Chapter 45

_Treatment._--On account of the danger of spreading the infection, neither medicinal treatment nor inoculation is permitted in European countries, with the exception of Russia, where the disease is more generally diffused. The most effective method of exterminating rinderpest in those districts in which the disease is not indigenous has been found to be the slaughter of all affected and exposed animals. Where the disease is general, successful efforts adopted for its control have followed the immunization by inoculation of the exposed animals and a strict application of appropriate sanitary measures. This protective inoculation has been practiced with very gratifying results in Russia, South Africa, and in the Philippine Islands. An active immunity is thus induced in susceptible animals which lasts until the danger from exposure to the disease is over. This immunity may be attained (1) by the inoculation of pure bile from an animal which recently died of rinderpest, (2) by the inoculation of glycerinated bile, followed by pure bile or virulent blood, or (3) by the simultaneous inoculation of strong standardized serum and virulent blood.

The latter method has been adopted by the United States Government in its endeavor to exterminate the disease in the Philippines, and to protect the cattle and carabaos against rinderpest after their importation into those islands. Owing to the existence of this and other infectious diseases in the Philippine Islands, an order has been issued by the Department of Agriculture prohibiting the landing of any live stock or animals of any kind from the Philippines at any of the ports of the United States or the dependencies thereof. This prohibition removes the greatest source of danger to which the United States is exposed as the result of its intercourse with the islands. The introduction of rinderpest from those countries from which we import animals is rendered extremely improbable, especially in live animals, owing to its short period of incubation and to the 90-day quarantine for cattle (counting from date of shipment) and 15-day (counting from date of landing) quarantine for sheep and other ruminants and swine which are at present enforced in the United States at all ports of entry.

FOOT-AND-MOUTH DISEASE.

[Pl. XXXIII.]

Foot-and-mouth disease, also known as aphthous fever, epizootic aphtha, and eczema contagiosa, is an acute, highly communicable disease chiefly confined to cloven-footed animals and characterized by an eruption of vesicles or blisters on the mucous membrane of the mouth and on the skin between the toes and above the hoofs. The vesicles rupture, forming erosions and ulcerations; there are also salivation, tenderness of the affected parts, loss of appetite, lameness, emaciation, and diminution in the quantity of milk secreted.

The tremendous ravages of the disease are seen in the number and variety of the species attacked. While it may be regarded as essentially a disease of cattle, hogs would seem to be as easy a prey. Almost in the same grade of receptivity are sheep and goats. Next in order of susceptibility come the buffalo, American bison, camel, chamois, llama, giraffe, and antelope. Horses, dogs, cats, and even poultry may occasionally become infected with the disease, the last three being particularly dangerous as carriers of the contagion. Man himself is not immune, and the frequency of his infection by coming in contact with diseased animals is established by numerous observations.

As with other communicable diseases, the source and origin of foot-and-mouth disease have given rise to much speculation. The disease had been known in Europe for centuries, but it was not until comparatively recent years that the erroneous conceptions of its spontaneous origin as a result of climatic and meteorological conditions, exhausting journeys, etc., were abandoned. It is now conceded that foot-and-mouth disease is propagated by a specific virus and that every outbreak starts from some preexisting outbreak.

So far investigators have been unable to identify or isolate the specific organism causing the disease, although numerous attempts have been made to cultivate and stain it by laboratory methods. Experiments have shown that the virus will pass through standard germ-proof filters, thus indicating its minute size and the reason it has not been detected by the staining methods. The contagion may be found in the serum of the vesicles on the mouth, feet, and udder; in the saliva, milk, and various secretions and excretions; also in the blood during the rise of temperature.

A wide distribution of the virus and a rapid infection of a herd is the result. Animals may be infected directly, as by licking, and in calves by sucking, or indirectly by such things as infected manure, hay, utensils, drinking troughs, railway cars, animal markets, barnyards, and pastures. Human beings may carry the virus on their shoes and clothing and transmit it on their hands when milking, since the udder is occasionally the seat of the eruption. It may also be carried by dogs, cats, rats, chickens, pigeons, etc. Milk in a raw state may also transmit the disease to animals fed with it.

The observations made by some veterinarians would lead us to suppose that the virus is quite readily destroyed. It is claimed that stables thoroughly cleaned become safe after drying for a short time; hence, litter of all kinds, such as manure or soiled hay and straw, may remain infective for a longer time because they do not dry out. Other authorities maintain that the virus is quite tenacious and may live in stables even so long as a year. They also state that animals which have passed through the disease may be a source of infection for several months after recovery.

