Foot and Mouth Disease

Aphthae, Aphthous fever, Maul- und Klauenseuche

Overview
- Foot-and-mouth disease (FMD) is a highly infectious viral disease that affects
cloven-hoofed animals, including cattle, sheep and pigs.
- FMD is not a public health or food safety threat. It is also not related to hand,
foot, and mouth disease, which is a common childhood illness caused by a
different virus (Coxsackievirus A16, Enterovirus 71)
- One of the most contagious animal diseases, with important economic losses.
Etiology
- Foot and Mouth Disease Virus (FMDV)
- Family Picornaviridae
- Genus Aphthovirus
- 7 immunologically distinct serotypes:
- A
- O
- C
- SAT1
- SAT2
- SAT 3
- Asia1
Epidemiology
Host
- All domestic cloven-hoofed animals are susceptible, including cattle, pigs,
sheep, goats, and buffalo
- All wild cloven-hoofed animals are also susceptible, including deer, antelope,
wild pigs, elephant, giraffe, and camelids
- African buffalo are the only wildlife species to play a significant role in the
epidemiology of FMD
Epidemiology
Transmission
- Direct contact between infected and susceptible animals
- Direct contact of susceptible animals with contaminated inanimate objects (hands,
footwear, clothing, vehicles, etc.)
- Consumption (primarily by pigs) of untreated contaminated meat products (swill
feeding).
- Ingestion of contaminated milk (by calves)
- Artificial insemination with contaminated semen
- Inhalation of infectious aerosols
- Humans can harbour FMDV in their respiratory tract for 24–48 hours, leading to
the common practice of 3-5 days of personal quarantine for personnel exposed in
research facilities
Epidemiology
Source of the virus
- Incubating and clinically affected animals
- Meat and by-products in which pH has remained above 6.0
- Carriers: recovered or vaccinated and exposed animals in which FMDV persists in
the oropharynx for more than 28 days
- The carrier state in cattle usually does not persist for more than 6 months,
although in a small proportion it may last up to 3 years
- Domestic buffalo, sheep and goats do not usually carry FMD viruses for more than
a few months
- African buffalo are the major maintenance host of SAT serotypes, and may
harbour the virus for at least 5 years
Pathogenesis

- Adheres to respiratory mucosa (usual site of entry)

- Macrophages transport the virus to secondary sites: epithelium,
mucosa, myocardium
- Virus replicates, then a marked viremia develops and the virus infects
epithelium at many other sites
- Vesicles then develop and rupture within 48 hours
Clinical Signs
Incubation period: 2-14 days

Cattle:

- Pyrexia, anorexia, shivering, reduction in milk production for 2–3 days, then
- Vesicles (aphthae) on buccal and nasal mucous membranes and/or between
the claws and coronary band
- after 24 hours: rupture of vesicles leaving erosions
- vesicles can also occur on the mammary glands
- Recovery generally occurs within 8–15 days
- Death of young animals from myocarditis
 Profuse salivation and
nasal discharge in
cattle are significant
clinical signs included
in the FMD disease
complex.

https://www.msdvetmanual.com/generalized-conditions/foot-and-mouth-disease/foot-and-mouth-di
sease-in-animals#Properties-of-Foot-and-Mouth-Disease-Virus_v53073798
 Erosive lesions on the
dental pad and tongue
of a cow. Vesicles
have ruptured, and the
overlying epidermis
sloughed off.
Hyperemia and
hemorrhage in the
underlying tissue
follows.

https://www.msdvetmanual.com/generalized-conditions/foot-and-mouth-disease/foot-and-mouth-di
sease-in-animals#Pathogenesis_v3272928
 Erosive lesion in the
interdigital cleft of a
cow. Lesions may
involve one or more
feet.

https://www.msdvetmanual.com/generalized-conditions/foot-and-mouth-disease/foot-and-mouth-di
sease-in-animals#Clinical-Findings_v23374862
Clinical Signs
Sheeps and Goats

- Pyrexia. Lameness and oral lesions are often mild

- Foot lesions along the coronary band or interdigital spaces may go
unrecognised, as may lesions on the dental pad
- Agalactia in milking sheep and goats is a feature
- Death of young stock may occur without clinical signs
Clinical Signs
Pigs

- Pyrexia
- May develop severe foot lesions and lameness with detachment of the claw
horn, particularly when housed on concrete
- Vesicles often occur at pressure points on the limbs, especially along the
carpus (‘knuckling’)
- Vesicular lesions on the snout and dry lesions on the tongue may occur. High
mortality in piglets is a frequent occurrence
 Foot lesions in a pig;
ruptured and white
(unruptured) vesicles are
present on the heel bulb.
Lesions on the feet,
resulting in lameness and
reluctance to move, are a
characteristic finding in
pigs.

https://www.msdvetmanual.com/generalized-conditions/foot-and-mouth-disease/foot-and-mouth-di
sease-in-animals#Diagnosis_v3272947
 Foot lesions in a pig.
Note the erosive lesions
on the coronary band

https://www.msdvetmanual.com/generalized-conditions/foot-and-mouth-disease/foot-and-mouth-di
sease-in-animals#Treatment,-Control,-and-Prevention_v3272956
 Unruptured vesicle on a
pig tongue.

https://www.msdvetmanual.com/generalized-conditions/foot-and-mouth-disease/foot-and-mouth-di
sease-in-animals#Treatment,-Control,-and-Prevention_v3272956
Lesions
- Vesicles or blisters on the tongue, dental pad, gums, cheek, hard and soft
palate, lips, nostrils, muzzle, coronary bands, teats, udder, snout of pigs,
corium of dewclaws and interdigital spaces
- Erosions on rumen pillars at post mortem. Gray or yellow streaking in the
heart from degeneration and necrosis of the myocardium in young animals of
all species (‘tiger heart’)
 Tigers striping (focal
myocarditis) on the heart

https://www.youtube.com/watch?v=OLlYPR_gh-
I
Differential Diagnosis
- Vesicular stomatitis
- Swine vesicular disease
- Vesicular exanthema of swine
Diagnosis
Identification of agent:

- Antigen ELISA
- Complement fixation
- Virus isolation
- RT-PCR
Treatment
- There is no specific treatment for FMD, but supportive care may be allowed in
countries where FMD is endemic.
Prevention and Control
Sanitary prophylaxis

- Protection of free zones by border animal movement control and surveillance.

- Quarantine measures
- Slaughter of infected, recovered, and FMD-susceptible contact animals
- Cleaning and disinfection of premises and all infected material, such as
implements, cars, and clothes
- Disposal of carcasses, bedding, and contaminated animal products in the
infected area
Prevention and Control
Medical prophylaxis

- Standard Potency Vaccines (commercial vaccines)

- Higher Potency Vaccines (emergency vaccines)

Conventional live FMD vaccines are not acceptable due to the danger of reversion
to virulence and as their use would prevent the detection of infection in vaccinated
animals.
Emerging or Reemerging?
Emerging

- North America
- Eastern Europe

Reemerging

- Sub-Saharan Africa
- South Asia
- South America
References
- https://www.msdvetmanual.com/generalized-conditions/foot-and-mouth-disea
se/foot-and-mouth-disease-in-animals
- https://www.woah.org/fileadmin/Home/eng/Animal_Health_in_the_World/docs
/pdf/Disease_cards/FOOT_AND_MOUTH_DISEASE.pdf