Difference between revisions of "Foot and Mouth Disease"

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{{unfinished}}
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== Introduction<br> ==
  
FMD
+
This apthovirus is very small (25nm) +ss RNA virus, unenveloped and has a number a serotypes, namely&nbsp;'''Oise (O),&nbsp;''''''Allemagne (A),&nbsp;''''''C (also German),&nbsp;'''South African Territories (SAT) 1, 2, and 3 and India (Asia-1). Each serotype has '''at lease three subtypes.&nbsp;'''Serotype and subtype can be quickly identified by '''ELISA''' using guinea pig antisera. '''All isolates are virulent'''.<br>
FMDV
 
  
====Morphology====
+
This disease affects all '''cloven-hoofed animals, EXCLUDING the horse, '''namely cattle, sheep, goats, pigs, deer, elephants and other wild ruminants such as buffalo and kudu etc. The main presentation of the disease is the formation of vesicles.<br>
*Very small (25nm) +ss RNA virus, unenveloped
 
*12 capsomeres (1 per vertex)
 
*5 subunits per capsomere
 
*1 molecule of virus protein (VP) per subunit
 
*4 virus proteins (VP1-VP4)
 
*VP1 is the attachment protein
 
  
====Antigenicity====
+
The disease is NOTIFIABLE in the UK and any animals with the disease, or in contact with the disease have to be destroyed.<br>
*FMDV was the first animal virus in which serotypes were isolated
 
*To date, there are (important in bold):
 
**'''Oise (O)'''
 
**'''Allemagne (A)'''
 
**'''C (also German)'''
 
**South African Territories (SAT) 1, 2, and 3
 
**India (Asia-1)
 
*Each serotype has '''at lease three subtypes'''
 
*Serotype and subtype can be quickly identified by '''ELISA''' using guinea pig antisera
 
*'''All isolates are virulent'''
 
  
====Hosts====
+
The virus replicates primarily in the upper respiratory tract, tonsils, or upper alimentary tract and there is '''aerosol''' excretion during this incubation period. This is then followed by a viremia. Virus targets stratum spinosum of stratified squamous epithelia and mucus membranes and secondary [[Foot and Mouth Disease|'''vesicles''']] appear after incubation of 2-14 days. Lesions also affect the feet with cutaneous erosions in interdigital cleft, at coronet and bulbs of heals . These feet lesions often take a long time to heal as secondary bacterial infections may ensue and produce true deep ulcerative dermatitis. In the young, without maternal antibody, virus will localize in the heart and cause death by myocarditis. <br>
*'''Cloven-hoofed animals, EXCLUDING the horse'''
 
**Cattle
 
**Sheep
 
**Goats
 
**Pigs
 
**Deer
 
**Elephants
 
**Wild ruminants: buffalo, kudu, impala, etc
 
  
====Pathogenesis====
+
FMDV causes loss of condition and productivity but is NOT typically fatal.<br>
*Primary replication in the upper respiratory tract, tonsils, or upper alimentary tract
 
*'''Aerosol''' excretion during this incubation period
 
*Viremia
 
*Virus targets stratum spinosum of stratified squamous epithelia and mucus mebranes
 
*Secondary [[Foot and Mouth Disease|'''vesicles''']] appear after incubation of 2-14 days
 
*Appearance of lesions by age:
 
**0-2 days: unruptured vesicles
 
**1-3 days: newly ruptured vesicles with adherent epithelia at margins
 
**3-7 days: ruptured vesicles, loss of epithelia, no marked fibrous margin
 
**7-10+ days: open lesions with marked fibrous  margin
 
*'''Lameness'''
 
**Also produces cutaneous erosions in interdigital cleft, at coronet and bulbs of heals
 
**These feet lesions often take a long time to heal as secondary bacterial infections may ensue and produce true deep ulcerative dermatitis
 
*'''Teats''' on animals that are suckling may also develop vesicles
 
*In the young, without maternal antibody, virus will localize in the heart and cause death by myocarditis
 
*FMDV causes '''loss of condition and productivity''' but is NOT typically fatal
 
  
=====Pathogenesis by species=====
+
The virus is highyl contagious and spread is by aerosol, direct contact, saliva, infected swill and fomites. Pigs produce 3000 times more aerosol virus than cows, but cows are much more susceptible to infection than pigs
*'''Pigs''' and '''Sheep''':
 
**Lesions less obvious, but vesicles around nose, mouth, and coronary band
 
**Pigs have vesicles on snout, which are quickly traumatised to leave an eroded lesion
 
**Lesion at '''coronary band''' means infection is usually less than a week old
 
**Lesions grow down claw at a rate of 1mm per week
 
*'''Cattle'''
 
