Foot and Mouth

Disease
BY: ZAINAB MUSHTAQ
SAMMAR ABBAS
SHERAZ
Overview

 Organism
 Economic Impact
 Epidemiology
 Transmission
 Clinical Signs
 Diagnosis and Treatment
 Prevention and Control
 Actions to take
The Organism
 Foot & Mouth Disease
Definition:
 Highly contagious, viral disease of domestic cloven-hoofed and many wild
animals
 Characterized by vesicles followed by erosions in the mucosa of mouth
and / or hooves
 Not usually fatal in adults but causes economic losses in young animals –
myocarditis

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 Etiology:
FMD- a Viral Disease

Genus: Aphthovirus

Family: Picornaviridae

Small RNA Virus

5
The Virus

 Picornaviridae, Aphthovirus
 7 distinct serotypes
 Not cross protective
 Cloven-hoofed animals
 Two-toed
 Inactivation
 pH below 6.5 and above 11
 Survives in milk, milk products, bone marrow, lymph
glands
Serotypes:

 Type A
 Type O
 Type C
 Asia-I
 Southern African Territories (SAT) 1
 Southern African Territories (SAT) 2
 Southern African Territories (SAT) 3

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Sub-Serotypes of FMDV
 Over 100 subtypes
 Antigenic variation seems to
be greater for Serotype A
 Vaccination against one serotype does
not protect the animal against other
Serotype
 New subtypes continue to arise
 However, at a specific time, there are usually only a few subtypes causing
disease throughout FMD endemic areas.
 There is usually cross-protection among different sub-serotypes of a
particular serotype.
 However, some of the sub-serotypes may not be adequately protecting
other sub-serotypes.

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Importance
History

 1929: Last case in U.S.

 1953: Last cases in Canada and Mexico
 1993: Italy
 1997: Taiwan
 United Kingdom
 1967-68, 1981
 2001, 2007
Economic Impact

 Direct costs  Indirect costs

 Economic  Exports shut
losses down
to farmers  $14 billion in
and producers lost farm
 Eradication income
costs  $6.6 billion in
 Millions to livestock
billions of exports
dollars lost  Consumer fear

Economically Devastating
Epidemiology
Geographic Distribution
Countries with Routine
FMD Vaccination
Morbidity/ Mortality

 Morbidity 100% in susceptible

animal population
 U.S., Canada, Mexico, others
 Mortality less than 1%
 Higher in young animals and
highly virulent virus strains
 Animals generally destroyed to
prevent spread
Transmission
Animal Transmission

 Respiratory aerosols
 Travel long distances
 Proper temperature and humidity
 Direct contact
 Vesicular fluid
 Ingestion of infected animal parts
 Indirect contact via fomites
 Boots, hands, clothing
Animal Transmission

Species Host Carrier

Sheep Maintenance Pharyngeal
Goats tissue 4-6
months
Pigs Amplifier No

Cattle Indicator Pharyngeal

tissue 6-24
months
Human Transmission
 Clinical disease rare
 Infected by direct contact, ingestion of unprocessed milk/dairy products
 Type O, C, rarely A
 Transmit virus to animals
 Rarely harbor virus in respiratory tract for 1-2 days
 Low risk of prolonged carriage
 Contaminated boots, clothing, vehicles
Disease in Animals
History
1st recorded in 1544 in europe
FMD occurs throughout much of the world
After World War II, the disease was widely distributed
throughout the world
some countries have been free of FMD

as of August 2007, Chile is disease-free

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
However, in 2001, a serious outbreak of FMD in 
Britain resulted in the slaughter of many animals

Center for Food Security and Public Health, Iowa State University, 2011
Transmission
The FMD virus 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.

Center for Food Security and Public Health, Iowa State University, 2011
Host Range:

 Cattle & Buffalo (Indicator)

 Sheep & Goats
(Maintenance)
 May be carrier for up to 9
months
 Swine (Amplifier)
 Most Cloven-footed wild
animals
 Deer, Bison, Feral Hogs,
Antelope, Llamas &
Alpacas, Giraffes,
Elephants,
 Not Seen in Odd-toed
animals
 Horses, Zebras, Rhinos

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 Progressive Control of FMD in Pakistan

Host Range:

 Not Seen in Odd-toed

animals
 Horses, Zebras,
Rhinos

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A cloven hoof, cleft hoof, divided hoof or
split hoof is ahoof split into two toes.
This is found on members of the
mammalian order Artiodactyla.
Examples of mammals that possess this
type of hoof are
cattle, deer, antelopes, gazelles, goats,
and sheep.

