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Diseases / List of Viral Diseases / Disease description:

Foot-and-Mouth Disease
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INDEX - INFORMATION AVAILABLE

GENERAL INFORMATION

SUSCEPTIBILITY, DISEASE CHARACTERISTICS & DIAGNOSIS

TREATMENT & CONTROL
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THE FOLLOWING INFORMATION IS HELD ON THE INFECTIOUS AGENT INFORMATION PAGE:

Picornaviridae: Foot and Mouth Disease Virus

  • Virus Structure and Identification
  • Associated Host Species of Virus (Animal Types Affected) and Hazard / Risk
  • Virus Life Cycle, Transmission and Effects of Chemicals
  • Transmission and Biogeographical / Climatic Range for Virus

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General and References

Disease Summary
An acute, highly contagious viral disease, mainly (but not exclusively) of cloven-hoofed mammals (cattle, sheep, goats, deer, pigs, camels), which is characterised by the formation of lesions (initially vesicles, later erosions) on the feet and mouth (leading to lameness, salivation and unwillingness to eat), high fever, and sometimes a fatal myocarditis (particularly in juveniles).

In most countries the government MUST BE NOTIFIED if Foot-and-Mouth Disease occurs or is suspected.
This is a usually a statutory requirement and is enforced through national legislation.

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Alternative Names (Synonyms)
  • FMD
  • Foot and Mouth Disease
  • Aphthous fever
  • Hoof-and-mouth disease
  • Hoof and Mouth Disease
  • Epizootic aphthae
  • Infectious aphthous stomatitis
  • Aftosa (Italian, Spanish)
  • Fièvre aphteuse (French)
  • Maul-und-Klauenseuch (German).
  • Afta epizootica
  • Bek-en-klouseer
  • Fiebre aftosa (Spanish)

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Disease Type

 Viral

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Infectious/Non-Infectious Agent (directly associated with the Disease)
  • The Foot-and-Mouth Disease Virus is classified within the family Picornaviridae
  • It is a small RNA virus which is very infectious, multiplying in and causing damage to cells throughout the body of susceptible animals, and which can survive in the environment for some time.
  • It causes particular damage to the epithelial cells of cloven-hoofed mammals: to the skin around the mouth and feet, and the mucous membrane lining the mouth and gut system (and may also damage heart muscle cells particularly in young animals, the milk-secreting cells of the udder and hormone-producing cells).
  • There are seven different serotypes (A, O, C, SAT1, SAT2, SAT3, Asia1), each of which can produce Foot-and-Mouth disease. Once an animal has had FMD caused by one serotype, it is still susceptible to attacks by the other serotypes and major different strains within the same serotype. Likewise, each serotype or major strain must be vaccinated against separately.

Information on Hazard / Legislation etc. is held on the Agent (Virus) page (see link below):

Species/Taxa

Chemical
  • --

Physical
  • --

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References

Disease Author

 Debra Bourne
Click image for main Reference Section

References / Reviews

Code and Title List

 B47, B58, B100, B207, B209, B210.89.w89, B211, B212, B214.2.4.3.w2, B214.3.7.w3, B214.3.14.w6, B214.3.17.w7, B214.3.18.w8, B215, B216, B217.38.w38, B218, B219,

J3.77.w3, J3.82.w3, J3.83.w2, J3.87.w1, J3.89.w1, J3.96.w3, J3.99.w1, J3.99.w2, J3.102.w6, J3.102.w7, J3.102.w8, J3.102.w9, J3.115.w2, J3.119.w3, J3.131.w1, J3.140.w6, J3.141.w2, J3.148.w3, J3.148.w6, J12.74.w1, J13.24.w1, J13.51.w1, J13.57.w1, J16.8.w1, J16.22.w1, J18.41.w1, J18.49.w1, J18.116.w1, J19.45.w1, J19.61.w1,J19.68.w5, J19.100.w1,J19.114.w1, J19.116.w1, J19.124.w1,J19.124.w2, J20.278.w1, J21.13.w1, J21.16.w1, J21.33.w1, J21.9.w1, J21.12.w2, J21.12.w3, J21.40.w2, J21.41.w2, J21.69.w1, J24.43.w1, J35.127.w1, J35.134.w2, J35.141.w1, J35.148.w1, J35.149.w1, J35.151.w1, J35.158.w1, J24.43.w1, J42.80.w1, J42.81.w1, J42.82.w2, J42.84.w1, J42.85.w2, J42.118.w1, J62.53.w2, J62.39.w1, J62.40.w1, J63.14.w1, J64.7.w1, J64.7.w2, J64.10.w1, J64.11.w1, J64.11.w2, J66.27.w1, J66.33.w1, J67.3.w1, J67.32.w1, J68.B302.w1,J69.20S2.w1, J69.20S2.w2, J70.6.w1, J70.8.w1, J70.9.w1, J70.10.w1, J70.10.w2, J70.10.w3, J70.11.w1, J70.11.w2, J70.12.w1, J70.16.w2, J70.17.w2, J70.17.w3, J70.17.w4, J72.41.w1, J71.57.w1, J71.142.w1, J71.143.w1, J71.144.w1, J71.145.w1, J78.3.w1, J79.11.w1,

