Foot and Mouth Disease

1. Foot and Mouth Disease FMD, Aftosa

2. Overview • Organism • Economic Impact • Epidemiology • Transmission • Clinical Signs • Diagnosis and Treatment • Prevention and Control • Actions to take Center for Food Security and Public Health Iowa State University - 2004

3. The Organism

4. Foot and Mouth Disease • Picornaviridae, Aphthovirus • 7 distinct serotypes • Not cross protective • Affects cloven-hoofed animals • Inactivated at • pH below 6.5 and above 11 • Survives in milk, milk products, bone marrow, lymph glands Center for Food Security and Public Health Iowa State University - 2004

5. Importance

6. History • 1929: Last case in U.S. • 1953: Last cases in Canada and Mexico • 1993: Italy • 1997: Taiwan • 2001: United Kingdom • Other outbreaks in 1967-68 and 1981 Center for Food Security and Public Health Iowa State University - 2004

7. Direct costs Economic losses to farmers and producers Eradication costs Millions to billions of dollars lost Economically Devastating!! Indirect costs Exports shut down $3.1 billion in beef $1.3 billion in pork $14 billion in lost farm income $6.6 billion in livestock exports Consumer fear Economic Impact Center for Food Security and Public Health Iowa State University - 2004

8. Epidemiology

9. Geographic Distribution Center for Food Security and Public Health Iowa State University - 2004

10. Foot and Mouth Disease Distribution 2003 Center for Food Security and Public Health Iowa State University - 2004

11. Morbidity/ Mortality • Morbidity 100% in susceptible animal population • United States, Canada, Mexico, others • Mortality less than 1% • Higher in young animals and highly virulent virus strains • Animals generally destroyed to prevent spread Center for Food Security and Public Health Iowa State University - 2004

12. Transmission

13. Animal Transmission • Respiratory aerosols • Proper temperature and humidity • Survives 1-2 days in human respiratory tract • Direct contact • Ingestion of infected animal parts • AI, biologicals, hormones • Indirect contact via fomites Center for Food Security and Public Health Iowa State University - 2004

14. Animal Transmission Center for Food Security and Public Health Iowa State University - 2004

15. Human Transmission • Very rarely develop mild clinical signs • Type O, C, rarely A • Act as a transmitter to animals • Harbor virus in respiratory tract for 1-2 days • Contaminated boots, clothing, vehicles • Spread to susceptible animals • Ingestion of unprocessed milk or dairy products from infected animals Center for Food Security and Public Health Iowa State University - 2004

16. Animals and FMD

17. Clinical Signs • Incubation period: 2-12 days • Fever and vesicles • Feet, mouth, nares muzzle, teats • Progress to erosions • Abortion • Death in young animals • Recover in two weeks unless secondary infections arise Center for Food Security and Public Health Iowa State University - 2004

18. Clinical Signs in Cattle • Oral lesions • Vesicles on tongue, dental pad, gums, soft palate, nostrils, muzzle • Excess salivation, drooling, serous nasal discharge Center for Food Security and Public Health Iowa State University - 2004

19. Clinical Signs in Cattle • Teat lesions • Decreased milk production • Hoof lesions • Interdigital space • Coronary band • Lameness • Reluctant to move Center for Food Security and Public Health Iowa State University - 2004

20. Clinical Signs in Pigs • Hoof lesions • More severe than in cattle • Coronary band, heel, interdigital space • Lameness • Snout vesicles • Oral vesicles less common • Drooling is rare Center for Food Security and Public Health Iowa State University - 2004

21. Clinical Signs in Sheep and Goats • Mild, if any, signs • Fever • Oral lesions • Lameness • Makes diagnosis and prevention of spread difficult Fred Ward, USDA Larry Rana, USDA Center for Food Security and Public Health Iowa State University - 2004

22. Center for Food Security and Public Health Iowa State University - 2004

23. Post Mortem Lesions • Clinically indistinguishable from other vesicular diseases, especially swine • Single or multiple vesicles • Various stages of development • White area, 2mm-10cm • Fluid filled blister • Red erosion, fibrin coating • Dry lesions • Tiger heart Center for Food Security and Public Health Iowa State University - 2004

24. Differential Diagnosis • In swine • Vesicular stomatitis • Swine vesicular disease • Vesicular exanthema of swine • Foot rot • Chemical and thermal burns • In cattle • Rinderpest, IBR, BVD, MCF, Bluetongue Center for Food Security and Public Health Iowa State University - 2004

25. Sampling • Before collecting or sending any samples, the proper authorities should be contacted • Samples should only be sent under secure conditions and to authorized laboratories to prevent the spread of the disease Center for Food Security and Public Health Iowa State University - 2004