Center for Food Security and Public Health, Iowa State University, 2011
The even-toed ungulates are
ungulates whose weight is borne
equally by the third and fourth
toes.
By contrast, odd-toed ungulates,
such as horses , antelope , bear
their weight primarily on their third
toe

Center for Food Security and Public Health, Iowa State University, 2011
Clinical Picture: Cattle
Initial Signs:
 Fever of 103-106oF
 Dullness, anorexia
 Sudden drop in milk production in lactating animals
 Sudden death in suckling or young animals without showing any sign of disease

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 Progressive Control of FMD in Pakistan

Main Symptoms:
 Excessive ropy viscous salivation; drooling
 Serous nasal discharge
 Vesicle (blister) formation;
 Single or multiple vesicles (2 mm to 10 cm)
tongue, dental pad, gums, soft palate, nostrils,
muzzle, interdigital space, coronary band, and
teats
 kicking of the feet or lameness;
 Pregnant animals may abort.
 Disease is more severe in exotic and crossbred cattle
as compare to buffaloes, and indigenous cattle.
 Clinical signs in sheep and goats are usually mild but
severe form of the disease is also sometimes seen.
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 Progressive Control of FMD in Pakistan

Panting in summer is also an

important squeal to FMD usually seen
in recovered crossbred/exotic
animals.

This is due to disturbance in

thermoregulatory mechanism of the
affected animal caused by FMD, is
permanent in nature

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Pictorial View of FMD

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 Progressive Control of FMD in Pakistan
FMD Lesions

Un-ruptured blisters on tongue FMD Virus

Ruptured blisters on tongue

Un-ruptured blisters on tongue Healed wound on

tongue Ruptured Vesicle on Gums
Progressive Control of FMD in Pakistan

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Progressive Control of FMD in Pakistan

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 Progressive Control of FMD in Pakistan

Ruptured Vesicle on Hoof

Un-ruptured Blister on Hoof

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As nouns the difference
between blister and vesicle
 is that blister is a small bubble between
the layers of the skin that contains
watery or bloody fluid and is caused by
friction and pressure, burning, freezing
, chemical irritation, disease or infection
while vesicle is (cytology) a membrane-
bound compartment found in a cell. 

Center for Food Security and Public Health, Iowa State University, 2011
Clinical Signs

 Incubation period: 2 to 14 days

 Fever and vesicles
 Feet, mouth, nares, muzzle, teats
 Progress to erosions
 Lameness,
reluctance to move,
sloughing of hooves
 Abortion
 Death in young animals
Clinical Signs: Cattle
 Oral lesions (vesicles)
 Tongue, dental pad, gums, soft palate,
nostrils, muzzle
 Excess salivation, drooling, nasal discharge
 Lethargy, loss of body condition
Clinical Signs: 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, 2011
Clinical Signs: Pigs

 Hoof lesions
 More severe than in cattle
 Very painful
 Coronary band, heel,interdigital space
 Lameness
 Snout vesicles
 Oral vesicles less common
Clinical Signs:
Sheep and Goats
 Mild, if any
 Fever
 Lameness
 Oral lesions
 Makes diagnosis
and prevention of
spread difficult
 Foot & Mouth Vesicular Swine Vesicular Vesicular
Disease Stomatitis Disease Exanthema of
Swine
Clinical
All vesicular diseases produce a fever with vesicles that progress to
Signs by
Species erosions in the mouth, nares, muzzle, teats, and feet

Oral & hoof lesions,

salivation, drooling, Vesicles in oral
lameness, abortions, cavity, mammary
Cattle death in young glands, coronary Not affected Not affected
animals, "panters"; bands, interdigital
Disease space
Indicators

Severe signs in
Severe hoof lesions, animals housed on
hoof sloughing, snout concrete; lameness, Deeper lesions with
Pigs vesicles, less severe Same as cattle salivation, granulation tissue
oral lesions: neurological signs, formation on the feet
Amplifying Hosts younger more
severe

Sheep & Mild signs if any; Rarely show signs Not affected Not affected
Goats Maintenance Hosts

Most severe with

Horses, oral and coronary
band vesicles,
Donkeys, Not affected
drooling, rub
Not affected Not affected
Mules mouths on objects,
lameness
Post Mortem Lesions

 Single or multiple vesicles

 Various stages
of development
 White area, 2mm-10cm
 Fluid filled blister
 Red erosion, fibrin coating
 Dry lesions
 Sloughed hooves
 Tiger heart
tiger-heart
A form of fatty degeneration in which, on
post-mortem examination, the substance of
the heart shows alternate streaks of yellow
(fat) and red color (normal muscular tissue).