Unlike most other infectious diseases, foot-and-mouth disease may repeatedly attack the same animals. The immunity conferred by an attack is of limited duration.

The period of incubation (that is, the time between the exposure of an animal to infection and the development of the disease) is variable, usually from three to six days. The disease may appear in 24 hours, or, in exceptional cases, not for 18 days or even longer.

_Losses._--The highly contagious character of foot-and-mouth disease and its rapid spread to practically all exposed susceptible animals lead to heavy losses. Since the mortality is comparatively low, ranging from only 3 per cent or less in mild forms to 30 or 40 per cent in malignant cases, the havoc caused by the pestilence is sometimes underestimated. But there are other sources of loss which are much more important than the actual mortality. The fever and the difficulty of eating cause a rapid and extreme loss in flesh and a lessening or cessation of the milk secretion. The udders often become inflamed and ruined by the formation of abscesses, and cows affected in this way are sometimes rendered permanently valueless for milk production. The inflammation of the feet may cause the horn to drop from the toes, producing great lameness and lasting injury. Abortion is frequent, and typical lesions have been observed in the newly born at birth. Altogether these losses may amount to 20 or 30 per cent of the value of the affected animals.

In addition there are indirect losses of a commercial nature. Dairy farmers are put out of business for a time. Necessary quarantine restrictions greatly interfere with the movement of live stock and such commodities as hay, straw, hides, and farm produce. The business of the stockyards and slaughtering centers is greatly interfered with. Sometimes it is necessary to close stockyards for disinfection. The whole business of marketing, transporting, feeding, and slaughtering is interrupted and deranged. Losses of this character may reach enormous proportions.

_The disease in other countries._--Foot-and-mouth disease has prevailed in Europe for a great many years and has occasioned tremendous economic losses there.

In Italy, France, Switzerland, Germany, and Russia the plague has existed so long and has gained such a foothold that it is economically impossible to fight it with the American methods of slaughter and disinfection, for to do so would kill a large percentage of the live stock of those countries. In consequence, little or no progress toward eradication has been made by the authorities, though the severity of the disease in France appears to have abated somewhat in recent months.

The outbreak which appeared in Germany in 1888 increased steadily until 1892, when it diminished gradually for a few years, but the disease again reached great proportions in 1899. Thereafter it continued to exist to a greater or less extent until in 1911 it attained a virulence unequaled before. In that year 3,366,369 cattle, 1,602,927 sheep, 2,555,371 hogs, and 53,674 goats were affected. At that time the total number of cattle, sheep, swine, and goats in Germany was only 51,319,000, while there were in the United States 172,572,000, or between three and four times as many. It can readily be imagined, therefore, what it would mean to the United States if the disease were to gain the foothold here that it had in Germany, where, as these figures show, approximately one out of seven of the animals susceptible to the disease was affected.

The German Government, of course, has not left the disease to itself. It attempted to control some outbreaks by the method of slaughter, but the pestilence had gained too much headway and was too firmly established in too many portions of the country for this method to succeed, and the slaughter of the infected herds had to be abandoned. It now appears that there is no hope of getting rid of it until the virus has worn itself out. As soon as the animals' period of acquired immunity is over and favorable conditions present themselves, the contagion breaks out with renewed virulence. It has been impossible to control it by means of quarantines. One scientist has asserted that unless all the infected farms were absolutely isolated and the movement, not only of live stock but of persons, absolutely prohibited, the disease could not be stamped out. Such a quarantine is, of course, utterly impossible to enforce. In portions of Germany the farmers, realizing that the disease is inevitable, make haste to be done with it by exposing their stock deliberately to mild cases in the hope that this will result in an immediate, mild attack and immunity for several years thereafter. Such immunity, however, is very uncertain.

Great Britain, Denmark, Norway, and Sweden, on account of their comparatively isolated positions, have been more successful in keeping out the disease. The outbreaks in those countries have been more sporadic, and by resorting to immediate slaughter the authorities have been able to stamp them out. Great Britain has applied both quarantine and slaughter for many years, and in an outbreak near Dublin in 1912 measures were adopted which were even more stringent than any that have been used in the United States. A British official (Cope) asserted in 1899 that after his country's experience with this disease it was "more dreaded by the farmers and stock raisers of Great Britain than cattle plague or pleuropneumonia, and they are now willing and ready to put up with any restrictions, of however drastic a character, considered necessary by the central department to stamp it out." The British authorities have succeeded in suppressing each outbreak, but reinfection often occurs from the neighboring continent. At the present time (April, 1922) Great Britain is having a siege of the disease, but is applying vigorous measures for its suppression.

