.html
  16. ↑ US Department of Agriculture - Foreign Animal Report 1998, p41 http://www.aphis.usda.gov/lpa/pubs/fadrep.pdf
  17. ↑ http://copus.org.uk/page.asp?tip=1&id=1252|title=What is foot and mouth disease?
  18. ↑ Kitching, Hutber and Thrusfield (2005). The Veterinary Journal, 169 (2), 197-209.
  19. ↑ DEFRA - Origin of the UK Foot and Mouth Disease Epidemic 2001 http://www.defra.gov.uk/foodfarm/farmanimal/diseases/atoz/fmd/documents/fmdorigins1.pdf
  20. ↑ Jia Hepeng, China confirms bird flu and foot-and-mouth outbreaks http://www.scidev.net/News/index.cfm?fuseaction=readNews&itemid=2122&language=1
  21. ↑ Foot-and-mouth Outbreaks Confirmed - china.org.cn
  22. ↑ WAHID Interface - OIE World Animal Health Information Database
  23. ↑ "Foot and Mouth Disease confirmed in cattle, in Surrey". DEFRA. 2007-08-03. http://www.defra.gov.uk/news/latest/2007/animal-0803.htm. Retrieved 2007-08-03. 
  24. ↑ "Further farms tested for disease". BBC News. 2007-08-04. http://news.bbc.co.uk/1/hi/uk/6931395.stm. Retrieved 2007-08-04. 
  25. ↑ Miles Goslett (2007-08-03). "Foot and mouth: new possible cases reported". London: The Daily Telegraph. http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/08/04/ndefra1104.xml. Retrieved 2007-08-04. 
  26. ↑ "Results of Foot and Mouth Disease Strain in Surrey, extension of zones". DEFRA. 2007-08-04. http://www.defra.gov.uk/news/2007/070804a.htm. Retrieved 2007-08-04. 
  27. ↑ "Foot-and-mouth strain identified". BBC News. 2007-08-04. http://news.bbc.co.uk/1/hi/uk/6931639.stm. Retrieved 2007-08-04. 
  28. ↑ "'Pirbright link' to farm outbreak". BBC News. Dated 12 September 2007
  29. ↑ "Outbreak at second farm confirmed" BBC News
  30. ↑ "UN agency warns of increased foot-and-mouth threats after outbreaks in Asia" UN News Centre
  31. ↑ The UK Foot and Mouth Epidemic of 2001: A Research Resource
  32. ↑ 32.0 32.1 http://www.inspection.gc.ca/english/anima/heasan/disemala/fmdfie/plan/plan-1e.shtml section 1.6.1

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