P5.40S.w1, P5.40S.w2, P22.2000App18.w1

D33, D34, D35.w1, D36.Para35, D36.Para70, D37.Para85, D36.AppendixII, D37.Para138, D37.Para216, D34, D38,

V.w5, V.w6, V.w23,

W18.Apl01.sib1, W32.Apl01.sib1, W32.Apl01.sib2, W32.Apl01.sib4, W32.Apl01.sib5, W32.Apl01.sib16, W32.Apl01.sib17, W32.Apl01.sib19, W32.Apl01.sib21, W32.Apl01.sib22, W32.Apl01.sib23, W32.Apl01.sib24, W39.31May01.sib1, W39.31May01.sib3, W39.31May01.sib4, W39.31May01.sib5, W39.31May01.sib7

Associated Guidelines Linked in Wildpro

Code and Title List

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Epidemiology and Host Susceptibility Factors

Incubation Period, Time Course and Persistence of Disease
General Editorial Description 1) INCUBATION PERIOD:

Foot-and-Mouth Disease virus replicates very rapidly inside an infected animal and clinical signs usually develop within two weeks (recorded up to three weeks), quite often as little as two days after infection.

The time taken for clinical signs to become visible varies within the above range depending on:

  • virus dose
    • animals exposed to a higher dose may develop clinical signs earlier
  • virus strain
    • some strains are much more invasive and cause more tissue damage earlier, and may affect different species to different degrees.
  • how the virus enters the animal's body
    • experimental injection of the virus usually causes clinical signs to develop earlier
  • animal species or breed infected
    • the time taken for clinical signs to develop in different species may vary, even if the animals are exposed to the same strain of virus under similar conditions.

(B47, B207, B210.89.w89, B211, B212, B218, D34, J3.82.w3, J3.89.w1, J3.96.w3, J3.102.w6, J19.45.w1, J19.114.w1, J24.43.w1, J35.158.w1, J42.84.w1, J42.85.w2, J62.39.w1, J62.40.w1)

2) DISEASE DURATION (TO RECOVERY) IN INDIVIDUAL ANIMALS:

The time course in individual animals depends largely on the degree of tissue damage caused by the virus.

  • In uncomplicated cases, without secondary infection (usually bacterial) the disease course is considered to be two to three weeks.
  • Convalescence may take over six months and in some cases damage may be permanent where there has been more extensive damage to the gut, feet, heart or hormonal system. Mechanical damage and secondary infection may slow down recovery considerably: e.g. foot damage, diabetes mellitus etc.

(J19.114.w1, J35.149.w1, B47, B210.89.w89, B211, B495.3.w3 - full text provided, D34)

3) TIME COURSE / PERSISTENCE OF DISEASE IN A SUSCEPTIBLE POPULATION:

Largely speaking, Foot-and-Mouth Disease Virus spreads RAPIDLY through a particular group of susceptible animals in direct contact: normally taking between a couple of days up to 3 weeks to move between animals. This will usually result in the animals being immune to THAT PARTICULAR STRAIN OF THE VIRUS, whether or not they develop clinical disease.

If all susceptible animals either become immune (or die), and there are no more hosts in which the virus can replicate, the virus will effectively "die-out", unless it can find a new group of susceptible animals.

In order for infection to persist in an area (become endemic), there must be new susceptible hosts coming into contact with FMD virus in that area. Circumstances in which this may occur include:

  • Extensive management situations with limited direct/indirect contact between animals and therefore a long time taken for disease to move through a herd/flock.
    • If this takes a sufficiently long time, there may be a constant source of susceptible juveniles entering the herd/flock.
  • Domestic animals not subject to effective movement control entering an infected area (e.g. nomadic herds).
  • Restocking prior to virus elimination from the environment (N.B. prolonged virus survival may occur in the external environment under some conditions unless thorough cleaning and disinfection is carried out).
  • Susceptible animals brought into an area when active virus sources (infected animals) are still present. Most likely if infection is present subclinically in animals (e.g. sheep) in an area.
  • Protection due to vaccination wanes before the virus has been eliminated from an area.
  • Protection of juveniles by passive immunity (from the mother) wanes before the virus has been eliminated from an area.
  • Possibly occasional transfer from carrier animals to susceptible animals.

(B47, B58, B207, J3.131.w1, J19.124.w1, J21.13.w1, J21.16.w1, J42.82.w2, J64.10.w1, J64.7.w2, D33, D36.AppendixII, D36.Para70, V.w5, V.w6)
Literature Reports
Editorial Overviews Available
"Normal" Incubation Range Reported
  • Peracute (Less than 2 days)
  • Acute (2 - 14 days)
"Normal" Disease Duration in Individual Animals Reported
  • Medium (Individual Disease Duration: 2 - 6 weeks)
    to ...
  • Chronic (Development of permanent damage)
"Normal" Time Course/ Persistence of Disease in a Susceptible Population Reported
  • 1 - 14 day period (Becomes evident in exposed susceptible in-contact animals)

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Mortality / Morbidity / Susceptibility / Life stage affected
General Editorial Description 1) NUMBER OF DEATHS

The percentage of animals that die (Mortality Rate) directly from Foot-and-Mouth Disease during an outbreak is usually fairly low (reported to be around 2% of adults). However, mortality rates may be much higher under the following conditions

  • in young animals.
  • in more susceptible species.
  • with more virulent FMD virus strains (e.g. in "malignant FMD" up to 50% mortality has been reported in adults).
  • with increased complications from secondary bacterial infections, which may require euthanasia.

