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Foot and Mouth Disease

Foot and mouth disease (FMD) is described as a severe and contagious disease in cattle and pigs. This disease is also seen in goats, sheep, and deer [1]. FMD is not considered an anthrozoonotic infection; thereby, infected animals do not transmit the viral infection to humans.


The incubation period of the virus can be as short as 18 hours to as long as 2 weeks in pigs. The clinical signs are more marked and severe in swine and cattle than those found in goats and sheep [6]. After the incubation period, the initial signs of observed among cattle and pigs with FMD is high grade fever up to 41 degrees centigrade (106 F). Vesicular lesions of the mouth, lips, and tongue leads to the incessant salivation of the afflicted animal. The irritating blisters and vesicles of the foot pads make the animal stomp there feet frequently.

Newly born lambs, kids, piglets, and calves may die from FMD virus even without the cutaneous signs, but this is primarily because of myocardial cell damage by the virus. There is a considerable growth retardation in the case of the younger afflicted animals with progressive deterioration in milk production from the teats. The oral vesicles found in the affected species will resolve spontaneously within 7 days from the onset of symptoms. The horns of the foot may be missing among the deer and the cattle population during FMD infection. In a similar way, the deer shed their antler in face of an impending FMD infection in the afflicted animal.

  • Early symptoms of hand, foot and mouth disease Early symptoms of the condition include (1-8): Fever – High fever as high as 40º C (104º F) may be seen in most children.[news-medical.net]
  • A low grade fever and malaise are often related to non-specific viral infections. Hand-foot-and mouth disease (HFMD) is specifically caused by coxsackie virus.[ncbi.nlm.nih.gov]
  • It usually begins with fever, poor appetite, tiredness and sore throat. One to two days after fever onset, painful sores may develop in the mouth. They begin as small red spots with blisters and then often become ulcers.[chp.gov.hk]
  • The first symptoms of HFMD include a mind fever, loss of appetite, sore throat, and lethargy. After the fever is present for a day or two, your child can develop sores inside their mouth and on the tongue. The sores can be extremely painful.[mummypages.ie]
Heat Intolerance
  • 'Atypical' FMD-associated syndromes such as myocarditis, reproductive losses and chronic heat intolerance have also received little attention. Yet, all of these manifestations of FMD are reflections of distinct pathogenesis events.[ncbi.nlm.nih.gov]
  • ‘Atypical’ FMD‐associated syndromes such as myocarditis, reproductive losses and chronic heat intolerance have also received little attention. Yet, all of these manifestations of FMD are reflections of distinct pathogenesis events.[doi.org]
  • Through ruptured blisters, the animal is at risk from secondary bacterial infections [64] and, in some cases, permanent disability.[en.wikipedia.org]
  • This rash can show up on the buttocks, arms, and face, and diarrhea, nausea, and vomiting may round out the symptoms, Schaffner says.[self.com]
  • Common constitutional signs and symptoms of the HFMD include fever, nausea, vomiting, feeling tired, generalized discomfort, loss of appetite, and irritability in infants and toddlers.[en.wikipedia.org]
  • Complications include the following: "Aseptic" (also called "viral") meningitis (rare): Symptoms of meningitis are moderate-severe headache, discomfort when bending the head forward (classically tested by trying to touch the chin to the chest), and nausea[medicinenet.com]
  • Rural News ( Nanfang Nongcunbao ), in an article "Breaking the Hoof and Mouth Disease Taboo", noted that FMD has long been covered up in China by referring to it that way. [41] FMD is also called canker (口疮, literally "mouth ulcers" kǒuchuāng ) or hoof jaundice[en.wikipedia.org]
Left Ventricular Dysfunction
  • The illness rapidly progressed to include seizures (28%), flaccid limb weakness (17%), or cardiopulmonary symptoms (of 24 children, 17 had chest radiographs showing pulmonary edema, and 24 had echocardiograms showing left ventricular dysfunction), resulting[ncbi.nlm.nih.gov]
Sore Mouth
  • Treatments for a sore mouth Soft foods may be easier to eat with a sore mouth, so try foods such as soups, ice cream, smoothies and mashed potato. There are a few treatments available for ulcers in the mouth.[patient.info]
  • Signs and symptoms Symptoms may include: fever tiredness loss of appetite blisters in the mouth and on the hands and feet (see image) a sore mouth for a few days before the ulcers or blisters appear.[sahealth.sa.gov.au]
  • This will help if your child is experiencing a sore mouth or throat from the ulcers. Give Paracetamol to relieve pain and discomfort related to temperature (always follow the instructions on the box).[chroniclelive.co.uk]
  • To help with the symptoms: drink fluids to prevent dehydration – avoid acidic drinks such as fruit juice eat soft foods like soup – avoid hot and spicy foods take paracetamol or ibuprofen to help ease a sore mouth or throat A pharmacist can help with[nhs.uk]
Retinal Pigmentation
  • Fluorescein angiography demonstrated attenuation of the retinal pigment epithelium. Serologic tests at 1 month after the onset disclosed serum antibody to enterovirus.[ncbi.nlm.nih.gov]
Retinal Lesion
  • The close association between the cutaneous eruption and the onset of visual symptoms suggests that the retinal lesion was caused by coxsackievirus infection.[ncbi.nlm.nih.gov]
  • Ophthalmic examination revealed a single circumscribed area of pigment epithelial mottling in the left eye and a corresponding nonarcuate absolute scotoma. Fluorescein angiography demonstrated attenuation of the retinal pigment epithelium.[ncbi.nlm.nih.gov]
Oral Blisters
  • Foot-and-mouth disease Other names Hoof-and-mouth disease, Aphthae epizooticae Ruptured oral blister in diseased cow.[en.wikipedia.org]
Oral Blisters
  • Foot-and-mouth disease Other names Hoof-and-mouth disease, Aphthae epizooticae Ruptured oral blister in diseased cow.[en.wikipedia.org]
Limb Weakness
  • The illness rapidly progressed to include seizures (28%), flaccid limb weakness (17%), or cardiopulmonary symptoms (of 24 children, 17 had chest radiographs showing pulmonary edema, and 24 had echocardiograms showing left ventricular dysfunction), resulting[ncbi.nlm.nih.gov]