**Lesions are seen inside mouth, around muzzle, in the interdigital cleft, around coronary band, and on teats
 
**Excessive salivation, anorexia, secondary mastitis
 
**PM: lesions in oesophagus and forestomachs
 
  
====Epidemiology====
+
Persistent infection of cattle can occur in unkeratinized lesions, but subclinical carriers do not usually transfer infection
*'''Highly contagious''' virus that is spread by '''aerosol''', '''saliva''', '''infected swill''', '''direct contact''', and '''fomites'''
 
*'''Pigs''' produce '''3000 times more aerosol virus''' than cows
 
*Cows are much more susceptible to infection than pigs
 
**Persistent infection of cattle can occur in unkeratinized lesions, but subclinical carriers do not usually transfer infection
 
**Subclinical '''buffalo''' CAN transmit the disease
 
*1967 + 2001  major outbreaks in UK
 
*Still widespread in many parts of world especially S. America, far East
 
*Foot and Mouth disease is NOT a highly fatal disease: approximately 5% mortality (usually young animals); older animals recover
 
  
====Diagnosis====
+
Subclinical buffalo CAN transmit the disease
*Clinical signs for provisional diagnosis
 
*Confirmed by '''ELISA''' for virus '''antigen'''
 
**ELISAs are serotype-specific
 
*Should soon be replaced by immunochromatography-bedside ELISA to allow on-farm diagnosis
 
*'''Virus isolation''' can also be performed in kidney culture cells, and then serotyped by ELISA
 
*Serology for virus '''antibody''' can determine past infection
 
**ELISAs used to detect subclinical carrier sheep
 
**Cannot be done on vaccinated animals
 
*RT-PCR has been suggested for on-farm diagnosis, but has flaws:
 
**RNA is readily degraded by tissue enzymes
 
**RNA must be purified before converting to DNA for PCR
 
**False positives can occur easily by contamination with previously amplified DNA
 
*May see animals that have discoloration of [[Tongue - Anatomy & Physiology|tongue]] due to having had FMD
 
**In these cases take scraping of retropharyngeal region, put scrapings in transport medium and send for testing
 
  
====Control====
+
1967 + 2001 major outbreaks in UK
*Recovered animals show immunity ONLY to the subtype of first exposure, and even this is relatively short-lived
 
*Re-exposure to the original serotype after immunity as waned will still result in virus excretion, even without clinical symptoms
 
*Infection by a second serotype will result in clinical disease
 
*For these reasons, '''vaccination is not practiced''' in the UK
 
**Further, vaccination would mean a loss of meat export markets
 
  
=====Prevention in the UK=====
+
Still widespread in many parts of world especially S. America, far East
*Imported stock must come from virus-free countries that DO NOT vaccinate
 
*Meat imported from endemic countries must be de-boned
 
  
=====In an Outbreak=====
+
Foot and Mouth disease is NOT a highly fatal disease: approximately 5% mortality (usually young animals); older animals recover<br>
*ANY sign of lesions in a susceptible animal is '''NOTIFIABLE''' to the Divisional Veterinary Officer and local police
 
*Once diagnosis is confirmed, all animals on the premises must be '''slaughtered and incinerated'''
 
*Further disinfection of the premises
 
*Movement is controlled within a 10-mile radius
 
*Follow-up serology must be performed to ensure no spread has taken place
 
*'''Ring vaccination''' with relevant subtype to create a barrier of immune animals (although this was not done in the 2001 outbreak)
 
  
=====In Endemic Areas=====
+
<br>
*Disease cannot be prevented by slaughter due to large numbers of carrier stock
 
*Annual '''Inactivated whole virus vaccination''' using local subtypes
 
**Inactivated by azuridines, using alhydrogel adjuvant for cows, and oil for pigs
 
**Attenuated virus reverts to virulence
 
**Subunit vaccines ineffective
 
**Expensive
 
**2 initial injections at 4 months (if dams vaccinated), followed by boosters every 6-12 months
 
**Induces virus-neutralizing antibodies
 
*Vaccination DOES NOT render meat harmful to consumers, but does affect when it can be exported
 
  
====Pathology====
+
== Clinical Signs<br> ==
=====Gross=====
 
#Initially - hyperaemia of mucosa (e.g. catarrhal inflammation) then within 12 hours produces fluid filled vesicles on dorsum of [[Tongue - Anatomy & Physiology|tongue]], may be other places
 
