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| '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' | | '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' |
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| {{CMG}} | | {{CMG}} |
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| {{Globalize/UK}} | | {{Foot-and-mouth disease}} |
| {{distinguish|hand, foot and mouth disease}}
| | ==[[Foot-and-mouth disease overview|Overview]]== |
| {{Infobox_Disease |
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| Name = Foot-and-mouth disease |
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| Image = |
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| Caption = |
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| DiseasesDB = 31707 |
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| ICD10 = {{ICD10|B|08|8|b|00}} |
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| ICD9 = {{ICD9|078.4}} |
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| eMedicineTopic = |
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| MeshID = D005536 |
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| {{Taxobox
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| | color = violet
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| | name = ''Foot-and-mouth disease virus''
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| | image = Foot-and-Mouth-Disease-Virus.png | |
| | image_caption = Foot-and-mouth disease virus coating protein
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| | virus_group = iv
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| | familia = ''[[Picornaviridae]]''
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| | genus = ''[[Aphthovirus]]''
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| | species = '''''Foot-and-mouth disease virus'''''
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| }}
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| ==Overview== | | ==[[Foot-and-mouth disease historical perspective|Historical Perspective]]== |
| {{Current-related|article|2007 United Kingdom foot-and-mouth outbreak|date=August 2007}}
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| '''Foot-and-mouth disease''' (FMD, [[Latin]] [[binomial nomenclature|binomial]] ''Aphtae epizooticae''), sometimes called '''hoof-and-mouth disease''', is a [[infectious disease|highly contagious]] and sometimes fatal [[virus (biology)|viral]] [[disease]] of [[cattle]] and [[pig]]s. It can also infect [[deer]], [[goat]]s, [[Domestic sheep|sheep]], and other [[bovid]]s with [[Cloven-hoof|cloven hooves]], as well as [[elephant]]s, [[rat]]s, and [[hedgehog]]s. Humans are very rarely affected. Foot-and-mouth disease virus (FMDV) is the prototypic member of the Aphthovirus genus in the Picornaviridae family. This picornavirus is the etiological agent of the acute systemic vesicular disease that affects cattle and other animals worldwide. It is a highly variable and transmissible virus.<ref>{{cite book |chapterurl=http://www.horizonpress.com/hsp/abs/absavir.html|author=Martinez-Salas E, Saiz M, Sobrino F|year=2008|chapter=Foot-and-Mouth Disease Virus|title=Animal Viruses: Molecular Biology|publisher=Caister Academic Press|pages=pp. 1-38|id=[http://www.horizonpress.com/avir ISBN 978-1-904455-22-6]}}</ref>
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| 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 fine porcelain filter and found that the fluid that was collected could still cause the disease in healthy animals.
| | ==[[Foot-and-mouth disease pathophysiology|Pathophysiology]]== |
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| 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,<ref>{{cite paper
| | ==[[Foot-and-mouth disease causes|Causes]]== |
| | title = Foot and Mouth Disease
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| | publisher = Washington State Department of Health
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| | date = [[March 2002]]
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| | url = http://www.doh.wa.gov/ehp/ts/zoo/foot-and-mouth-disease.pdf
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| | format = [[PDF]]
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| | accessdate = 2007-08-05
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| }}</ref> and [[Uruguay]] and [[Argentina]] have not had an outbreak since April 1994.{{Fact|date=August 2007}} [[North America]], [[Australia]] and [[Japan]] have been free of FMD for many years. [[New Zealand]] has never had a case of foot and mouth disease.<ref>http://www.biosecurity.govt.nz/pests-diseases/animals/foot-n-mouth/freedom-statement.htm, official government press release, New Zealand's Freedom From Foot And Mouth Disease, Biosecurity New Zealand, accessdate = 2007-08-06 </ref> Most [[Europe]]an countries have been recognized as disease free, and countries belonging to the [[European Union]] have stopped FMD [[vaccination]].