(B47, B210, B207, B210, B211, B212, B215, B217.38.w38, B495.3.w3 - full text provided, D33, D34, J3.99.w1, J3.99.w2, J19.45.w1, J24.43.w1, J42.81.w1, J42.84.w1, J42.85.w2, J62.40.w1, W18.Apl01.sib1)

2) NUMBER OF ANIMALS AFFECTED

The percentage of animals that become affected in a population (Morbidity Rate) is often extremely high and may approach 100%. However the morbidity rate may be lower under the following conditions:

  • with less virulent FMD virus strains (e.g. with "occult FMD" morbidity may be very low in some populations).
  • where species are less susceptible.
  • where there is immunity either through naturally circulating virus (in endemic regions) or through vaccination.

(B58, B210.89.w89, B211, J3.99.w1)

3) EFFECTS OF BODY CONDITION AND OTHER DISEASES

Animals in good condition seem to be particularly severely affected.

(B207, B211)

4) EFFECTS OF AGES, SEX AND REPRODUCTIVE STATUS

Animals in all life-stages (age, sex, reproductive status) may be affected, although young animals are particularly severely affected and animals in good condition are generally affected to a greater extent than those in relatively poor condition.

(B47, B207, B210.89.w89, B211, B215, B219, D33, D34, D36.AppendixII, J3.102.w6)
Literature Reports
Editorial Overviews Available
"Typical" Mortality Range (s) Reported
Various
  • High (e.g. 50% - 100%)
    to
  • Episodic (Usually single cases)
"Typical" Morbidity Range (s) Reported
Various
  • High (e.g. 50% - 100%)
    to
  • Low (1% - 10%)
"Typical" Life Stage(s) Reported
  • all (any)
"Typical" Predisposing Physiological Factor (s) Reported
  • Not recorded for this category

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Clinical & Pathological Characteristics, and Diagnosis

Clinical Signs (by physiological system)
Overall Clinical Presentation

1) TYPICAL CLINICAL SIGNS OF Foot-and-Mouth Disease:

FMD is an ACUTE viral infection, with Clinical Signs appearing within a few days of virus infection.

The severity of the Clinical Signs in an animal depends on the virulence of the virus strain, the age of the animal (young animals are more severely affected), and the species or breed (for individual details see Page: Editorial Overview of Clinical Signs by Species / Taxa).

Recovery tends to occur within days or weeks, unless CHRONIC DISEASES subsequently develop. These are caused by long-standing tissue damage or secondary infection (see below), in which case full recovery may take many months, or in some cases not occur as the damage is permanent.

a) Commonly seen Clinical Signs with active FMD Virus infection:

  • Vesicles (Blisters); Erosions and/or Ulcers on the skin and mucous membranes:
    • probably due to damage to cells of the skin and mucous membranes, particularly areas subject to epithelial trauma (damage): usually feet and mouth, but also muzzle (snout), horns, knees, udder and teats.
  • Separation of hoof/horny tissue (complete hoof, heel bulbs and/or horns) from underlying tissue:
    • probably due to damage to cells of the skin and swelling of epithelial layers.
  • Unwillingness to eat; Dullness; Salivation; Jaw-champing; Lameness; Lying down:
    • probably due to pain accompanying vesicles, erosions and ulceration, and swelling of epithelial layers of mouth and feet.
  • Swelling and Pain of the mammary gland (udder); Reduced milk yield:
    • probably due to damage to the cells that secrete milk.
  • Fever; Weight Loss; Abortion:
    • probably due to a number of systems suffering cellular damage.

b) Additional Clinical Signs which may be seen in young animals, in very susceptible species (or breeds) and/or with particularly virulent virus strains:

  • Diarrhoea; Dysentery:
    • probably ulceration and damage to the cells of the tissue lining the gut system
  • Weak, irregular pulse:
    • probably due to damage to the heart cells.
  • Difficulty in breathing; Collapse; Convulsions; Death:
    • probably due to damage to the heart cells.
  • Sudden death:
    • probably due to damage to the heart cells.

2) CHRONIC DISEASES / PROBLEMS WHICH HAVE OCCURRED AS A RESULT OF FMD VIRUS INFECTION:

  • Persistent Foot Infection -
    • probably due to secondary infection (usually bacterial) and chronic damage of the tissues of the foot (including the hoof)
  • Prolonged Enteritis - persistent diarrhoea:
    • probably due to secondary infection (usually bacterial) and chronic damage to the tissues lining the gut system.
  • Pneumonia;
    • probably secondary to infection (usually bacterial) of lesions in tissue of the upper respiratory system.
  • Permanent Udder Damage - reduced milk yield;
    • probably due to secondary infection (usually bacterial) and chronic damage to the milk-producing tissues
  • Diabetes Mellitus;
    • abnormally high blood sugar levels, probably due to damage to pancreatic (insulin-producing) tissue
  • Chronic "Poor-Doing" - specific syndrome with panting (heat intolerance), anaemia and long hair coat;
    • probably due in part to damage to endocrine (hormone-producing) tissues and possibly heart muscle tissue
  • Infertility;
    • probably caused by various chronic tissue damage
  • General Poor Condition and Reduced Growth Rate;
    • probably caused by various chronic tissue damage