#Small vesicle coalesce to produce big ones -i.e. Bullae
 
#Very quickly rupture; epithelium appears dirty grey in colour because of necrosis - sloughed skin, very good for diagnosis
 
#Leave painful, hyperaemic epithelium
 
#Looks like "ulcer "with ragged edge but not a true ulcer as stratum germinativum retained and will rapidly heal completely in about 2 weeks unless becomes secondarily infected
 
  
=====Microscopic lesions=====
+
Main clinical signs include pyrexia, depression,seperation away from the herd, drooling, excess salivation, anorexia due to inability to eat due to pain as well as smacking of the lips. Lameness is also a key clinical sign and in pigs may often be the first noticeable sign as mouth lesions in this specie are less severe.<br>
*Degeneration of prickle cells
 
*Cells "balloon" as fill with fluid and then die to produce vesicle containing straw coloured or clear fluid
 
  
 +
Lesions in the mouth and on the tongue have the following characteristics depending on age of lesions. At 0- 2 days they will be unruptured vesicles, at 1-3 days newly ruptured vesicles with adherent epithelia at margins will appear. By 3-7 days there will be ruptured vesicles, loss of epithelia, no marked fibrous margin and at days 7-10+ open lesions with marked fibrous margin will be present. '''Teats''' on animals that are suckling may also develop vesicles.<br>
  
====For more information====
+
In pigs and sheep, lesions are less obvious, but vesicles around nose, mouth, and coronary band are present. Pigs have vesicles on snout, which are quickly traumatised to leave an eroded lesion. Presence of a lesion at '''coronary band''' means infection is usually less than a week old. The lesions grow down the claw at a rate of 1mm per week. <br>
[http://www.defra.gov.uk/footandmouth/ DEFRA]
 
  
 +
In cattle, lesions are seen inside mouth, around muzzle, in the interdigital cleft, around coronary band, and on teats. There will be excessive salivation, anorexia, secondary mastitis and on PM there will be lesions in oesophagus and forestomachs.
  
*Caused by [[Picornaviridae|Apthovirus]]
+
<br>
*Main presentation are vesicles
 
*May also involve skeletal and heart muscle
 
*Grossly:
 
**Yellow streaks and grey foci
 
*Histologically:
 
**Segmental myofibre [[Muscle Necrosis|necrosis]]
 
**Infiltration of lymphocytes and [[Neutrophils|neutrophils]]
 
  
 +
== Diagnosis ==
  
 +
Clinical signs are enough to make a provisional diagnosis. This must be confirmed by '''ELISA''' for virus '''antigen.&nbsp;'''ELISAs are serotype-specific. This method is soon to be replaced by immunochromatography-bedside ELISA to allow on-farm diagnosis. '''Virus isolation''' can also be performed in kidney culture cells, and then serotyped by ELISA. Serology for virus '''antibody''' can determine past infection and&nbsp;ELISAs are used to detect subclinical carrier sheep. This cannot be done on vaccinated animals.
  
 +
RT-PCR has been suggested for on-farm diagnosis, but has flaws such as, RNA is readily degraded by tissue enzymes, RNA must be purified before converting to DNA for PCR, false positives can occur easily by contamination with previously amplified DNA.
  
[[Category:Apthoviruses]]
+
Samples should be taken from the vesicle itself and include the vesicle fluid as well as the tissue. These should be placed in transport medium and sent for testing.
[[Category:Oral Diseases - Cattle]][[Category:Oral Diseases - Sheep]][[Category:Oral Diseases - Goat]][[Category:Oral Diseases - Pig]][[Category:Dermatological Diseases - Cattle]][[Category:Dermatological Diseases - Sheep]][[Category:Dermatological Diseases - Goat]][[Category:Dermatological Diseases - Pig]]
+
 
[[Category:Oral Cavity - Vesicular Pathology]][[Category:To_Do_-_Clinical/Viruses]]
+
<br>
[[Category:Integumentary System - Viral Infections]][[Category:Viral Myositis]]
+
 
 +
== Control ==
 +
 
 +
Recovered animals show immunity ONLY to the subtype of first exposure, and even this is relatively short-lived, therefore re-exposure to the original serotype after immunity has waned will still result in virus excretion, even without clinical symptoms. Infection by a second serotype will result in clinical disease. It is for these reasons, that '''vaccination is not practiced''' in the UK. Further, vaccination would mean a loss of meat export markets.<br>
 +
 