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| However, in 2001, [[2001 UK foot and mouth crisis|a serious outbreak of FMD]] in [[Great Britain|Britain]] resulted in the slaughter of many animals, the postponing of the [[United Kingdom general election, 2001|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]]{{Fact|date=October 2007}}, 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.
| | ==[[Foot-and-mouth disease differential diagnosis|Differentiating Foot-and-mouth disease from other Diseases]]== |
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| There are seven FMD [[serotype]]s: O, A, C, SAT-1, SAT-2, SAT-3, and Asia-1. These serotypes show some regionality, and the O serotype is most common.
| | ==[[Foot-and-mouth disease epidemiology and demographics|Epidemiology and Demographics]]== |
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| ==Symptoms== | | ==[[Foot-and-mouth disease natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| The average incubation period of the Foot and Mouth virus varies but is generally around 3-8 days.<ref>{{cite news|url=http://www.fwi.co.uk/Articles/2007/08/04/105713/foot-and-mouth-symptoms.html|title=Foot and Mouth Symptom Guide |publisher=[[Farmers Weekly]]|date=[[2007-08-04]]|accessdate = 2007-08-06}}</ref> The disease is characterized 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 [[Asymptomatic carrier|carry]] FMD and can transmit it to others.
| | ==Diagnosis== |
| | [[Foot-and-mouth disease history and symptoms| History and Symptoms]] | [[Foot-and-mouth disease physical examination | Physical Examination]] | [[Foot-and-mouth disease laboratory findings|Laboratory Findings]]| [[Foot-and-mouth disease other diagnostic studies|Other Diagnostic Studies]] |
| | ==Treatment== |
| | [[Foot-and-mouth disease medical therapy|Medical Therapy]] | [[Foot-and-mouth disease primary prevention|Primary Prevention]] | [[Foot-and-mouth disease cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Foot-and-mouth disease future or investigational therapies|Future or Investigational Therapies]] |
| | ==Case Studies== |
| | [[Foot-and-mouth disease case study one|Case #1]] |
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| [[Image:Foot and mouth disease in mouth.jpg|thumb|left|Ruptured oral vesicle in a cow with FMD]]
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| Infection with foot-and-mouth disease tends to occur locally - that is, the virus is passed on to susceptible animals through direct contact with infected animals or with contaminated pens or vehicles used to transport livestock. 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.
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| [[Image:Foot and mouth disease in swine.jpg|thumb|Ruptured blisters on the feet of a pig with FMD]]
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| 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, the viral genetic material). 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 [[lysis|lyses]] (bursts) and releases the new viruses.
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| ==Foot-and-mouth disease infecting humans==
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| 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]]<ref>{{cite web|url=http://www.defra.gov.uk/news/2007/070814c.htm|title=Foot and Mouth Disease update: further temporary control zone established in Surrey |publisher=[[Defra]]|date=[[2007-08-14]]|accessdate = 2007-08-14}}</ref><ref>{{cite web|url=http://www.guardian.co.uk/footandmouth/story/0,,604980,00.html|title=Foot and Mouth Disease |publisher=[[The Guardian]]|date=[[2001-11-23]]|accessdate = 2007-08-14}}</ref>, 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 Foot and Mouth disease killed two children in England in 1884, suspectedly due to infected milk.<ref>{{cite web|url=http://www.guardian.co.uk/footandmouth/story/0,,604980,00.html|title=Foot and mouth 'killed people in 1800s'|publisher=[[The Guardian]]|date=[[2001-11-23]]|accessdate = 2007-08-14}}</ref>
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| 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 to FMDV. Both are members of the ''[[Picornaviridae]]'' family, but while FMDV belongs to the ''[[Aphthovirus]]'' genus, Coxsackie viruses belong to the ''[[Enterovirus]]es''.
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| 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.
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| ==Virus replication==
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| Soon after infection, the single stranded positive RNA that constitutes the viral genome is efficiently translated using a cap-independent mechanism driven by the internal ribosome entry site element (IRES). This process occurs concomitantly with the inhibition of cellular protein synthesis, caused by the expression of viral proteases. Processing of the viral polyprotein is achieved cotranslationally by viral encoded proteases, giving rise to the different mature viral proteins. Viral RNA as well as viral proteins interact with different components of the host cell, acting as key determinants of viral pathogenesis. In depth knowledge of the molecular basis of the viral cycle is needed to control viral pathogenesis and disease spreading.<ref>{{cite book |chapterurl=http://www.horizonpress.com/hsp/abs/absavir.html|author=Martinez-Salas E, Saiz M, Sobrino F|year=2008|chapter=Foot-and-Mouth Disease Virus|title=Animal Viruses: Molecular Biology|publisher=Caister Academic Press|pages=pp. 1-38|id=[http://www.horizonpress.com/avir ISBN 978-1-904455-22-6]}}</ref>
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| ==Vaccination==
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| [[Image:Plum Island Animal Disease Center.jpg|thumb|Plum Island Animal Disease Center]]
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| Seven main types of Foot and Mouth Virus are believed to exist<ref>http://copus.org.uk/page.asp?id=1253 Foot and Mouth Virus Information</ref>. 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 [[serotype]]s (meaning that a vaccine for one serotype won't protect against any others) and in addition, two [[strain (biology)|strains]] within a given serotype may have [[DNA|nucleotide]] sequences that differ by as much as 30% for a given gene. This means that FMD [[vaccine]]s must be highly specific to the strain involved. Vaccination only provides temporary [[immune system|immunity]] that lasts from months to years.