26. Clinical Diagnosis • Clinically vesicular diseases are indistinguishable • Salivation, lameness with vesicles requires further testing • Tranquilization may be necessary Center for Food Security and Public Health Iowa State University - 2004

27. Diagnosis • Laboratory Tests • Initial diagnosis • Virus isolation and identification • Antigen or nucleic acid detection • Complement fixation • ELISA and virus neutralization • Notify authorities and wait for instructions before collecting samples Center for Food Security and Public Health Iowa State University - 2004

28. Treatment • No treatment available • Supportive care to those afflicted • U.S. outbreak could result in • Quarantine • Euthanization • Disposal • Vaccine available • Ramifications are many and discussed later Center for Food Security and Public Health Iowa State University - 2004

29. FMD in Humans

30. Human Clinical Signs • Very low incidence of human disease • 40 cases since 1921 • Most reports ended when FMD was eradicated in Europe • Incubation period: 2-6 days • Clinical signs • Mild headache, malaise, fever • Tingling, burning sensation of fingers, palms, feet prior to vesicle formation Center for Food Security and Public Health Iowa State University - 2004

31. Human Clinical Signs • Vesicles 2 mm to 2 cm in diameter • Fluid-filled • Oral blisters on tongue, palate • Painful • Interfere in eating, drinking, talking • Diarrhea • Vesicles dry up in 2-3 days • Recover within a week of last blister appearing Center for Food Security and Public Health Iowa State University - 2004

32. Diagnosis and Treatment • Clinically FMD in humans resembles • Coxsackie A group viruses • Hand, foot and mouth disease • Herpangina • Herpes simplex virus • Primary herpetic gingivostomatitis • Vesicular stomatitis • Virus isolation or antibody identification required for diagnosis • Treatment is supportive care Hand, Foot & Mouth Disease Center for Food Security and Public Health Iowa State University - 2004

33. Public Health Significance • FMD in humans is not a public health concern • 40 cases since 1921 documented in humans • Europe, Africa, South America Center for Food Security and Public Health Iowa State University - 2004

34. Prevention and Control

35. Prevention • USDA APHIS: Strict import restrictions • Prohibit live ruminants, swine, and their products from FMD-affected countries • Monitor travelers and belongings at ports of entry • 450 FADD to investigate suspicious lesions • State planning/training exercises • Biosecurity protocols for livestock facilities Center for Food Security and Public Health Iowa State University - 2004

36. Recommended Actions • Notification of Authorities • Federal: Area Veterinarian in Charge (AVIC) www.aphis.usda.gov/vs/area_offices.htm • State veterinarian www.aphis.usda.gov/vs/sregs/official.html • Quarantine Center for Food Security and Public Health Iowa State University - 2004

37. Recommended Actions • Confirmatory diagnosis • Depopulation may occur • Proper destruction of exposed cadavers, litter, animal products Center for Food Security and Public Health Iowa State University - 2004

38. Disinfection • Effective solutions include • 2% sodium hydroxide (lye) • 4% sodium carbonate (soda ash) • 5.25% sodium hypochlorite (household bleach) • 0.2% citric acid • Areas must be free of organic matter Center for Food Security and Public Health Iowa State University - 2004

39. Vaccination • Killed vaccine, serotype specific • North American Foot-and-Mouth Vaccine Bank • Plum Island, NY • Monitor disease outbreaks worldwide and stock active serotypes and strains • It is essential to isolate virus and identify the serotype to select the correct vaccine Center for Food Security and Public Health Iowa State University - 2004

40. Vaccination • U.S. has no need to vaccinate • Have not had animals affected since 1929 • May be used to control an outbreak • Huge implications if we do vaccinate • Annual re-vaccination required • Costly, time consuming • Does not protect against infection, just clinical signs • Spread infection to other animals • International trade status harmed Center for Food Security and Public Health Iowa State University - 2004

41. Additional Resources

42. Resources • World Organization for Animal Health (OIE) website • www.oie.int • USDA APHIS Veterinary Services • www.aphis.usda.gov/vs • 1-866-SAFGUARD is a toll-free hotline with recorded messages for international travelers Center for Food Security and Public Health Iowa State University - 2004

43. Development of this presentation was funded by a grant from the Centers for Disease Control and Prevention to the Center for Food Security and Public Health at Iowa State University. Acknowledgments

44. Acknowledgments Author: Co-authors: Reviewer: Danelle Bickett-Weddle, DVM Anna Rovid Spickler, DVM, PhD Kristina August, DVM James Roth, DVM, PhD Bindy Comito Sornsin, BA