The mouth, the palms and the limbs - B

Despite the similar names, the foot and mouth disease of farm animals is not the foot and mouth disease that attacks children. The second part of the article

Dror Bar-Nir

The disease in history
In his writings from 350 BC, Aristotle described a cattle plague whose symptoms may have been foot-and-mouth disease (but perhaps it was the cattle thing, rinderpest, which is caused by a different virus).

The first certain description of this disease appears in the book "On Contagion and Contagious Diseases" (De contagione et contagiosis morbis), published in 1546 by the doctor Girolamo Fraxtoro from the city of Verona in Italy. It describes an outbreak, which occurred in 1514, of a deadly plague in the cattle herds of northern Italy.

Since then, additional cases of the disease have been documented, which continues to cause heavy damage to herds and the meat and dairy industries. Towards the end of the 19th century, the German government funded research to find the cause of the disease, following which (in 1897) the researchers Friedrich Loeffler and Paul Frosch declared that the cause of the disease is smaller than any known bacteria, and cannot be observed under a light microscope. It was the second virus known to scientists, and the first to affect mammals. (The first virus was the tobacco mosaic virus, TMV.)

The next breakthrough in the study of the virus and the disease occurred in 1920, when Otto Waldmann (Waldmann) and his colleague Pape (Pape) succeeded in using the vole (guinea pig) as a model animal for the study of the disease. Vallee and Carre first distinguished in 1922 between strain (serotype) O (named after the Oise Valley in France) and strain A (named after Allemagne in Germany). Four years later, in 1926, Otto Waldmann and Carl Trautwein identified a third strain of the disease virus, called C.

In 1938, Otto Waldman developed the first vaccine for the disease, in collaboration with Köbe. The pair of researchers isolated viruses and treated them with heating and formalin. The vaccine was first tried successfully in an outbreak that occurred in Germany in the years 1940-1938.

The situation in the world
It is customary to divide the countries of the world into three groups, according to the criterion of the presence of the virus for foot and mouth disease and the appearance of the disease in them. The World Organization for Animal Health oversees this.

1. Infected countries - where disease cases are still being reported, or where a month has not yet passed since the last case was reported.
2. Countries free of the disease, where it is customary to vaccinate farm animals vulnerable to the virus. In May of this year, three countries were included in this group.
3. Countries free of the disease, where farm animals are not stored. This group includes, for example, the United States, whose last outbreak of the disease occurred in 1929. In May of this year, there were 59 countries in this group (including Great Britain, which will now be removed from the list).

Some countries have been divided into regions, classified in groups 2 and 3.

The difference between the last two groups is due to the fact that vaccinated animals are hard to tell if they are carriers of the virus or not. Countries from the third group can export meat and dairy products to other countries without any restrictions.

And what about Israel?
We are also at the end of a prolonged epidemic, which started last December (2006) in the Acre region and spread to many districts all over the country - from the Golan Heights and the Jordan Valley in the north to the Beer Sheva region in the south.

The disease affected herds of beef cattle, dairy cattle, sheep and goats. Mortality in most places was relatively low, probably because the animals are vaccinated (there is routine vaccination for three strains: O1, A22 and Asia1). In the planted settlement, where the plague began, there was a high mortality of the sick goats (201 out of 260), because the animals were not vaccinated. In Israel, unlike the UK, since the animals are vaccinated, the sick animals or those exposed to the disease are not destroyed.

The deer population in the Ramot Issachar region (which are of course not vaccinated) was also affected by the disease. 68 of them got sick and 28 of them died.

The last report of the disease was received on July 1 of this year, and on July 31 the waiting period ended. As of today, Israel is clean - until the next outbreak.


Foot and mouth disease in humans
As mentioned, FMDV can also infect humans, but the phenomenon is very rare. However, children (and rarely adults too) get a viral disease with a similar name, which manifests itself in the rise of the body's temperature, sores in the mouth and a rash accompanied by blisters on the hands and feet. Today this disease is known in English as HFMD - Hand foot and mouth disease. In Hebrew, it was proposed to call it mouth and limb disease - but the name has not been adopted (yet).

The disease is highly contagious and is easily passed from child to child through contact with secretions from the mouth and nose, bladder contents and feces. Despite the discomfort, especially in mouth sores that are sometimes very painful and disabling, the disease is considered mild from a medical point of view, and goes away without treatment after a week to ten days. Rarely the disease gets complicated and develops into viral meningitis, or other diseases that require hospitalization and supervision in a hospital. In very rare cases, encephalitis develops, which may end in death.

Sometimes severe epidemics of the disease break out. In Beijing, the capital of China, over a thousand cases of the disease were reported last July - most of them in children under the age of 10. In Singapore, about 700 cases were reported last April. In 2006, 14,000 cases were reported from Malaysia. To remove doubt: despite the similarity in the name of the disease and in some of the symptoms, it is a different cause of the disease (both this and those are viruses).
Does unpasteurized goat's milk help in overcoming the sores of the disease?

Many claim that goat's milk, preferably directly from the goat's udder, relieves and even heals the painful sores that develop in the mouth, both from foot and mouth disease and for other reasons.

The proponents of the use claim that there is probably an unknown factor in the milk, which the pasteurization process damages. The detractors point to the risks of consuming unpasteurized milk, and some claim that the goat's milk was used right before the wounds healed on their own, and that there is no connection between the recovery and the milk consumption. There have been no controlled experiments examining the relationship between milk and wound healing.

What is the risk of using unpasteurized goat milk? - Unpasteurized milk may contain dangerous amounts of disease-causing bacteria and viruses. The most common disease in Israel as a result of drinking unpasteurized milk is brucellosis, or by its names in Hebrew "infectious abortion" (in domestic animals) and "malta fever" (in humans). In Malta fever, ulcers form in internal organs, which cause lasting, and sometimes permanent, damage to the bones, liver and spleen, the nervous system and other systems.
In conclusion

A distinction must be made between the two different viral diseases, which are similar in name and symptoms, but differ in the causes of the disease and the host. The first is of agricultural economic importance, and the other causes suffering for our children. And the main thing is that we will be healthy.

Dr. Dror Bar-Nir teaches microbiology and cell biology at the Open University

links

The Epidemiological Report of the Plague in Syria»

The information page about foot-and-mouth disease on the website of the World Organization for Animal Health»

The information page about foot and mouth disease on the website of the Center for Disease Control»