(B47, B58, B210.89.w89, B211, B212, B215, B216, B218, D33, J3.99.w1, J3.99.w2, J3.102.w6, J3.115.w2, J3.119.w3, J19.45.w1, J24.43.w1, J42.81.w1, J42.84.w1, J62.39.w1, J62.40.w1, J66.27.w1, J66.33.w1, J67.3.w1, J79.11.w1)
Specific Clinical Characteristic Descriptions available
Editorial Overviews Available
Overall Typical-Indicative Findings (List Automatically generates from Detailed Report Pages)
  • jaw grinding or champing or lip-smacking
  • anorexia
  • dullness
  • lameness
  • recumbency
  • death
  • reduced: growth rate
  • weight loss
  • Fever
  • mouth - vesicles: mucus membranes of buccal mucosa
  • mouth - erosion / ulcerations: mucus membranes of buccal mucosa
  • mouth - increased: salivation
  • alimentary - diarrhoea
  • head - vesicles: skin of muzzle / snout / trunk
  • head - erosion / ulceration: skin of muzzle / snout / trunk
  • feet - vesicles: skin of feet
  • feet - erosion / ulceration: skin of feet
  • feet - swelling: coronet or growing base of nail of hoof
  • feet - pain: coronet or growing base of nail of hoof 
  • feet - separation of hoof/horny tissue (heel bulbs) from underlying tissue
  • vesicles: external surface of mammary gland, including teats
  • erosion / ulceration: external surface of mammary gland, including teats
  • reduced: milk yield

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Clinical Pathology (Testing Samples incl. Serology)
Overall Clinical Pathology findings The major clinico-pathological findings reported for animals with foot-and-mouth disease infection are the findings of virus, viral antigen, or antibody to the virus, in a wide variety of tissues and fluids, i.e. in general the use of these samples for diagnosis has been the main concern

Haematological, biochemical and other changes which may be expected to occur with a viral infection are not generally recorded, although a change in the amount and character of milk produced is commonly reported for dairy cattle, goats, and sheep.

(B47, B58, B207, B209, B210.89.w89, D36.Para35, J3.77.w3, J3.82.w3, J3.83.w2, J3.87.w1, J3.96.w3, J12.74.w1, J13.57.w1, J18.41.w1, J19.114.w1, J35.148.w1, J42.80.w1, J42.118.w1, J62.53.w2, J63.14.w1, J67.3.w1, J67.32.w1, J69.20S2.w1, J69.20S2.w2, J70.17.w2, J71.142.w1, J71.143.w1, J71.145.w1, W18.Apl01.sib1).

SAMPLING

Detection of virus (virus isolation or detection of virus antigen) is generally carried out on epithelium from intact vesicles (blisters), fluid from vesicles, or the tags of epithelium from the edges of ruptured vesicles (erosions). Blood may also be tested for the presence of virus (viraemia) and other tissues/secretions are also used sometimes. Cells and mucus from the pharynx, sampled using a probang cup, may be used for the detection of virus in subclinically infected animals and carriers (J3.77.w3, J42.118.w1, W18.Apl01.sib1).

Detection of antibody is carried out on serum samples.

  • Traditional tests detect antibody to structural proteins of the FMD virus and the serum must be tested for each of the seven different types of virus. These tests can be used to determine which types of virus are/have been present in an area.
  • More recently, tests have been developed which detect non-structural proteins. These tests detect infection with any type of FMD virus (they do not differentiate between virus types). (J69.20S2.w1, J69.20S2.w2, J70.17.w2, J71.142.w1, J71.143.w1, J71.145.w1).
Literature Reports
Editorial Overviews Available
Overall Typical-Indicative Findings (List Automatically generates from Detailed Report Pages)
  • Viral Antigen: Body Fluids and Tissue
  • Serum Antibody

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Pathological Findings (by anatomical system)

Overview The lesions which may be found in animals at post mortem examination are to a large extent the same as those seen as clinical signs in the live animal, as most of the lesions are on the external surfaces of the body.
  • Vesicles (blisters) or erosions may be found on the mucous membranes of the mouth, sometimes of the pharynx, larynx, trachea, oesophagus, the wall of the rumen, particularly around the oesophageal groove, and the intestines. Additional sites where vesicles (blisters) are sometimes seen include the muzzle, interdigital space, coronary band, teats, sometimes the udder, sometimes the base of the horns.
  • Species differences in the sites of lesions are seen related to the areas where there is maximal mechanical stress on infected epithelial surfaces.
  • Findings may be complicated by the presence of bacterial infection
  • Heart lesions, seen mainly in juveniles, may be seen as pale streaks separated by darker areas, giving the descriptive term "tiger heart".
  • Mastitis changes may be found in the udder.
  • Pancreatic lesions may be seen in chronically infected cattle.
  • Epithelial lesion development progresses from balloon degeneration of cells in the stratum spinosum to micro-vesicle formation, vesicle formation and erosion. There may be a mild cellular infiltration around erosions. The myocardium (of juveniles in particular) may have multifocal myocardial degeneration and necrosis.

