Foot and mouth disease (FMD) is a severe, highly contagious viral disease of livestock that has a significant economic impact. The disease affects cattle, swine, sheep, goats and other cloven-hoofed ruminants. Intensively reared animals are more susceptible to the disease than traditional breeds. The disease is rarely fatal in adult animals, but there is often high mortality in young animals due t
o myocarditis or, when the dam is infected by the disease, lack of milk. FMD is characterised by fever and blister-like sores on the tongue and lips, in the mouth, on the teats and between the hooves. The disease causes severe production losses, and while the majority of affected animals recover, the disease often leaves them weakened and debilitated. The organism which causes FMD is an aphthovirus of the family Picornaviridae. There are seven strains (A, O, C, SAT1, SAT2, SAT3, and Asia1) which are endemic in different countries worldwide. Each strain requires a specific vaccine to provide immunity to a vaccinated animal. All seven of the serotypes have also been found in wildlife, although the latter does not play a significant role in the maintenance of the disease1. To date, the only confirmed reservoir in wildlife is African buffalo Syncerus caffer). FMD is an OIE-listed disease and must be reported to the Organisation, as indicated in the OIE Terrestrial Animal Health Code. It was the first disease for which the OIE established official status recognition. Member Countries can also apply for official endorsement of their national control programmes. Transmission and spread
FMD is found in all excretions and secretions from infected animals. Notably, these animals breathe out a large amount of aerosolised virus, which can infect other animals via the respiratory or oral routes. The virus may be present in milk and semen for up to 4 days before the animal shows clinical signs of disease. The significance of FMD is related to the ease with which the virus can spread through any or all of the following:
infected animals newly introduced into a herd (carrying virus in their saliva, milk, semen, etc.);
contaminated pens/buildings or contaminated animal transport vehicles;
contaminated materials such as hay, feed, water, milk or biologics;
contaminated clothing, footwear, or equipment;
virus-infected meat or other contaminated animal products (if fed to animals when raw or improperly cooked);
infected aerosols (spread of virus from an infected property via air currents). Animals that have recovered from infection may sometimes carry the virus and initiate new outbreaks of the disease. Public health risk
FMD is not readily transmissible to humans and is not a public health risk. Clinical signs
The severity of clinical signs will depend on the strain of virus, the exposure dose, the age and species of animal and the host immunity. Morbidity can reach 100% in susceptible populations. Mortality is generally low in adult animals (1–5%), but higher in young calves, lambs and piglets (20% or higher). Clinical signs can range from mild or inapparent to severe: they are more severe in cattle and intensively reared pigs than in sheep and goats. The typical clinical sign is the occurrence of blisters (or vesicles) on the nose, tongue or lips, inside the oral cavity, between the toes, above the hooves, on the teats and at pressure points on the skin. Ruptured blisters can result in extreme lameness and reluctance to move or eat. Usually, blisters heal within 7 days (sometimes longer), but complications, such as secondary bacterial infection of open blisters, can also occur. Other frequent symptoms are fever, depression, hypersalivation, loss of appetite, weight loss, growth retardation and a drop in milk production, which can persist even after recovery. Chronically affected animals are reported to have an overall reduction of 80% in milk yield. The health of young calves, lambs, and piglets may be compromised by lack of milk if dams are infected. Death can occur before development of blisters due to a multifocal myocarditis. Myositis may also occur in other sites. More information on the disease can be found in the OIE Technical Disease Card. Diagnostic
The disease may be suspected based on clinical signs. However, FMD cannot be differentiated clinically from other vesicular diseases, such as swine vesicular disease, vesicular stomatitis and vesicular exanthema. Confirmation of any suspected FMD case through laboratory tests is therefore a matter of urgency. Relevant tests are described in the OIE Terrestrial Manual. Prevention and control
The initial measures described in the Global Food and Mouth disease control strategy are the presence of early detection and warning systems and the implementation of effective surveillance in accordance with the guidelines detailed in the OIE Terrestrial Code. They help monitor the occurrence and prevalence of the disease and allow characterisation of FMD viruses. The implementation of the FMD control strategy varies from country to country and depends on the epidemiological situation of the disease:
In general, it is essential for livestock owners and producers to maintain sound biosecurity practices to prevent the introduction and spread of the virus. Measures that are recommended at the farm level include:
control over people’s access to livestock and equipment;
controlled introduction of new animals into existing herds;
regular cleaning and disinfection of livestock pens, buildings, vehicles and equipment;
monitoring and reporting of illness;
appropriate disposal of manure and dead carcasses. Contingency planning for potential outbreaks will identify the elements included in a response effort to eradicate the disease, such as:
humane destruction of all infected, recovered and FMD-susceptible contact animals;
appropriate disposal of carcasses and all animal products;
surveillance and tracing of potentially infected or exposed livestock;
strict quarantine and controls on movement of livestock, equipment, vehicles, and;
thorough disinfection of premises and all infected materials (implements, cars, clothes, etc.). Use of vaccination
Depending on the FMD situation, vaccination strategies can be designed to achieve mass coverage or be targeted to specific animal sub-populations or zones. Vaccination programmes carried out in a target population should meet several critical criteria, mainly:
coverage should be at least 80%;
campaigns should be completed in the shortest possible time;
vaccination should be scheduled to allow for interference from maternal immunity;
vaccines should be administered in the correct dose and by the correct route;
The vaccines used should meet OIE standards of potency and safety, and the strain or strains in the vaccine must antigenically match those circulating in the field. It is important to use inactivated virus vaccines, as inactivated virus does not have the ability to multiply in vaccinated animals. The use of live virus vaccines is not acceptable due to the danger of reversion to virulence
Vaccination can play a role in an effective control strategy for FMD, but the decision on whether or not to use vaccination lies with national authorities. For more information on FMD vaccination, consult the related FAQ. Geographical distribution
FMD is endemic in several parts of Asia and in most of Africa and the Middle East. In Latin America, the majority of countries apply zoning and are recognised as FMD-free, either with or without vaccination. Australia, New Zealand, Indonesia, Central and North America, and continental Western Europe are currently free of FMD. However, FMD is a transboundary animal disease that can occur sporadically in any typically free area. FMD-free Status
FMD is the first disease for which the OIE established an official list of disease-free countries. Through a transparent, science-based and impartial procedure, countries can be officially recognised as free of the disease either in their entirety or in defined zones and compartments. Categories for FMD disease status include:
FMD free without using vaccination (country or zone)
FMD free with use of vaccination (country or zone)
Member Countries can also ask the OIE to officially endorsetheir national programmes for FMD control. Details on the granting, maintenance, suspension and recovery of official recognition of FMD status or official endorsement of an FMD control programme can be found here, including the relevant Standard Operating Procedures.