In November, 1906, the disease reached Belgium from France, where it was quite prevalent, and by the end of the year every Province in Belgium was affected, and the Netherlands as well. Efforts to eradicate it from Belgium were unavailing. The Netherlands apparently succeeded in stamping it out for about six months, but it reappeared there.

The disease is also more or less prevalent in Central Europe, Spain, and in the Balkan countries.

Australia and New Zealand have remained free from it.

We have less accurate information regarding Asia and Africa, but the disease is known to prevail in Japan and China and in the Philippine Islands, and it is doubtful whether any considerable part of the Orient is free from it.

In South America it is reported as common in Brazil, Argentina, and Uruguay, and it probably exists in other countries.

Canada and Mexico are fortunately free from the disease.

_Outbreaks in the United States._--Foot-and-mouth disease has appeared in the United States on six different occasions--1870, 1880, 1884, 1902, 1908, and 1914.

An extensive outbreak in 1870 was introduced by way of Canada, where the infection was brought by an importation of cattle from Scotland. It spread into the New England States and New York and appears to have been arrested within a few months. Its failure to spread more extensively and its early disappearance have been ascribed to favorable conditions, such as the movement of live stock from west to east, the limited trading at that period as compared with the present time, the restriction of traffic by winter weather, and the infrequency of travel which obtained at that time among people.

About 1880 two or three lots of animals affected by this disease were brought to the United States, but there was no extension from the animals originally affected.

In 1884, at Portland, Me., there was a small outbreak caused by imported cattle, and the disease spread to a few herds outside the quarantine station. Owing to the small number of animals affected and the limited area of territory covered by the disease, it was easily controlled by the ordinary measures of quarantine and disinfection.

It will be observed that in all these early outbreaks the contagion was introduced with imported animals. Since the development of a stringent system of inspection and quarantine of imported live stock, no instance of that kind has occurred. On subsequent occasions the infection has evidently been brought in with contaminated products or materials and not by means of live animals.

In November, 1902, the disease was discovered in Massachusetts and Rhode Island. The earliest cases were traced to Chelsea, Mass., near the docks, and it was suspected for a time that the infection was brought in with foreign shipping, by some such means as hay, straw, halters, ropes, hides, hair, wool, etc. Later developments, however, and especially investigations into the cause of the 1908 outbreak, led to the belief that a more probable source of the infection was cowpox vaccine virus imported from a country (probably Japan) where foot-and-mouth disease existed, the vaccine virus being contaminated with the virus of foot-and-mouth disease.

A Federal quarantine was declared by the Secretary of Agriculture on November 27, 1902, as soon as the nature of the disease was established, and steps for eradication were at once taken by the Bureau of Animal Industry of the United States Department of Agriculture in cooperation with authorities of the affected States. The methods followed consisted of inspection to trace and detect the disease, quarantine of infected premises and territory, slaughter and burial or burning of diseased and exposed animals, and disinfection of premises.

This outbreak involved Massachusetts, New Hampshire, Vermont, and Rhode Island, and was eradicated in about six months. Two hundred and forty-four herds, including 4,712 cattle, were found infected. Of these, 205 herds with 3,872 cattle, as well as 360 hogs and 220 sheep and goats, were slaughtered. The cattle infected but not slaughtered were those that either died or completely recovered before slaughtering could be carried out. The animals slaughtered were valued at $184,155.10, and the Federal Government reimbursed owners to the extent of 70 per cent, or $128,908.57. It is understood that the States paid the remainder. The total cost to the Department of Agriculture of stamping out the disease was about $300,000.

The next appearance of the foot-and-mouth disease was early in November, 1908, when it was observed in cattle near Danville, Pa. A Federal quarantine was issued November 12. The infection was traced back to the stockyards at East Buffalo, N. Y., and to Detroit, Mich. The disease appeared in the States of Michigan, New York, Pennsylvania, and Maryland. A careful and thorough investigation made by Mohler of the Bureau of Animal Industry and Rosenau of the Public Health Service demonstrated that the outbreak started from calves used to propagate vaccine virus at an establishment near Detroit, and that the source of the infection was contaminated Japanese vaccine virus.

Vigorous measures of eradication similar to those employed in 1902-3 were at once put into effect and the disease was stamped out in about five months at an expense of about $300,000 to the Department of Agriculture, and of about $113,000 to the States. The inspectors made 108,683 visits to farms, stockyards, etc., and inspected more than 1,500,000 animals (including reinspections). One hundred and fifty-seven premises were found infected, and 3,636 animals (2,025 cattle, 1,329 hogs, and 282 sheep and goats), valued at $90,033.18, were slaughtered. Owners were reimbursed for the value of their animals and property destroyed, one-third being paid by the States and two-thirds by the Federal Government.