(B47, B58, B209, B100, B211, D33, D34, J3.115.w2)

Click for Video: Bird Necropsy Protocol for West Nile Virus Surveillance Video Available: Necropsy of Wild Ungulates:
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Specific Pathological Findings Descriptions available
Editorial Overviews Available
Overall Typical-Indicative Findings (List Automatically generates from Detailed Report Pages)
  • Pathological findings have not been key-worded for FMD

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Diagnostic Criteria
General Indicative Signs
  • FMD should be suspected whenever mouth lesions and/or foot lesions/lameness develops in a number of animals of a susceptible species at any one time. The mouth and feet should then be examined for vesicles. (B47, B209)
  • Provisional diagnosis is usually based on clinical evidence: a highly contagious disease with vesicular lesions on the tongue and feet of bovines, pigs, sheep, goats and/or other susceptible species (B58).
  • Disease in cattle "is usually acute and relatively unmistakable" (J3.102.w6)
  • In sheep and pigs, the occurrence of a sudden-onset severe lameness in several animals at one time is suspicious (J3.102.w6).
    • Note: Episodes of lameness may not be recognised as being due to FMD. (J3.149.w8)
  • FMD should always be suspected in pigs with vesicular lesions (J3.102.w6)
  • N.B. initial diagnosis may be difficult if strains produce anomalous disease pictures; this may occur with:
    • strains with a high species-tropism, e.g. the O Taiwan 1997 strain affected pigs and it was very difficult to infect cattle (J3.141.w2).
    • low virulence strains in which few typical vesicular lesions are produced (J63.14.w1).
    • exceptionally virulent strains causing unexpectedly high adult mortality (J63.14.w1).

A guide to detection of FMD lesions, for farmers, has been produced by Defra. See: D321 - Fact Sheet 1 How to spot foot and mouth disease (full text provided)

Definitive Diagnosis "Rapid diagnosis of foot-and-mouth disease is of paramount importance, especially in countries that are usually free of infection, so that quarantine and eradication programs can be implemented as quickly as possible." (B216).

Usually a definitive diagnosis of FMD is based on the presence of FMD virus or antigen. Tests identify whether or not virus is present, and the specific serotype. In the absence of tissue samples, diagnosis can be made based on the demonstration of specific antibodies in serum. (J64.11.w2).

Definitive diagnosis of foot-and-mouth disease is usually based on detection of virus or virus antigens. Serological tests for antibody may be used to confirm diagnosis even in the absence of detectable virus, but antibodies are not detectable very early in the infection.

  • Differential diagnosis from other vesicular diseases affecting livestock (swine vesicular disease SVD, vesicular stomatitis VS, vesicular exanthema VE) depends on history including the species affected, clinical signs and laboratory tests. Only VS affects horses; cattle may be affected by both FMD and VS; only pigs are affected by SVD and VE. If a vesicular disease is seen in pigs, all four diseases must be suspected until a definitive diagnosis is made (B47, D34).

Field diagnosis can be carried out using large animals, by inoculation with fresh vesicular fluid:

  • Horse (intradermolingual inoculation) will develop vesicles with VS only (small local lesion may occur with VE). (B47, D34).
  • Cattle (intradermolingual inoculation) will develop disease with FMD and VS, not with VE. (B47, D34).
  • Cattle (intramuscular or intravenous inoculation) will develop disease with FMD only. (B47, D34).
  • Guinea-pig (intradermal in footpad) will develop lesion with FMD or VS. (B47, D34)
  • Inoculation of pigs is not helpful as lesions may develop with any of the four vesicular diseases. (B47, D34).
  • N.B. This must be carried out under biosecure conditions (V.w23).

Detection of virus (virus isolation or detection of virus antigen) is generally carried out on epithelium from intact vesicles (blisters), fluid from vesicles, or the tags of epithelium from the edges of ruptured vesicles (erosions). Blood may also be tested for the presence of virus (viraemia) and other tissues/secretions are also used sometimes. Cells and mucus from the pharynx, sampled using a probang cup, may be used for the detection of virus in subclinically infected animals and carriers (J3.77.w3, J42.118.w1, W18.Apl01.sib1).

  • Virus typing by complement fixation (CF) test, enzyme-linked immunosorbent assay (ELISA) or polymerase chain reaction (PCR) may be carried out directly on material expected to contain large amounts of virus, such as fluid or epithelium from intact or recently ruptured vesicles. Samples which are negative must then be tested by growth in cell culture followed by virus typing of the cell culture supernatant. Samples which are less likely to contain large amounts of virus are tested by growing the virus from the sample in cell culture, followed by virus typing. (B58, B207, B210.89.w89, B216, B219).
  • Direct serotyping using ELISA is able to produce a result within three hours from the time the test is set up (J64.15.w3).
  • Repeated sampling of oesophageal/pharyngeal fluid and detection of virus in this fluid is required for the detection of carrier animals as an animal negative on one occasion may be positive at a later date. The sensitivity of testing is probably 50%; this can be improved by repeated sampling.(J3.77.w3, J42.118.w1).
  • Recently, work has been carried out developing kits which, subject to satisfactory validation, could be used for rapid pen-side testing for FMD virus (J71.144.w1, P22.2000App18.w1)

Detection of antibody is carried out on serum samples.

