Published Date: 2016-11-01 08:26:16
Subject: PRO/AH/EDR> Foot & mouth disease - Russia (07): (VL) bovine, st Asia1, milk, public hlth RFI
Archive Number: 20161101.4598212
FOOT AND MOUTH DISEASE - RUSSIA (07): (VLADIMIR) BOVINE, SEROTYPE ASIA 1, MILK, PUBLIC HEALTH, REQUEST FOR INFORMATION
A ProMED-mail post http://www.promedmail.org
ProMED-mail is a program of the International Society for Infectious Diseases http://www.isid.org
Date: Fri 28 Oct 2016
Source: Komsomolskaya Pravda (Rostov on Don) [in Russian, machine trans. edited]
Users of the social networks in Rostov are in a real panic facing the circulated warning about FMD [foot and mouth disease] virus found in milk products on the shelves:
"Do not buy, and if you already have, throw it away."
Since the evening of 27 Oct 2016, the following internet alarm message, addressing milk, has been circulating among Rostov's residents:
"All dairy products [listed with pictures of their logos presented] produced since 11 Oct 2016 have been promptly withdrawn from the market. Do not buy, and if you have, throw them away. According to Rospotrebnadzor."
Foot and mouth disease is a viral infection manifested in animals by high fever and lesions of the mucous membranes. Human infection may occur when contaminated food, such as milk, is consumed. As a rule, the adult immune system is able to cope with the disease, but children are at risk. Within 4 days, they may develop high fever, diarrhea, muscle pain and blisters on the cheeks and tongue [see comment].
The hysteria over the "milk" has been growing, despite published announcements that there is no cause for concern.
Rospotrebnadzor [the Russian Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing] did not hide the situation, but explained: "There is no danger to the consumer because all the relevant goods have already been withdrawn. This involved dairy products distributed by the holding company "Opole," which is the distributor of the manufacturer, Wimm-Bill-Dann [WBD; owned by PepsiCo]."
The withdrawal affected products that were manufactured from milk originating from an FMD-infected dairy farm. Its application started on 21 Oct 2016. It involved dairy products produced between 1 and 19 Oct 2016, which have not undergone re-pasteurization or sterilization. The manufacturers showed good faith by carrying out the withdrawal by themselves.
The company held a consultation with Rospotrebnadzor experts to evaluate the possible risk of the use of different types of its products. Disinfection was carried out also in production lines.
According to the department, ["Opole"] products that have undergone re-pasteurization are safe, as well as their products manufactured after 20 Oct 2016; their marketing is not limited.
[Byline: Olga Gopal]
[Reader comments included on the above web-site:
From: Natalia, Rostov-on-Don, 30 Oct 2016:
"I bought yogurt -- "Kuban Burenka" -- produced on 19 Oct 2016. I discovered your report after the children consumed this product. Are there risks?"
Though the milk recall affected mainly, if not only, Moscow, its impact was felt throughout the Russian Federation. The distance between Moscow and Rostov-on-Don is 958 km (596 miles). - Mod.AS]
Date: Sun 30 Oct 2016
Source: The Russian Times [in Russian, machine trans. summarized, edited]
Foot and mouth disease [FMD] in milk has become a serious event in the capital of our country. Dairy products of the yogurt and milk company "House In the Village" have been seized from the counters of Moscow food shops following the discovery of the FMD virus. It turned out that the FMD-contaminated products were brought to the capital's stores from 1 to 19 Oct 2016.
FMD virus is found in cloven-hoofed animals. The disease can be caused by several types of viruses, namely SAT (1,2,3), O, A and Asia-1. The virus can remain active in the hair of animals for up to 28 days; on human clothing, it can remain viable up to 24 days. The virus is easily inactivated by heating milk and dairy products to 60 C [140 F] and irradiating contaminated animal wool with ultraviolet light. In barns, disinfectants are applied.
FMD virus can go from animals to humans. Such cases occur occasionally in the countryside. People at risk are those engaged with animals in barns and other similar places. In addition, the virus can be transmitted to humans consuming contaminated animal products.
Following infection and an incubation period of 3 to 4 days, fever of up to 40 C [104 F] may appear, accompanied by loss of appetite, headache and muscle pains. The fever may last 3 to 6 days. 1st, visible lesions appear in the mouth and nasal cavity, manifested by small vesicles of up to 3 millimeters. A rash may begin on the face, the hands, between the fingers, feet and legs. Total recovery takes 2 to 14 days. FMD is rarely fatal in humans [see comments].
[In serious cases], hospitalisation of up to 2 weeks is required. Ointments (e.g. including interferon) should be applied to the nose and mouth and other affected areas. Supplementary physiotherapy by laser and UV irradiation is recommended.
[The alarming descriptions of FMD in humans, published by the (local and national) Russian media since the start of the FMDV-Asia 1 event in Vladimir, combined with the producer's recall of nearly 4000 tons of dairy products suspected as FMD-contaminated, have seriously bothered consumers throughout the Russian Federation, as is apparent from the 2 reports above, and there are numerous others. The concern may have come close to panic in view of the fact that milk makes up a significant part of the juvenile diet and in view of the alarming descriptions of human FMD cases.