 +
===== Prevention in the UK =====
 +
 
 +
Imported stock must come from virus-free countries that DO NOT vaccinate. Any meat imported from endemic countries must be de-boned.<br>
 +
 
 +
ANY sign of lesions in a susceptible animal is '''NOTIFIABLE''' to the Divisional Veterinary Officer and local police. Once diagnosis is confirmed, all animals on the premises must be '''slaughtered and incinerated''' and the premises fully disinfected. Movement is controlled within a 10-mile radius and follow-up serology must be performed to ensure no spread has taken place on any nearby farms. '''Ring vaccination''' with relevant subtype to create a barrier of immune animals (although this was not done in the 2001 outbreak) can be used. <br>
 +
 
 +
There is to be no movement on or off the farm as soon as a case is suspected.<br>
 +
 
 +
'''In Endemic Areas''' disease cannot be prevented by slaughter due to large numbers of carrier stock. Annual '''Inactivated whole virus vaccination''' using local subtypes is used. This vaccine is inactivated by azuridines, using alhydrogel adjuvant for cows, and oil for pigs. Subunit vaccines are ineffective. The course involves 2 initial injections at 4 months (if dams vaccinated), followed by boosters every 6-12 months, which induces virus-neutralizing antibodies. Vaccination DOES NOT render meat harmful to consumers, but does affect when it can be exported.<br>
 +
 
 +
 
 +
 
 +
<br>
 +
 
 +
==== For more information ====
 +
 
 +
[http://www.defra.gov.uk/footandmouth/ DEFRA]
 +
 
 +
<br>
 +
 
 +
== References<br> ==
 +
 
 +
Andrews, A.H, Blowey, R.W, Boyd, H and Eddy, R.G. (2004) Bovine Medicine (Second edition), Blackwell Publishing<br>Brownlie, J (2007) Virology Study Guide, Royal Veterinary College.<br>Radostits, O.M, Arundel, J.H, and Gay, C.C. (2000) Veterinary Medicine: a textbook of the diseases of cattle, sheep, pigs, goats and horses Elsevier Health Sciences<br>Taylor, D.J. (2006) Pig Diseases (Eighth edition) St Edmunsdbury Press ltd<br><br>
 +
 
 +
<br>
 +
 
 +
[[Category:Apthoviruses]] [[Category:Oral_Diseases_-_Cattle]] [[Category:Oral_Diseases_-_Sheep]] [[Category:Oral_Diseases_-_Goat]] [[Category:Oral_Diseases_-_Pig]] [[Category:Dermatological_Diseases_-_Cattle]] [[Category:Dermatological_Diseases_-_Sheep]] [[Category:Dermatological_Diseases_-_Goat]] [[Category:Dermatological_Diseases_-_Pig]] [[Category:Oral_Cavity_-_Vesicular_Pathology]] [[Category:To_Do_-_Review]] [[Category:Integumentary_System_-_Viral_Infections]] [[Category:Viral_Myositis]]
 +
 
 +
<br>

Revision as of 15:50, 17 March 2011

Introduction

This apthovirus is very small (25nm) +ss RNA virus, unenveloped and has a number a serotypes, namely Oise (O), 'Allemagne (A), 'C (also German), South African Territories (SAT) 1, 2, and 3 and India (Asia-1). Each serotype has at lease three subtypes. Serotype and subtype can be quickly identified by ELISA using guinea pig antisera. All isolates are virulent.

This disease affects all cloven-hoofed animals, EXCLUDING the horse, namely cattle, sheep, goats, pigs, deer, elephants and other wild ruminants such as buffalo and kudu etc. The main presentation of the disease is the formation of vesicles.

The disease is NOTIFIABLE in the UK and any animals with the disease, or in contact with the disease have to be destroyed.

The virus replicates primarily in the upper respiratory tract, tonsils, or upper alimentary tract and there is aerosol excretion during this incubation period. This is then followed by a viremia. Virus targets stratum spinosum of stratified squamous epithelia and mucus membranes and secondary vesicles appear after incubation of 2-14 days. Lesions also affect the feet with cutaneous erosions in interdigital cleft, at coronet and bulbs of heals . These feet lesions often take a long time to heal as secondary bacterial infections may ensue and produce true deep ulcerative dermatitis. In the young, without maternal antibody, virus will localize in the heart and cause death by myocarditis.

FMDV causes loss of condition and productivity but is NOT typically fatal.