  • Traditional tests detect antibody to structural proteins of the FMD virus and the serum must be tested for each of the seven different types of virus. These tests can be used to determine which types of virus are/have been present in an area.
  • More recently, tests have been developed which detect non-structural proteins. These tests detect infection with any type of FMD virus.
  • The oldest of the tests for non-structural antibodies detect antibodies to "virus infection associated antigen" (D3). However, animals which have been vaccinated repeatedly with inactivated vaccines may be positive with this test (for example due to contamination of some impure vaccines with this non-structural protein and because the virus particle contains some of this protein in its capsid (V.w23)).
  • In the last several years, tests have been developed, mostly based on ELISAs to various non-protein antigens, which are sensitive, specific and suitable for screening large numbers of serum samples. These tests are able to distinguish between animals which have been infected with foot-and-mouth disease virus (had virus replicating in them) and those which have not, whether or not the animals have been vaccinated. (J69.20S2.w1, J69.20S2.w2, J70.17.w2, J71.142.w1, J71.143.w1, J71.145.w1) 
    • The OIE has now accepted the use of tests for non-structural proteins and permits a return to "FMD free" status in six months after the last case or last vaccination, if vaccination is used, vaccinated animals are not culled, and appropriate serological testing is carried out. (W31.Sept07.w2) See: Terrestrial Animal Health Code Sixteenth Edition: Chapter 2.2.10 Foot and Mouth Disease and Appendix 3.8.7 Surveillance (Office International des Epizooties) (full text provided)
Specific Technique Reports
Specific Clinical Pathology Findings (Sample Results)
Similar Diseases
  • Diseases producing vesicles which may affect the mouth and feet
    • Vesicular stomatitis VS (cattle, pigs, horses, sometimes sheep/goats) (B100, B211, B207)
    • Swine vesicular disease SVD (pigs only) (B100, B211, B58, B207, J3.102.w6)
    • Vesicular exanthema VE (pigs only) (B100, B211 B58, B207)
    • Sunlight-induced snout and sometimes foot vesicles in white-skinned pigs fed parsnips or celery (B207, B210.89.w89, B211)
    • Rarely, fungal lesions may produce confusing skin lesions (B207)
    • In humans, hand, foot and mouth disease (B47)
  • Diseases which may produce lesions affecting the mouth and feet, but not vesicles
    • Mucosal disease BVD/MD (no vesicles, lesions begin as erosions) (B207, B210.89.w89, B211)
    • Bluetongue (sheep, goats, rarely cattle) (B211, B58, B210.89.w89, B207)
    • Orf (contagious pustular dermatitis) (B210.89.w89, B207)
    • Malignant catarrhal fever (foot lesions rare)(B58, B210.89.w89, B207)
  • Diseases which may produce mouth lesions, but not vesicles and not foot lesions:
    • Rinderpest (no vesicles, lesions begin as erosions) (B211, B58, B210.89.w89, B207)
    • Bovine papular stomatitis (B210.89.w89, B207)
    • Epizootic haemorrhagic disease of deer (B58, B207)
    • Infectious bovine rhinotracheitis (B210.89.w89, B207)
    • Lumpy skin disease (Bovine herpesvirus 2: Allerton strain).(B209)
      • In African buffalo in East Africa. Well-defined ulcers on the tongue, palate and buccal mucosae (J64.7.w2).
  • Diseases which may produce foot lesions, but not vesicles and not mouth lesions
  • Diseases which may produce udder lesions
    • Pox infections of the udder (e.g. cowpox, pseudocowpox, orf) (B207, B211)
    • Bovine herpes mammilitis (B207)
  • Disease producing skin lesions, in elephants
    • Elephantpox (B212)
  • Disease producing neonatal mortality
    • Enterotoxaemia (B207).
    • Bluetongue (B207).
    • Encephalomyocarditis virus disease (B207).

N.B.

  • Cattle fed grain treated with caustic soda may salivate profusely (B207).
  • Pigs with white skins who are exposed to sunlight after being fed parsnips or celery may develop vesicles (B496).
  • Ingestion of any caustic material may result in salivation and oral blisters (vesicles) (B207).
  • Trauma may cause lesions similar to those seen with FMD (W18.Apl01.sib1).
  • Abscesses, e.g. at the coronary band, may appear similar to FMD vesicles (W18.Apl01.sib1).
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Treatment and Control

Specific Medical Treatment (Antiserum, Antidote, Anti-(viral/bacterial/fungal) etc.)
Specific Medical Treatment Treatment with hyperimmune serum is not common but has been used, for example in zoos in the face of an outbreak

(B47, B219, B214.3.18.w8, J3.148.w6, J79.11.w1, P5.40S.w1)
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  • No specific techniques described

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General Nursing and Surgical Techniques
Nursing and Supportive Care Supportive care is recommended in endemic areas where there is no slaughter policy and may greatly reduce the development of secondary infections.

