Forty people have caught it before

April 24, 2001 The Times (London) by Nigel Hawkes

CASES of foot-and-mouth in people are rare but by no means unknown. If tests confirm that the slaughterman from Cumbria has the disease he would join about 40 other cases recorded by medical journals, the first as long ago as 1834.

In people the disease is generally mild, producing blisters on the hands, mouth and feet that disappear after about two months.

In 1966 there was formal confirmation of a human case. Bobby Brewis, a Northumberland farm worker, became something of a celebrity when he caught the disease during an isolated outbreak at a farm in the Cheviot Hills where he was living.

His case was described, anonymously, in the British Medical Journal. Mr Brewis, who was 35, had watched the animals being slaughtered but took no direct part in the process. Scientists later noted that one of the infected cows had supplied milk to the farmhouse.

Four days later Mr Brewis complained of a sore throat, which grew worse over the following days. His temperature rose and he began developing blisters on his hands. There were four or five solid weals on his tongue and some between his toes.

The BMJ reported: "The patient described his lesions as uncomfortable and tingling, while the tongue was hot, tingling and sore." The foot-and-mouth virus was found in tissue taken from him, confirming that was indeed the cause of his disease.

It is not clear why some people get foot-and-mouth and others equally exposed to the virus do not. The virus can cross the species barrier but it does so with difficulty, infecting people only occasionally.

The first recorded case was in 1834 when three American veterinary surgeons deliberately infected themselves by drinking milk from infected cattle. There were also cases in the 19th century among schoolchildren who drank unpasteurised milk.

The assumption is that the greater the exposure to the virus, the greater the risk. But differences in the immune response may explain why it is only the rare person who is unlucky enough to catch it. Scratches or scars on the skin may make it easier for the virus to enter.

If the Cumbrian case is confirmed as foot-and-mouth, the slaughterman's symptoms are likely to be mild and will cure themselves in time. There is no evidence that it can be transmitted from person to person.

Those dealing with the present outbreak can minimise risk by wearing protective clothing and washing their face and hands regularly and carefully, according to the Public Health Laboratory Service.

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