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Foot and Mouth Disease Does Pose a Human Health Risk

April 4, 2001 Michael Greger, MD
Foot and mouth disease is a zoonosis (meaning that it is disease of animals that may be transmitted to man under natural conditions).(1) Of this, there is no doubt.(2) Probable human cases go back over 300 years. There are some 400 reports of alleged foot and mouth disease in human beings across several continents.(3)

Those at highest risk are young children--found to develop clinical infection more readily than adults--and those in certain occupational groups such as veterinarians, farm workers and their families, butchers, lab workers and livestock auctioneers. The presence of minor breaks in the skin, such as dermatitis, or "Even manicure procedures may cause sufficient abrasion to facilitate infection."(4)

There are several ways people can contract the virus. These include the handling of animals and inhalation of airborne viral particles, but probably the most frequent routs of infection has been ingestion. Historically, for example, multiple outbreaks among schoolchildren were attributed to unpasteurized milk. High titers of virus are shed into cow's milk--as many as thousands of human infectious doses per drop--and there is evidence that the virus does survive pasteurization(5). There have also been cases of human infection attributed to cheese and other dairy products(6). Most strains of foot and mouth disease virus are susceptible to acidic environments, however, so acidified products such as yogurt are "probably safe."(7)

Human infections are usually, but not always, of a mild nature.(8) After an incubation period of 2-4 days, sufferers start experiencing symptoms such as fever, headaches, shivering and thirst. Later, itchiness, pharyngitis, tonsillitis and, rarely, gastro-enteritis precede the appearance of crops of painful blisters on the sufferer's hands and between their toes.(9) In the case of the man who contracted foot and mouth disease during the last outbreak in Britain, the blisters on the palms of hands were up to almost an inch in diameter.(10) Blisters can also form on the lips and inside the mouth, causing extensive ulceration and marked discomfort. Desquamation (skin peeling) of the palms and soles of feet is also known to occur. In one case it was described that the "Skin of [the] soles peeled off like sandals, in one piece."(11) Recovery is usually complete within 2 weeks, although there was one case reported of someone developing a serious heart infection. Reports of deaths, however, have not been verified.(12)

Human volunteers experimentally infected with foot and mouth disease virus were found to be able to pass the virus along by coughing, sneezing , talking and breathing.(13) It is unknown whether the virus is excreted in human urine or feces.(14)

Although it must be concluded that the transfer of the foot and mouth disease virus between animals and man occurs more frequently than was suspected in the past, clinical disease occurs infrequently considering the extent of human exposure.(15) Under-reporting is assumed, since the disease may be so mild that sufferers might not seek medical attention(16) and systemic searches for the disease haven't been advised out of fear that "They would create misunderstandings, and possibly even panic..."(17)

(1) Prempeh H, Smith R and B M�ller. "Foot and mouth disease: the human consequences." British Medical Journal 10 March 2001:565-6.

(2) Bauer K. "Foot- and-Mouth Disease as Zoonosis." Archives of Virology Supplemental 13(1997):95-7.

(3) Hyslop NSG. "Transmission of the Virus of Foot and Mouth Disease Between Animals and Man." Bulletin of the World Health Organization 49(1973):577-85. <

(4) Ibid.

(5) "The Potential for International Travelers to Transmit Foreign Animal Diseases to US Livestock or Poultry." USDA:APHIS:VS Centers for Epidemiology and Animal Health. August 1998.

(6) Hyslop NSG. "Transmission of the Virus of Foot and Mouth Disease Between Animals and Man." Bulletin of the World Health Organization 49(1973):577-85.

(7) Hyslop NSG. "Transmission of the Virus of Foot and Mouth Disease Between Animals and Man." Bulletin of the World Health Organization 49(1973):577-85.

(8) Hyslop NSG. "The Epizootiology and Epidemiology of Foot and Mouth Disease." Advances in Veterinary Science and Comparative Medicine 14(1970):261.

(9) Hyslop NSG. "Transmission of the Virus of Foot and Mouth Disease Between Animals and Man." Bulletin of the World Health Organization 49(1973):577-85.

(11) Dlugosz H. "Foot and Mouth Disease in Man." British Medical Journal 27 January 1967:251-2.

(12) Hyslop NSG. "Transmission of the Virus of Foot and Mouth Disease Between Animals and Man." Bulletin of the World Health Organization 49(1973):577-85.

(13) Sellers RF, Donaldson AI and KAJ Herniman. "Inhalation, Persistence and Dispersal of Foot and Mouth Disease Virus by Man." Journal of Hygeine 68(1970):565-73.

(14) Smyth DH. "Foot and Mouth Disease in Man." British Medical Journal 2 December 1967:503.

(15) Hyslop NSG. "Transmission of the Virus of Foot and Mouth Disease Between Animals and Man." Bulletin of the World Health Organization 49(1973):577-85.

(16) Dlugosz H. "Foot and Mouth Disease in Man." British Medical Journal 27 January 1967:251-2.

(17) "Foot and Mouth Disease in Man." Lancet 6 May 1967:994.


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