In areas of the world where slaughter of animals with clinical signs of foot-and-mouth disease is not mandatory, and in the case of infection in very important animals where an exception to an automatic slaughter policy might be given, nursing and supportive care are important for the welfare of the individual animal and to minimise the time for which it is clinically affected.

However, with severe disease and particularly if there are severe secondary infections and complications, culling may be preferable on the grounds of the welfare of the animal and also the prevention of additional losses to the farmer due to animals which are "poor doers".

(B207, B211, B214.3.7.w3, D34, J79.11.w1)
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Surgical Treatment

Not applicable.
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Vaccination & Prophylactic Treatment
Vaccination

1) VACCINATION REGIMES

Vaccination may be used to prevent major epidemics of disease. By providing vaccinated animals with protection, the number of susceptible animals is kept below the level required for disease transmission to be sustained.

In many areas of the world where foot-and-mouth disease is enzootic or there is a high risk of the disease, vaccination is used on a routine, prophylactic basis. Following initial vaccination, booster vaccinations are given at appropriate intervals for the area. Species other than cattle are not always included in these programmes.

In the face of an epidemic, whether or not in an endemic area, vaccination may be used alongside other measures to limit the spread of disease. In such a situation, it is advisable to vaccinate as many animals as possible of all susceptible species. It has been suggested that vaccination of at least 80-85% of the livestock in an area is required to provide "herd immunity" and effectively prevent disease spread.

The vaccine strain or stains to be used should be chosen carefully to ensure maximum protection is given against the virus type(s) circulating in the field.

The use of vaccines is often controlled at a national or regional level by the FMD control policy in force.

(B207, B210.89.w89, B214.3.14.w6, B214.3.17.w7, B217.38.w38, B219, J3.102.w8, J16.8.w1, J16.22.w1, J18.49.w1, J18.116.w1, J19.100.w1, J19.116.w1, J21.9.w1, J21.12.w2, J21.12.w3, J21.40.w2, J21.41.w2, J35.141.w1, J35.151.w1, J35.158.w1, J64.11.w1, J64.11.w2, J70.9.w1, J70.11.w2, J70.12.w1, J70.16.w2, J70.17.w4, J71.57.w1, J78.3.w1, P5.40S.w1, P5.40S.w2, D38, V.w23, W18.Apl01.sib1, W32.Apl01.sib1)

2) FOOT-AND-MOUTH DISEASE VACCINE DEVELOPMENT

Conventional, inactivated (killed) vaccines have been used effectively for many years, and provide good immunity if used correctly (J70.10.w3). However, improvements could be made in areas such as the breadth of strains covered by a given vaccine; longevity of the immune response; ease of differentiation between vaccinated and infected animals; prevention of any local infection and thus of the possibility of carrier animals; route of inoculation (topical rather than parenteral) and elimination of the need for maintenance of a cold chain. (J112.25.w3)

Killed Vaccines

Killed vaccines against FMDV are produced by growing virus in cell culture, inactivating the virus and combining it with an adjuvant, a substance which enhances the immune response. Further processing may be carried out to concentrate the antigen to reduce the volume required for vaccination of each animal, and allow storage of antigen for prolonged periods without loss of efficacy. Testing during vaccine production ensures safety and efficacy of vaccines produced under standards of Good Manufacturing Practice.

The development and use of vaccines against foot-and-mouth disease virus (FMDV) has been complicated by the presence of seven different immunologically distinct virus types, antigenic variation within virus types, the continuous emergence of new subtypes, the relatively short time for which FMD vaccines provide effective protection.

Considerable progress has been made in areas such as virus growth, inactivation, purification and the development of effective adjuvants to boost the immune response to the vaccine.

In recent years "vaccine banks" have been developed containing purified concentrated vaccine which may be used to produce high potency emergency vaccines at short notice.

The effectiveness of vaccination in practice depends not only on the standard of the vaccine but also on its being stored, transported and administered correctly.

(B47, B210.89.w89, D35.w1, J3.102.w8, J3.102.w9, J13.24.w1, J16.8.w1, J16.22.w1, J19.61.w1, J35.148.w1, J70.6.w1, J70.8.w1, J70.9.w1, J70.10.w1, J70.10.w2, J70.12.w1, J70.16.w2, J70.17.w3, W18.Apl01.sib1).

Live Vaccines

Live vaccines have been used historically. Their use ceased due to the problem and potential problem of reversion to virulence.

(J3.102.w8, J16.8.w1, J35.148.w1, J70.9.w1).

Genetically Modified Vaccines

There has been considerable interest in the development of genetically modified vaccines which would, for example, not need to be kept refrigerated during storage. There are a yet no fully-developed genetically modified FMD vaccines., although some appear very promising.

(J13.51.w1, J20.278.w1, J20.337.w1, J35.148.w1, J64.21.w24,J70.6.w1, J70.10.w3, J70.11.w1, J70.20.w3, J70.20.w4, J70.22.w1, J70.24.w2, J472.33.w1, B210.89.w89) 
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Prophylactic Treatment
  • Theoretically, antiviral drugs could be used to protect animals from infection and to reduce the risk of carrier animals during emergency vaccination programmes. However, the costs involved mean that even if antiviral drugs effective against FMDV were identified, they are unlikely to be used except perhaps in very valuable individuals.
  • A novel system in which interferon is expressed in a replication-defective human adenovirus type 5 (Ad5) vector allows treated animals to produce interferon endogenously for a period of time (several days), providing protection against viral infection faster than can be obtained by vaccination.
  • Simultaneous inoculation of pigs with Ad5-pIFNα and a vaccine (Ad5 expressing FMDV capsids) provided both initial and ongoing protection from infection.