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| Currently, the [[OIE| 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.
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| Many early [[vaccine]]s used dead samples of FMD virus 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 [[Genetic engineering|genetically engineered]] vaccine.
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| 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 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.
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| ==Outbreaks==
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| ===United Kingdom, 1967===
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| {{main|1967 United Kingdom foot-and-mouth outbreak}}
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| {{sectionstub}}
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| ===United Kingdom, 2001===
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| {{main|2001 United Kingdom foot-and-mouth crisis}}
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| The outbreak 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<ref>http://copus.org.uk/page.asp?tip=1&id=1252|title=What is foot and mouth disease?</ref>. This episode saw 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 agricultural support industries and to the outdoor industry. The major reason this outbreak was so serious was the time between infection being present at the first outbreak loci and the time that countermeasures were put into operation against the disease such as transport bans and detergent washing of both vehicles and personnel entering livestock areas.
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| ===United Kingdom, 2007===
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| {{main|2007 United Kingdom foot-and-mouth outbreak}}
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| An outbreak 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|Normandy]], [[Surrey]].<ref>{{cite news|url=http://www.defra.gov.uk/news/latest/2007/animal-0803.htm|title=Foot and Mouth Disease confirmed in cattle, in Surrey|publisher=[[DEFRA]]|date=[[2007-08-03]]|accessdate = 2007-08-03}}</ref><ref>{{cite news |url=http://news.bbc.co.uk/1/hi/uk/6931395.stm|title= Further farms tested for disease |publisher=[[BBC News]] |date=[[2007-08-04]]|accessdate = 2007-08-04}}</ref> 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.<ref>{{cite news |url=http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/08/04/ndefra1104.xml|title= Foot and mouth: new possible cases reported|author=Miles Goslett|publisher=[[The Daily Telegraph]] |date=[[2007-08-03]]|accessdate = 2007-08-04}}</ref>
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| 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.<ref>{{cite news|url=http://www.defra.gov.uk/news/2007/070804a.htm|title=Results of Foot and Mouth Disease Strain in Surrey, extension of zones |publisher=[[DEFRA]]|date=[[2007-08-04]]|accessdate = 2007-08-04}}</ref> The same strain was used at the nearby [[Institute for Animal Health]] and [[Merial|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.<ref name=pirbright>{{cite news|url=http://news.bbc.co.uk/1/hi/uk/6931639.stm |title=Foot-and-mouth strain identified|publisher=[[BBC News]]|date=[[2007-08-04]]|accessdate = 2007-08-04}}</ref>
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| On [[12 September]] a new outbreak of the disease was confirmed in [[Egham]], [[Surrey]], 19km (12 miles) away from the original outbreak<ref>[http://news.bbc.co.uk/1/hi/uk/6992466.stm "'Pirbright link' to farm outbreak"]. [[BBC News]]. Dated 12 September 2007 </ref>, with a second case being confirmed on a nearby farm on [[14 September]].<ref> [http://news.bbc.co.uk/1/hi/uk/6994782.stm "Outbreak at second farm confirmed"] [[BBC News]]</ref>
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| ==Economic issues==
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| Outbreaks of foot-and-mouth disease have resulted in the slaughter of millions of animals, despite this being a frequently non-fatal disease. The destruction of animals is primarily to prevent the disease from spreading throughout herds intended for human consumption or producing milk. 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, especially when a significant proportion of infected animals, most notably those producing milk, would recover from infection and live normal lives.<ref>[http://www.fmd.brass.cf.ac.uk/FMDthstampingout.html The UK Foot and Mouth Epidemic of 2001: A Research Resource
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| ]</ref>
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| ==Foot-and-mouth disease infecting humans==
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| * [http://www.bmj.com/cgi/content/full/322/7286/565] Description
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| * [http://archives.cnn.com/2001/WORLD/europe/04/24/uk.slaughterman/index.html] [http://news.bbc.co.uk/1/hi/health/1292978.stm] Suspected case in 2001
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| * A case in 1966: <ref>Armstrong R, Davie J, Hedger RS. ''Foot-and-mouth disease in man.'' [[BMJ]] 1967; 4: 529-530.</ref>
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| * [http://www.guardian.co.uk/footandmouth/story/0,,604980,00.html In the 1884 outbreak in Britain]