The mouth vesicles found in FMD affliction is hard to distinguish from the common cattle and wine vesicular stomatitis [7]. The need to harvest the vesicular fluid for culture and histopathologic studies is imperative using buffered saline solution. The pH of the solution must be kept to as close to 7.4 pH as possible during the conduction to prevent viral material and antigen from disintegrating. This samples are diluted to 10% concentration and introduced for tissue culture where an enzyme linked immune-absorbent assay (ELISA) is utilized for identification of FMD antigen [8].

The identification of the viral non-structural proteins (NSP) from the sample distinguishes the actual presence of viral load from cattle and swine that has only been immunized against the disease [9]. The use of rapid diagnostic tests in farm producers is becoming more popular these days for on-farm diagnosis. The application polymerase chain reactions (PCR) in genetics laboratories have also been implored for the accurate diagnosis of the FMD virus [10].

  • We report the investigation methods for the diagnosis of an epidemic and culture-negative Kingella kingae endocarditis complicating a severe outbreak of hand, foot and mouth disease in a childcare center.[ncbi.nlm.nih.gov]


In most FMD-free countries, livestock identified to have the FMD virus are immediately slaughtered including those animals in direct contacted with the infected animal. The carcasses of these infected species are immediately burned. Animal movement is then limited for the other uninfected and susceptible farm animals in the area. In countries where FMD is endemic, a massive vaccination campaign is usually implemented especially among the dairy producing herds.


The majority of the infected animals does not die with the FMD. However, the disease often leaves them incapable of producing substantial milk and meat as they used to produce before. The morbidity associated from the pain of the blisters and vesicles tends to make the animal host anorexic, depressed, and lame. In general, FMD outbreaks leads to substantial production loss among ranchers and producers that leads to financial difficulties, and alters livestock trade [5].


The etiologic agent in FMD is identified as an apthovirus from the viral family of Picornaviridae. There are seven immunologic serotypes documented for FMD: The A, O, SAT, C, Asia 1, 1, 2, 3 and serotypes. The virus is susceptible to pH range of 6 to 9, and are immediately deactivated in these adverse environment. The viruses are resistant to lipid solvents like chloroforms and ethers. They may be transmitted to the young calf via the infected milk.


FMD outbreaks have been recently documented in previously FMD-free countries like Taiwan in 1997, and in United Kingdom last 2001. These developing threats have prompted the scientific community to re-examine this growing threat to the population of susceptible livestock. In the past, FMD outbreaks have been observed in all continents except in New Zealand. At present enzootic transmission from cattle to cattle has been observed worldwide except in the regions of Australia and North America.