Center for Food Security and Public Health, Iowa State University, 2011
Differential Diagnosis

 Swine
 Vesicular stomatitis
 Swine vesicular disease
 Vesicular exanthema
of swine
 Cattle
 Rinderpest, IBR, BVD, MCF, Bluetongue
 Sheep
 Bluetongue, contagious ecthyma
FMD
pyrexia of ~104° F,
followed by vesicular development on the tongue, hard
palate, dental pad, lips, gums, muzzle, coronary band,
interdigital cleft, and teats in lactating cows. Acutely
affected individuals may salivate profusely, stamp their
feet, and prefer to lie down.
. Ruptured oral vesicles can coalesce and form erosions
but heal rapidly, roughly 11 days after vesicle
formation. Feet vesicles take longer to heal and are
susceptible to bacterial infection leading to chronic
lameness. Secondary bacterial mastitis is common due
to infected teat vesicles and resistance to milking. After
vesicular disease develops, cattle quickly lose condition
and milk yield, which can persist chronically

Center for Food Security and Public Health, Iowa State University, 2011
VESICULAR STOMATITIS
The incubation period is 2–8 days and is typically followed
by a fever. Ptyalism is often the first sign of disease.
Vesicles in the oral cavity are rarely seen in naturally
occurring cases because of rupture soon after formation;
therefore, ulcers are the most common lesion seen during
initial examination. Ulcers and erosions of the oral
mucosa, sloughing of the epithelium of the tongue, and
lesions at the mucocutaneous junctions of the lips are
commonly seen in both cattle and horses.
. Ulcers and erosions on the teats are not uncommon in cattle
and may result in secondary cases of mastitis in dairy cows.
Loss of appetite due to oral lesions, and lameness due to foot
lesions, are normally of short duration, because the disease is
generally self-limiting and resolves completely within 10–14
days. Virus-neutralizing antibodies to either serotype persist
and have been documented in individual horses that had
previous clinical disease for >8 yr after an outbreak, but
reinfection can occur after a second exposure.
Center for Food Security and Public Health, Iowa State University, 2011
Swine Vesicular Disease
The primary signs are fresh or healing vesicular
lesions on the feet, especially the coronary band,
and less often other areas such as the mouth,
lips, teats, or snout.

Center for Food Security and Public Health, Iowa State University, 2011
Rinderpest
After an incubation period of 3–15 days, fever, anorexia,
depression, and oculonasal discharges developed,
followed by necrotic lesions on the gums, buccal mucosa,
and tongue. The hard and soft palates were often affected.
The oculonasal discharge became mucopurulent, and the
muzzle appeared dry and cracked. Diarrhea, the final
clinical sign, could be watery and bloody. Convalescence
was prolonged and could be complicated by concurrent
infections due to immunosuppression. Morbidity was often
100% and mortality was up to 90% in epidemic areas, but
in endemic areas morbidity was low and clinical signs were
often mild.
Center for Food Security and Public Health, Iowa State University, 2011
Infectious Bovine Rhinotracheitis (IBR)

Symptoms
•Fever
•Coughing
•Depression
•Loss of appetite
•Hyperaemia of the mucosae
•Mucosla lesions
•Nasal discharge
•Conjunctivitis
•Drop in milk production
•Infertility
•Abortion

Center for Food Security and Public Health, Iowa State University, 2011
 BVD,
Signs of acute infection include
fever, lethargy, loss of appetite,
ocular dishcharge,nasal discharge
m oral lesions, diarrhea and
decreasing milk
production. Chronicinfection may
lead to signs of mucosal disease. In
calves, the most commonly
recognised birth defect is
cerebellar hypoplasia.
Center for Food Security and Public Health, Iowa State University, 2011
MCF
typical MCF symptoms
including depression, loss of condition, a
rough hair coat, nasal discharge, corneal
opacity, transient loose stools,
hemorrhagic diarrhea and bloody urine have
been reported, with some animals surviving
for up to three weeks after the onset of ...