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| ==See also==
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| *[[Hand, foot and mouth disease]] (HFMD)
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| *[[Swine vesicular disease]] (SVD)
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| *[[Animal virology|Animal viruses]]
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| ==New suspected cases==
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| There is also currently a suspected case of FD under discovery in [[Solihull]], where a temporary control zone has been set up by [[Defra]] as detailed below:
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| {|cellspacing="0" border="1" bgcolor="white"
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| |Failure to comply with this Declaration may be an offence under section 72 or 73 of the Animal Health Act 1981.
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| :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.
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| Annex 1
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| :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.
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| Annex 2
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| :1. No person shall move any susceptible animal into or out of the Zone except where the movement is –
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| ::(a) through the Zone without stopping under a licence authorising movement within the Restricted Zone, granted before the creation of the Zone; or
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| ::(b) necessary to complete a journey started under a licence authorising movement within the Restricted Zone, granted before the creation of the Zone.
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| :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.
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| :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.
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| |}
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| ==References==
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| <references/>
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| ==External links==
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| *[http://www.fwi.co.uk/Articles/2007/08/06/105708/foot-and-mouth-disease-farmers-weekly-interactives-special-report-on-the-outbreak-at-surrey.html 2007 Outbreak Foot and Mouth Disease Timeline]
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| *[http://www.thecattlesite.com/footandmouth/ News updates on the 2007 UK Foot-and-mouth disease outbreak ]
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| *[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9413529&dopt=Abstract Foot-and-mouth disease in man]
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| *[http://www.fwi.co.uk/Articles/2007/08/04/105713/foot-and-mouth-symptoms.html Foot and Mouth Livestock Symptoms Guide and Images]
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| *Levy, Jay A., Heinz Fraenkel-Conrat, and Robert A. Owens. "Picornaviridae." Chap. 2, section 2.2 in Virology. Englewood Cliffs, NJ: Prentice Hall, 1994.[http://www.recent-articles.info -]
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| *''A Manufactured Plague: The History Of Foot-and-mouth Disease In Britain'' (2004, ISBN 1-84407-080-8) by [[Abigail Wood]], a veterinary researcher at the [[University of Manchester]]. [http://www.blancmange.net/tmh/articles/awoodfmd.html]
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| *The Lab-On-Site Project has more information in [http://www.labonsite.com/background.php?id=1 Foot and Mouth Disease Virus].
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| *Intervet International has a site devoted to FMD detailing information about Control, Vaccination, Legal Issues, and Preparation [http://www.foot-and-mouth-disease.com/].
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| *Current status of Foot and Mouth worldwide at ''International des Epizooties'' [http://www.oie.int/wahid-prod/public.php?page=disease_outbreak_map&disease_id=1]
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| *[http://www.horizonpress.com/gateway/animal-viruses.html Animal viruses]
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| {{Viral diseases}} | | {{Viral diseases}} |
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| [[Category:Picornaviruses]] | | [[Category:Picornaviruses]] |
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| [[Category:Sheep and goats diseases]] | | [[Category:Sheep and goats diseases]] |
| [[Category:Animal virology]] | | [[Category:Animal virology]] |
| [[Category:Mature chapter]] | | [[Category:Overview complete]] |
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| [[af:Bek-en-klouseer]]
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| [[ko:구제역]]
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| [[id:Penyakit Mulut dan Kuku]]
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| [[it:Afta epizootica]]
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| [[he:מחלת הפה והטלפיים]]
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