The said descriptions are not limited to the popular media, bloggers and social networks; similar descriptions appear in official web-sites, of which we present the following one, translated/summarised from the epizootic section of the web-site (in Russian) of the State Veterinary Service of the Trans-Baikal Territory (Chita region; 2016; thanks to Dr Boris Gelman for helping in response to our request) http://xn--80abcmf3a5bhl.xn--80aaaac8algcbgbck3fl0q.xn--p1ai/epizootiya/...
"FMD can affect people. Human infection is related mainly to contact with diseased animals and to the consumption of contaminated, raw dairy products. The FMD pathogen can be inactivated by pasteurization or boiling of the milk.
"Statistically, 65 percent of human infections are caused by the consumption of raw milk, 34 percent by contact with sick animals, either directly or with their litter, feed, water, manure, clothing of farm workers etc.; and about one percent of human infections are related to the consumption of other dairy products such as yogurt, kefir, butter and whey made from raw milk.
"Cattle, goat and camel milk is contagious even before the appearance of external, vesicular signs of FMD in the animal and remains so for another 12 days. The virus may remain viable for lengthy periods on human mucous membranes (nose, mouth), under nails and between the toes.
"FMD in a human initially infects the oral mucosa, and (or) the upper respiratory tract. The vesicles appear at the expiration of the incubation period (which takes 3 to 8 days), whereby the virus enters the bloodstream [viraemic phase]. At this stage, a secondary rash appears on the mucous membranes of the lips, nose, throat, mouth and cheeks. In rare cases, septicaemia may occur, characterized by high temperature (up to 40 C [104 F]) and the appearance of vesicles on the skin (between the fingers and around the nails). FMD virus gets into the internal organs and is excreted in feces, urine and saliva. In severe FMD cases in humans, the disease presents with high fever, fatigue, chills, low blood pressure, headache, and tachycardia. All this happens within the 1st 2 days of the disease, followed by more clear signs involving painful nasal, buccal and lingual mucosal lesions, including a burning sensation in the mouth, and lumbar muscular pains. Also, there is increased salivation, swollen mucous membranes, and blushed cheeks."
The article includes also a chapter on detailed symptomatic treatment, recommended dietetic instructions, even tube feeding when required. Interested subscribers may refer to the Russian text in the above URL and apply machine translation).
According to the view of most FMD experts internationally, clinical FMD infection in humans is considered, in striking difference from the above Russian sources, to be extremely rare and of mild clinical nature. The following text from a respected source, entitled "Public health," included in an FMD factsheet that was last revised in March 2015, adequately presents the widely prevailing view:
"Foot-and-mouth disease is not considered to be a public health problem, as infections seem to be very rare and their consequences mild. In the past, many people who worked with FMDV in vaccine laboratories or other locations developed antibodies to this virus, but there were few clinical cases. One laboratory reported only 2 cases in more than 50 years, and a large FMD vaccine manufacturer documented 3 cases among its workers. It may be that exposure to extremely large amounts of virus or a predisposing condition is necessary for infection. Between 1921 and 1969, reports of more than 40 laboratory-confirmed cases of FMD in humans were published. The symptoms included vesicular lesions and influenza-like symptoms, and the disease was generally mild, short-lived and self-limiting. Broken skin was a recognized route of entry for some human cases, with the initial lesions developing at the inoculation site. There is also a report that 3 veterinarians deliberately infected themselves in 1934, by drinking virus-contaminated, unpasteurized milk for 3 days. Person-to-person transmission has never been reported; however, vesicles from affected people do contain virus. [Note: Foot-and-mouth disease is not related to hand, foot and mouth disease, a condition seen only in humans]." See at http://www.cfsph.iastate.edu/Factsheets/pdfs/foot_and_mouth_disease.pdf (last revised March 2015; cited earlier in the commentaries of postings 20150301.3199433 and 20161026.4587331).
The description of FMD in humans, as published in the Russian media during the current event, resembles "Hand, foot and mouth disease," a non-zoonotic infectious human disease, with Coxsackievirus A16 as the most common cause and Enterovirus 71 as the 2nd-most common cause. HFMD affects mainly children (note the reference to children in item 1 above).
Having said that, Russian professionals may have encountered, throughout the years, cases which led them to regard FMD as a zoonotic disease with a potential to cause human disease of more serious nature than is generally known elsewhere. ProMED-mail will appreciate receiving references to such observations, particularly from Russian speaking countries, in case available.
Some additional background on HFMD is available at http://www.cdc.gov/hand-foot-mouth/index.html. It includes the following comment:
"Hand, foot, and mouth disease is often confused with foot-and-mouth disease (also called hoof-and-mouth disease), which affects cattle, sheep, and swine. However, the 2 diseases are caused by different viruses and are not related. Humans do not get the animal disease, and animals do not get the human disease. For more information, see the U.S. Department of Agriculture National Agricultural Library, Foot-and-Mouth Disease (at https://www.nal.usda.gov/awic/foot-and-mouth-disease). - Mod.AS
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/18153.