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Foot and Mouth Disease. FMD, Aftosa. Overview. Organism Economic Impact Epidemiology Transmission Clinical Signs Diagnosis and Treatment Prevention and Control Actions to take. The Organism. Foot and Mouth Disease. Picornaviridae, Aphthovirus 7 distinct serotypes

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overview
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

foot and mouth disease1
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

history
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

economic impact
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

geographic distribution
Geographic Distribution

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

foot and mouth disease distribution 2003
Foot and Mouth Disease Distribution 2003

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

morbidity mortality
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

animal transmission
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

animal transmission1
Animal Transmission

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

human transmission
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

clinical signs
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

clinical signs in cattle
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

clinical signs in cattle1
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

clinical signs in pigs
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

clinical signs in sheep and goats
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

post mortem lesions
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

differential diagnosis
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

sampling
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

clinical diagnosis
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

diagnosis
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

treatment
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

human clinical signs
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

human clinical signs1
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

diagnosis and treatment
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

public health significance
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

prevention
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

recommended actions
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

recommended actions1
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

disinfection
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

vaccination
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

vaccination1
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

resources
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

acknowledgments

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

slide44

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