The latest invasion was discovered in the vicinity of Niles, Mich., in October, 1914, after it had evidently been under way since August of the same year. This is the most serious and extensive outbreak ever known in this country. The disease extended to 22 States and the District of Columbia, at places ranging from the Atlantic to the Pacific coasts. The work of eradication was not completed for more than a year. The affected States were Connecticut, Delaware, Illinois, Indiana, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Montana, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island, Virginia, Washington, West Virginia, and Wisconsin. Illinois had the largest infected area and the largest number of animals affected. The Union Stock Yards at Chicago became infected and were a source of dissemination of the contagion north, east, south, and west. These and other yards found infected were closed temporarily and disinfected.

The first Federal quarantine was issued October 19, 1914. A campaign to check the spread of the disease and to stamp it out was immediately begun by the United States Department of Agriculture in cooperation with the State authorities. Quarantines against the movement of animals and certain materials from the infected areas were declared, shipments were traced, rumors investigated, and thorough inspections made in an effort to discover all infected stock. As measures of eradication, diseased herds were slaughtered and buried and the premises disinfected. The owners of live stock and other property destroyed on account of the disease were reimbursed to the extent of the appraised value, half of which is paid by the Federal Government and half by the State. There were slaughtered 172,720 animals (76,575 cattle, 86,492 swine, 9,511 sheep, 133 goats, and 9 deer), in 3,482 herds. The total appraised value of these animals was more than $5,800,000. The expense to the Federal Government of eradicating this outbreak was about $4,540,000.

_Symptoms._--In three to six days, or even longer, after the exposure of the animal to the infection the disease makes its appearance. It is usually first indicated by the animal suffering from a chill, quickly followed by an invasion of fever, which may cause the temperature to rise as high as 106∞ F. These symptoms are not always present, or may be in so slight a form as to escape notice. Following this in one or two days it will be noticed that small vesicles or blisters about the size of hempseeds or peas are making their appearance upon the mucous membranes of the mouth at the border and upper surface of the tongue near the tip, the inside of the cheeks, on the gums and the inner surface of the lips, or on the margin of the dental pad. These little blisters contain a yellowish, watery fluid and gradually become more extensive as the disease advances. Soon after the eruptions have appeared in the mouth of the animal considerable swelling, redness, and tenderness will be noticed about the feet, at the coronet, and between the digits of each foot. A day or two later eruptions similar to those within the mouth make their appearance upon these swollen regions of the foot, and at this stage it is usual to find that like lesions have made their appearance upon the perineum of the victim. In the case of milk cows the udder, and more particularly the teats, show the same vesicular eruption, but the latter as the result of milking soon become covered with reddened spots deprived of the superficial layer of skin and may develop deep, obstinate fissures.

As soon as the disease has become well established the patient evinces pain when attempting to eat; in fact, the appetite is often so seriously affected that all feed is refused, and the animal uneasily opens and shuts its mouth with a characteristic smacking sound, while strings of cohesive, ropy saliva hang suspended from the lips. With the advance of the disease the vesicles widen and extend until they may reach a diameter ranging from that of a dime to that of a silver dollar. These rupture soon after their appearance, sometimes on the first day, more rarely on the second or third day. After they have ruptured, the grayish-white membrane forming the blister may remain attached for a day or more, or disappear speedily and leave deeply reddened, sensitive spots or erosions, both within the mouth and upon the coronet and between the claws of the feet. Similar erosions, which quickly form scabs, as a rule, may be noticed in cases in which the teats of milk cows have become affected, and instances are reported in which sloughing of the tegument immediately around the lesions upon the udder has occurred. Owing to the tough, fibrous nature of the bovine skin, it is exceedingly rare for sloughing to occur upon any part of the body other than those mentioned.

The attack upon the feet of an animal is frequently manifested in all four feet at once, but one or more of the feet may entirely escape and remain unaffected throughout the course of the disease. The ulceration of the interdigital tissue may extend to the ligaments of the fetlock or produce disease of the joint or bone. As the feet become sensitive and sore the animal persistently lies down, and it has been found that bedsores develop with amazing rapidity in all such cases and wholly baffle all attempts at treatment until after the patient has regained its feet.

The disease may attack some of the internal organs before it appears upon any of the external tissues. These cases are very liable to prove quickly fatal. The animal dies from paralysis of the heart, due to the formation of poisonous principles within the system; it may suffocate by reason of the action of these same poisons upon the tissues of the lungs, or it may choke to death as a result of paralysis of the throat.