Center for Food Security and Public Health, Iowa State University, 2011
Bluetongue
•Bluetongue disease is a non-contagious,
insect-borne, viral disease of ruminants,
mainly sheep and less frequently cattle,
goats, buffalo, deer, dromedaries, and
antelope. ...
•Major signs are high fever, excessive
salivation, swelling of the face and tongue
and cyanosis of the tongue.

Center for Food Security and Public Health, Iowa State University, 2011
contagious ecthyma
he disease is found worldwide and is
caused by a parapoxovirus. The disease is
often more severe in goats than in sheep,
and kids and lambs are more susceptible to
the disease than adults. Contagious
Ecthyma is known by several other names
including orf, scabby mouth and sore
mouth

Center for Food Security and Public Health, Iowa State University, 2011
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
Clinical Diagnosis
 Vesicular diseases
are clinically indistinguishable!
 Suspect animals with salivation or lameness
and vesicles
 Tranquilization may
be necessary
 Laboratory testing essential
Laboratory Diagnosis

 Initial diagnosis
 Virus isolation
 Virus identification
 ELISA, RT-PCR, complement fixation
 Serology
 ELISA and virus neutralization
 Notify authorities and wait for instructions before
collecting samples
 Progressive Control of FMD in Pakistan

a) Antigen Detection
i) Virus Isolation
ii) CFT
iii) ELISA
iv) PCR

b) Antibodies Detection

i) ELISA

ii) SNT
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Treatment

 No treatment available
 U.S. outbreak could result in:
 Quarantine
 Euthanasia
 Disposal
 Vaccine available
 Ramifications are many
 See section “prevention
and control”
Disease in humans
Disease in Humans

 Very low incidence

 40 cases since 1921
 Most reports ended when FMD was eradicated in Europe
 NOT a public health concern
 Incubation period: 2 to 6 days
 Clinical signs
 Mild headache, malaise, fever
 Tingling, burning sensation of fingers, palms, feet prior to
vesicle formation
Clinical Signs: Humans

 Vesicles
 Fluid-filled, 2 mm to 2 cm in diameter
 Tongue, palate
 Painful
 Interfere in eating, drinking, talking
 Vesicles dry up in 2 to 3 days
 Diarrhea
 Recover within one week of last
blister appearing
Diagnosis and Treatment

 Clinically FMD in humans resembles:

 Coxsackie A group viruses
 Hand, foot, and mouth disease
 Herpangina
 Herpes simplex virus
 Vesicular stomatitis
 Virus isolation or antibody identification required for
diagnosis
 Treatment is supportive care
Prevention
and Control
Prevention

 Strict import restrictions

 Prohibit live ruminants and their products from FMD-
affected countries
 Travelers, belongings monitored at ports of entry
Prevention

 Suspicious lesions investigated

 State planning/training exercises
 Federal response plans
 Biosecurity protocols for livestock facilities
Recommended Actions
 Notification of Authorities

 Quarantine
Recommended Actions
 Confirmatory diagnosis
 Depopulation
 Must properly destroy exposed
cadavers, litter, animal products
Disinfection

 Products:
 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 for disinfectants to be effective
Vaccination
 Killed vaccine, serotype specific
 North American Foot-and-Mouth Vaccine Bank
 Plum Island, NY
 Monitor disease outbreaks worldwide
 Stock active serotypes and strains
 Essential to isolate virus and identify the serotype to select correct vaccine
Vaccination

 Currently U.S. has no need to vaccinate

 But, vaccine may be used in an outbreak
 Vaccination issues
 Annual re-vaccination required
 Costly, time consuming
 Does not protect against infection,
but reduces clinical signs
 Spread infection to other animals
 International trade status harmed
Additional Resources

 World Organization for Animal Health (OIE)

 www.oie.int
 U.S. Department of Agriculture (USDA)
 www.aphis.usda.gov
 Center for Food Security and Public Health
 www.cfsph.iastate.edu
 USAHA Foreign Animal Diseases
(“The Gray Book”)
 http://www.aphis.usda.gov/
emergency_response/downloads/
nahems/fad.pdf