Sex distribution
Age distribution


The apthovirus latches on the mucosae of the pharynx upon transmission [2]. Alternative viral routes of entry include skin cuts and the gastrointestinal tract of the animal [3]. Upon entry the virus is distributed to the body through the lymphatic system where it is seen to replicate in the epithelium of the mouth, muzzle, teats, and feet. The viral load is also noted in body areas with damage like the knees and hocks in swine. Vesicular lesions develop in these epithelium and eventually rupture giving out that characteristic lesions in FMD. The FMD viremia can exist up to 4 to 5 days in the animal host. Cattle, sheep, goat, and swine can remain as FMD carriers for as long as 2 to 3 years from the time of viral contraction [4].


The control of FMD infections among livestock is relatively difficult because of its endemicity in multiple countries. The active animal migration control is imperative to contain FMD outbreaks. This will include the effective restrictions of livestock meat and derivatives from infected animals. The use of vaccination against FMD among susceptible farm animal has been proven to be the most effective way to prevent the FMD disease.


Foot and mouth disease (FMD) is a highly contagious viral infection of the cloven hoofed species. FMD is characterized by the formation of vesicles in the mouth, muzzle, nipple, and feet. Morbidity in FMD approaches 100% in susceptible species but fatalities are relatively rare except in younger animals.

Patient Information

  • Definition: Foot and mouth disease (FMD) is a highly contagious and severe viral infection of the cloven hoofed species like cattle, swine, goats, and deer.
  • Cause: FMD is caused by an apthous virus from the family picornaviridae. It has seven immunologic serotypes and is exclusively an enzootic virus.
  • Symptoms: Afflicted farm animals will initially present with high grade fever. After the incubation period, the affected animal exhibits vesicular lesions of the mouth, teats, muzzle, and foot pads. Pain felt from the blistering and vesicular lesions adversely affects the behavior of the infected animals.
  • Diagnosis: Animals presenting with the clinical signs and symptoms of FMD are subjected into laboratory tests. Aspirates and discharges from the vesicles are sent to the laboratory for tissue culture, non-structural proteins (NSP) determination, and (enzyme linked immune-absorbent assay) ELISA immune tests. 
  • Treatment and follow-up: Massive livestock immunizations is still the primary mode of preventing and treating the disease process. Restriction of animal movements and destruction by incineration of infected carcasses are among the modalities of control utilized for FMD. 



  1. Fenner, F. J., P. J. Gibbs, F. A. Murphy, R. Rott, M. J. Studdert, and D. O. White. 1993. Veterinary virology, p. 403-430. Academic Press, New York, N.Y.
  2. Crowell, R. L., B. J. Landau, and J. Siak. 1981. Picornavirus receptors in pathogenesis, p. 170-180. In K. Lonberg-Holm and L. Philipson (ed.), Virus receptors, part 2. Animal viruses, series B, vol. 8. Chapman and Hall, New York, N.Y.
  3. Donaldson, A. I. 1987. Foot-and-mouth disease: the principal features. Irish Vet. J. 41:325-327.
  4. Brooksby JB Intervirology. Portraits of viruses: foot-and-mouth disease virus. 1982; 18(1-2):1-23.
  5. Leforban Y. Prevention measures against foot-and-mouth disease in Europe in recent years. Vaccine. 1999 Mar 26; 17(13-14):1755-9.
  6. Donaldson, A. I., and R. F. Sellers. 2000. Foot-and-mouth disease, p. 254-258. In W. B. Martin and I. D. Aitken
  7. Bachrach HL Annu Rev Microbiol. Foot-and-mouth disease. 1968; 22:201-44.
  8. Bergmann IE, de Mello PA, Neitzert E, Beck E, Gomes I. Diagnosis of persistent aphthovirus infection and its differentiation from vaccination response in cattle by use of enzyme-linked immunoelectrotransfer blot analysis with bioengineered nonstructural viral antigens. Am J Vet Res. 1993 Jun; 54(6):825-31
  9. Rueckert RR, Wimmer E. J .Systematic nomenclature of picornavirus proteins. Virol. 1984 Jun; 50(3):957-9
  10. Grubman MJ, Robertson BH, Morgan DO, Moore DM, Dowbenko D. J. Biochemical map of polypeptides specified by foot-and-mouth disease virus. Virol. 1984 May; 50(2):579-86.

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Last updated: 2019-07-11 20:49