Clarifying foot-and-mouth confusion -Mayo clinic

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Maybe this will clear up some of the confusion on this subject.

Headline Watch: Clarifying foot-and-mouth confusion

It's summertime and your children have been playing outside for days. Your daughter tells you she doesn't feel well. She complains of a slight fever and shows you blisterlike sores in her mouth and on the back of her hands. The doctor diagnoses hand-foot-and-mouth disease. But wait. Isn't this the illness that broke out among cattle and sheep in Great Britain this past February? How did your child get infected with the same disease? Is it the same disease? Hoof-and-mouth disease, foot-and-mouth disease, hand-foot-and-mouth disease. Who can keep them all straight?

First, don't worry. Your daughter did not catch the same illness that has devastated livestock in Great Britain. Although there is no specific treatment, her mild condition will resolve in a week or two.

But it is easy to understand the confusion. The terminology is too similar, and reports in April in Great Britain of possible foot-and-mouth outbreaks in humans have not helped clarify the situation. The following explanation will help you better understand what's happening in Europe and with your child.

Hoof-and-mouth disease Foot-and-mouth disease Hoof-and-mouth disease is the easiest of the three names to clarify. It is another name, used in the United States, for foot-and-mouth disease. Foot-and-mouth disease is the correct term for the disease caused by the Aphthovirus foot-and-mouth disease virus, a member of the Picornavirus family.

Foot-and-mouth disease is a highly infectious viral disease of ruminant animals (cows, sheep, pigs, deer). Symptoms include fever and blisterlike lesions on the tongue, lips, mouth, teats and between the hoofs of the infected animals. The first signs of infection may be excessive drooling or slobbering and lameness. Although most animals recover from foot-and-mouth disease, it may leave them weak and debilitated.

According to the Department of Agriculture (USDA), foot-and-mouth disease is one of the most difficult animal infections to control. Containment efforts include destroying entire herds, restricting meat and livestock imports, special cleaning of the feet and clothing of people who work with animals and discouraging travel to and from countries where an outbreak has occurred.

The cost of this past February's outbreak in Great Britain, including from the containment efforts and loss of livestock, income and tourism, is estimated to be in the billions of dollars. It also brings a high cost in worry of contagion to humans.

Although rare, foot-and-mouth disease can infect humans.

"On rare occasions people can get foot-and-mouth disease, but they have to be exposed to infected animals first," says William Marshall, M.D., an infectious disease specialist at Mayo Clinic, Rochester, Minn. "If they do get it, it's usually mild and doesn't have any long-term consequences or problems."

A reported case of human infection in Great Britain in April is under investigation. The person who may have the disease works as a slaughterer, working with infected animals. According to Great Britain's Public Health Laboratory Services, he was directly exposed to the fluid from a decomposing cow. If tests show that he does have foot-and-mouth disease, his will be the first diagnosis in a human since 1966, when the last foot-and-mouth outbreak occurred.

Hand-foot-and-mouth disease Hand-foot-and-mouth disease is a mild condition primarily seen in preschool children. Symptoms include blisterlike lesions on the tongue, mouth, hands and feet. Although it too is caused by a Picornavirus, it is a different microbe from the one infecting animals.

"Both viruses belong to the same large family of viruses called the Picornaviruses," says Dr. Marshall.

The virus causing hand-foot-and-mouth disease is a coxsackievirus and is spread via person-to-person contact. Outbreaks of illnesses caused by the hand-foot-and-mouth virus and other coxsackieviruses, such as hepatitis A, poliovirus and several forms of viral encephalitis, often peak in summer and fall.

Because hand-foot-and-mouth disease is so contagious, children in child-care centers and nurseries are susceptible to outbreaks. Steps to prevent the spread of hand-foot-and-mouth disease include:

Meticulous hand washing, particularly after going to the bathroom, changing or handling diapers. Covering mouth and nose when coughing or sneezing and then washing hands immediately afterward.

Washing toys or other surfaces that come in contact with children. Keeping children who are infected at home. They should not return to child-care settings until all lesions are dry or crusted over.

April 27, 2001 2001 Mayo Foundation for Medical Education and Research

-- Martin Thompson (mthom1927@aol.com), April 28, 2001

Answers

URL for the above.

http://www.mayohealth.org/home?id=NE00279

-- Martin Thompson (mthom1927@aol.com), April 28, 2001.


FYI: The coxsackie virus can be no fun. My little one got is at ~11 months old, and we both promptly got it (~11% chance for an adult). The blisters really itch and the mouth blisters hurt really bad. It went away promptly but it was no fun.

-- (perry@ofuzzy1.com), April 28, 2001.

Martin, Thank you for the clairification. Nobody in our area seems to be taking any chances. My butcher(who supplies my hamburger) is working overtime trying to keep up with an unusual demand for meat to be stored in freezers. Feed mills have delivered notices to all farms in the area that they will not deliver in the same manner as before. All products for example,will be left outside of the barns reducing their exposure as they travel from farm to farm. Everyone is holding their breath and praying. I think we can all hear the sound of the approaching hoof beats of the 4 horsemen - particularly the PALE ONE!

-- David Rowe (daverowe@linetap.com), April 30, 2001.

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