(B495.1.w1, J70.22.w1, J80.77.w4, J80.81.w1) 
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Environmental and Population Control Measures
General Environment Changes, Cleaning and Disinfection Cleaning and disinfection of infected premises is an important part of foot-and-mouth disease control. Essential points to remember for effective disinfection are:
  • Thorough cleaning is required as the presence of organic matter/dirt may stop the applied disinfectant being effective.
  • Disinfectants effective against FMD virus generally rely for their action on being acids or alkalis. These must NOT be mixed.
  • Prolonged times may be required for the action of disinfectants on some substances (e.g. slurry).
  • Small amounts of detergent (e.g. 1 mL detergent per litre of disinfectant solution) may be added to disinfectants to increase effectiveness.
  • It is important to use effective (approved) disinfectants and to use these at their effective (approved) concentrations.

(B214.2.4.3.w2, D37.Para138, J3.102.w7, W32.Apl01.sib1, W32.Apl01.sib16, W39.31May01.sib4, W39.31May01.sib5, W39.31May01.sib7)
Literature Reports
Technique Descriptions, if available
Population Control Measures Population control measures aim to prevent the introduction of foot-and-mouth disease (FMD) into FMD-free areas and to limit the spread of the disease where it is endemic or following introduction.

The measures may include:

  • Routine movement restrictions and quarantine for movement between areas, in countries with endemic FMD
  • Fencing to prevent contact between domestic livestock and wildlife populations in which FMD is known to circulate.
  • Import/export restrictions for between-country movement of animals.
  • Rapid culling of infected animals and appropriate disposal of their carcasses, which is particularly important in non-endemic areas.
  • Severe restrictions on movements of animals in an area during an outbreak of FMD.
  • Restriction on movements of animals back onto premises which have been infected.

It is important that population control measures are enforceable and enforced. Consideration must be given to the problems associated with movement restrictions, including welfare problems of wildlife prevented from reaching water or other vital resources. It is also important to consider that where means of enforcement are poor and/or the importance of such control measures are not understood and appreciated, illegal movement of livestock is likely to undermine control efforts.

Culling operations should be designed to minimise the spread of disease while avoiding unnecessary slaughter.

  • Because of the highly contagious nature of foot-and-mouth-disease virus (FMDV), and because animals are known to release large amounts of virus into the environment before starting to show clinical signs (up to five days before for cattle and sheep, as long as ten days for pigs), it is usual in FMD-free countries to cull not only those animals with clinical disease (lesions) but also all "dangerous contact animals" such as:
    • All other animals on the same farm;
    • All other animals which have been in contact at e.g. a market;
    • Other animals considered likely to have been infected by indirect contact (e.g. transported in same lorry immediately after it has been used for infected animals, or tended by stockman immediately after tending infected animals).
  • This is because there is a high chance that these animals will already be infected and may already be producing virus and releasing it into the environment. This policy, the slaughter and burial or burning of all affected and in-contact susceptible livestock (dangerous contact animals) on an affected premises is also known as "stamping out" (J3.131.w1).

Effective rapid disposal of carcasses following culling is recognised to be an essential part of effective FMD control.

(B209, B211, J3.96.w3, J3.131.w1, J3.140.w6, J3.148.w3, J18.49.w1, J19.68.w5, J21.33.w1, J19.124.w2, J21.69.w1, J35.134.w2, J35.127.w1, J42.84.w1, J42.85.w2, J42.118.w1, J64.7.w1, J68.B302.w1, J72.41.w1, W18.Apl01.sib1, W32.Apl01.sib1, W32.Apl01.sib6, W39.31May01.sib1, W39.31May01.sib3, D36.AppendixII, D37.Para216).
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Individual Technique Descriptions Available:
Isolation and Quarantine The aim of Isolation and Quarantine is to prevent susceptible animals from coming into contact with the virus. As FMD is a particularly virulent and infectious virus, strict physical separation of susceptible animals from animals, animal products, vehicles, clothes etc. must be enforced. The FMD virus can be transferred through all of these means. Great care must be taken not to introduce the FMD virus through the movements of people and vehicles. Isolation and quarantine cannot prevent infection if animals are exposed to airborne virus.

Quarantine of an individual animal or group of animals would frequently involve testing for disease (screening) to reduce any possible risk of introducing the virus to a previously unexposed population.

(B211, B214.3.14.w6, J3.102.w6, D37.Para85, W32.Apl01.sib1, W32.Apl01.sib2, W32.Apl01.sib4, W32.Apl01.sib5, W32.Apl01.sib16, W32.Apl01.sib17, W32.Apl01.sib19, W32.Apl01.sib21, W32.Apl01.sib22, W32.Apl01.sib23, W32.Apl01.sib24, W39.31May01.sib5)
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