North Cumbria District Control of Infection Committee: Notes for General Practitioners on the investigation of possible human cases of foot and mouth disease (27th April 2001)

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As you will be aware, there has been a great deal of national publicity surrounding a local man who has been investigated for possible human foot and mouth disease. The case is unproven and human foot and mouth disease remains extremely uncommon. There is no evidence that the virus has "jumped the species barrier" and human to human transmission has never been seen.

It is likely that patients may present with symptoms compatible with foot and mouth disease (particularly if they are worried because they have been in contact with animals) but diagnoses other than foot an mouth disease are very much more likely. These causes include:

Hand Foot and Mouth Disease (Coxsackie Virus). This is seen in children and is bu ne means uncommon. It is mild, self limiting and nothing to do with Foot and Mouth Disease, despite its similar name. For a factsheet, click here.

Herpes Simplex Infection Although ususally this virus causes coldsores, it can cause vlistering and soreness.

Orf This is a skin infection often caught by people working with sheep. It is characterised by lsions on the hands.

 

The working case definition for a human case of Foot and Mouth Disease (drawn up by colleagues at the Communicable Disease Surveillance Centre in Colindale) is:
People who have
(a) had direct physical contact with farm animals (cattle, sheep, pigs) on infected farms and
(b) have oral blistering lesions.

If a human case is suspected in North Cumbria, please inform the Consultant in Communicable Disease Control on 01228 603542. We will then liaiase with the duty doctor at Colindale about further investigation.

The following samples are likely to be required from a suspected case:

  • vesicular fluid (virology)
  • throat swab (virology)
  • serum sample (for antibodies)
  • stool sample (to exclude enterovirus)

Please do not send samples to Colindale without discussing the case with local colleagues.

I hope these notes are useful. You might also like to refer to the BMJ Editorial in March about Foot and Mouth Disease, and the recent article in the Communicable Disease Report about human aspects of the disease.

 

Dr N Calvert, 27th April 2001