The virus is highyl contagious and spread is by aerosol, direct contact, saliva, infected swill and fomites. Pigs produce 3000 times more aerosol virus than cows, but cows are much more susceptible to infection than pigs

Persistent infection of cattle can occur in unkeratinized lesions, but subclinical carriers do not usually transfer infection

Subclinical buffalo CAN transmit the disease

1967 + 2001 major outbreaks in UK

Still widespread in many parts of world especially S. America, far East

Foot and Mouth disease is NOT a highly fatal disease: approximately 5% mortality (usually young animals); older animals recover


Clinical Signs

Main clinical signs include pyrexia, depression,seperation away from the herd, drooling, excess salivation, anorexia due to inability to eat due to pain as well as smacking of the lips. Lameness is also a key clinical sign and in pigs may often be the first noticeable sign as mouth lesions in this specie are less severe.

Lesions in the mouth and on the tongue have the following characteristics depending on age of lesions. At 0- 2 days they will be unruptured vesicles, at 1-3 days newly ruptured vesicles with adherent epithelia at margins will appear. By 3-7 days there will be ruptured vesicles, loss of epithelia, no marked fibrous margin and at days 7-10+ open lesions with marked fibrous margin will be present. Teats on animals that are suckling may also develop vesicles.

In pigs and sheep, lesions are less obvious, but vesicles around nose, mouth, and coronary band are present. Pigs have vesicles on snout, which are quickly traumatised to leave an eroded lesion. Presence of a lesion at coronary band means infection is usually less than a week old. The lesions grow down the claw at a rate of 1mm per week.

In cattle, lesions are seen inside mouth, around muzzle, in the interdigital cleft, around coronary band, and on teats. There will be excessive salivation, anorexia, secondary mastitis and on PM there will be lesions in oesophagus and forestomachs.


Diagnosis

Clinical signs are enough to make a provisional diagnosis. This must be confirmed by ELISA for virus antigen. ELISAs are serotype-specific. This method is soon to be replaced by immunochromatography-bedside ELISA to allow on-farm diagnosis. Virus isolation can also be performed in kidney culture cells, and then serotyped by ELISA. Serology for virus antibody can determine past infection and ELISAs are used to detect subclinical carrier sheep. This cannot be done on vaccinated animals.

RT-PCR has been suggested for on-farm diagnosis, but has flaws such as, RNA is readily degraded by tissue enzymes, RNA must be purified before converting to DNA for PCR, false positives can occur easily by contamination with previously amplified DNA.

Samples should be taken from the vesicle itself and include the vesicle fluid as well as the tissue. These should be placed in transport medium and sent for testing.


Control

Recovered animals show immunity ONLY to the subtype of first exposure, and even this is relatively short-lived, therefore re-exposure to the original serotype after immunity has waned will still result in virus excretion, even without clinical symptoms. Infection by a second serotype will result in clinical disease. It is for these reasons, that vaccination is not practiced in the UK. Further, vaccination would mean a loss of meat export markets.

Prevention in the UK

Imported stock must come from virus-free countries that DO NOT vaccinate. Any meat imported from endemic countries must be de-boned.

ANY sign of lesions in a susceptible animal is NOTIFIABLE to the Divisional Veterinary Officer and local police. Once diagnosis is confirmed, all animals on the premises must be slaughtered and incinerated and the premises fully disinfected. Movement is controlled within a 10-mile radius and follow-up serology must be performed to ensure no spread has taken place on any nearby farms. Ring vaccination with relevant subtype to create a barrier of immune animals (although this was not done in the 2001 outbreak) can be used.

There is to be no movement on or off the farm as soon as a case is suspected.

In Endemic Areas disease cannot be prevented by slaughter due to large numbers of carrier stock. Annual Inactivated whole virus vaccination using local subtypes is used. This vaccine is inactivated by azuridines, using alhydrogel adjuvant for cows, and oil for pigs. Subunit vaccines are ineffective. The course involves 2 initial injections at 4 months (if dams vaccinated), followed by boosters every 6-12 months, which induces virus-neutralizing antibodies. Vaccination DOES NOT render meat harmful to consumers, but does affect when it can be exported.



For more information

DEFRA


References

Andrews, A.H, Blowey, R.W, Boyd, H and Eddy, R.G. (2004) Bovine Medicine (Second edition), Blackwell Publishing
Brownlie, J (2007) Virology Study Guide, Royal Veterinary College.
Radostits, O.M, Arundel, J.H, and Gay, C.C. (2000) Veterinary Medicine: a textbook of the diseases of cattle, sheep, pigs, goats and horses Elsevier Health Sciences
Taylor, D.J. (2006) Pig Diseases (Eighth edition) St Edmunsdbury Press ltd