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FOOT-AND-MOUTH DISEASE
351
THE LANCET LONDON :SATURDAY, MAROH 15, 1941
FOOT-AND-MOUTH DISEASE MOST medical men will have felt some sympathy with the views of those who have lately been urging the abolition of the Government’s slaughter policy in the control of foot-and-mouth disease. The Duke of WESTMINSTER1 has described how he has overcome - outbreaks in his pedigree dairy cattle, and he has had the support of such authorities as Lord BLEDISLOE. On the face of it the slaughter of all infected cattle seems a desperate measure for a disease with a low fatality, especially now when we need all the meat and milk we can get. The opponents of slaughter argue that the disease could be as effectively and more economically controlled by a combination of isolation and inoculation, and also that research can make little progress while all infected animals are immediately killed. Like influenza in man, foot-and-mouth disease comes in waves and favours the winter months. It attacks cattle, sheep and pigs, in that order of importance, but may also be carried by other animals, such
hedgehogs,
and possibly birds, in contaminated food, and perhaps by human beings, in dust. It is one of the most contagious diseases known. As the name implies the lesions are mainly found in the mouth and feet ; they consist of vesicles on the tongue, buccal mucous membrane and gums, which produce an exaggerated flow of highly infectious saliva, and similar blistering just above the hoof or behind the claws leading to lameness. In dairy cattle the udder may be involved, and hence human cases have arisen in milkers and milk-drinkers. Recovery within two or three weeks is the rule-the fatality in adult animals is not more than but complications such as mastitis, local necrosis round the lesions and even shedding of the hoof are not uncommon and may greatly prolong the illness or even make it necessary to destroy the animal. Occasionally the disease takes the form of an acute gastro-enteritis, and in young animals a septicaemic form, without local lesions, is highly fatal. The cause is a virus, of which three main immunologically distinct types are known. From the farmer’s point of view it is not so much the killing powers of the disease which are to be feared as the loss of flesh from wasting and of milk from reduced lactation. In most continental countries foot-andmouth disease has long been endemic and it appeared in this country a hundred years ago. Until measures for preventing the import of infected animals and for dealing with outbreaks here were taken, towards the end of the last century, there were repeated epizootics in Great Britain, of which that of 1883-84 affected half a million animals. Since then the incidence here has been small compared with that abroad ; thus in 1937 and 1938 there were 37,000 and 667,000 outbreaks in Germany, compared with 187 and 190 here. In this country attempts at curing the disease are not allowed ; when an outbreak is reported and confirmed all affected animals are destroyed and restricas
rabbits, rats, foxes,
1.
Sunday Times, Feb. 23, 1941.
tions are placed on the movements of all farm animals within a 15.mile radius. Before the war the carcasses of both cases and contacts were destroyed, but now although contacts must still be slaughtered their meat is saved for food. Compensation is paid by the Government for all animals slaughtered, but in the last fifteen years the cost of this has not averaged more than :E 100,000 a year. Compared with this figure the estimated losses abroad are gigantic : for instance, the Germans put theirs as 83,000,000 for 1937-38. Where the disease is endemic a slaughter policy is impracticable, but it seems that most European countries would adopt one if they could. The alternative is strict isolation of infected herds with the use of vaccines. Isolation in such a disease is extremely difficult-if dust and birds can really act as carriers, almost impossible ; and if slaughter was abandoned there would be great danger of dissemination. Ever since the Foot-and-Mouth Disease Research Committee was set up in 1924 intensive studies have been made of methods of immunisation, and much knowledge has been and is still being accumulated at the research station at Pirbright. The Germans, too, have been similarly engaged, and two years ago WALDEMANN and KoB]2reported a high degree of immunity in cattle injected with an attenuated virus. They claimed that there were only 3-3% of failures after the composition of the vaccine had been satisfactorily stabilised, but 1 animal in 108 developed the disease as the direct result of vaccination. In a country where foot-and-mouth disease is endemic even a partially successful vaccine would be valuable, but here its advantages must be offset by the added risks of introducing into the general animal population immunes which might act as carriers and imperil our vast export trade in pedigree livestock. The suggestion that adherence to a slaughter policy has led to neglect of research and experiment has been denied by Mr. R. S. HUDSON,3 and he makes it clear that it will need stronger arguments than those so far advanced to move the Government from their present
policy. ANDROGENS IN GYNÆCOLOGY TESTOSTERONE propionate has given satisfactory results in a number of gynaecological complaints, notably functional haemorrhage and painful chronic mastitis, and may prove useful in dysmenorrhoea and postpartum engorgement of the breasts. J. W. H UFFMAN4 of Chicago has made a critical experimental and clinical survey of the possibilities of androgenic therapy and largely agrees with previous workers. He treated 22 cases of functional uterine haemorrhage with 250-450 mg. of testosterone, given in doses of 25 mg. every other day. Some of these patients had been very stubborn bleeders, notably one who at the age of 24 had been curetted six times. He found the following sequence of events to be usual: for the first 10-14 days of treatment bleeding would continue as before ; after that the flow would gradually lessen and stop by the 18th day. When the flow ceased he gave three additional injections. The interval of amenorrhoea thus provoked varied in his cases according to the size of the dose used ; with doses up to 450 mg. the longest interval noted was 103 days. 2. See Lancet, 1938, 1, 1404. 3. Sunday Times, March 9, 4. Amer. J. Obstet. Gynec. 1940, 40, 675.
1941.
THE LANCET LONDON :SATURDAY, MAROH 15, 1941
FOOT-AND-MOUTH DISEASE MOST medical men will have felt some sympathy with the views of those who have lately been urging the abolition of the Government’s slaughter policy in the control of foot-and-mouth disease. The Duke of WESTMINSTER1 has described how he has overcome - outbreaks in his pedigree dairy cattle, and he has had the support of such authorities as Lord BLEDISLOE. On the face of it the slaughter of all infected cattle seems a desperate measure for a disease with a low fatality, especially now when we need all the meat and milk we can get. The opponents of slaughter argue that the disease could be as effectively and more economically controlled by a combination of isolation and inoculation, and also that research can make little progress while all infected animals are immediately killed. Like influenza in man, foot-and-mouth disease comes in waves and favours the winter months. It attacks cattle, sheep and pigs, in that order of importance, but may also be carried by other animals, such
hedgehogs,
and possibly birds, in contaminated food, and perhaps by human beings, in dust. It is one of the most contagious diseases known. As the name implies the lesions are mainly found in the mouth and feet ; they consist of vesicles on the tongue, buccal mucous membrane and gums, which produce an exaggerated flow of highly infectious saliva, and similar blistering just above the hoof or behind the claws leading to lameness. In dairy cattle the udder may be involved, and hence human cases have arisen in milkers and milk-drinkers. Recovery within two or three weeks is the rule-the fatality in adult animals is not more than but complications such as mastitis, local necrosis round the lesions and even shedding of the hoof are not uncommon and may greatly prolong the illness or even make it necessary to destroy the animal. Occasionally the disease takes the form of an acute gastro-enteritis, and in young animals a septicaemic form, without local lesions, is highly fatal. The cause is a virus, of which three main immunologically distinct types are known. From the farmer’s point of view it is not so much the killing powers of the disease which are to be feared as the loss of flesh from wasting and of milk from reduced lactation. In most continental countries foot-andmouth disease has long been endemic and it appeared in this country a hundred years ago. Until measures for preventing the import of infected animals and for dealing with outbreaks here were taken, towards the end of the last century, there were repeated epizootics in Great Britain, of which that of 1883-84 affected half a million animals. Since then the incidence here has been small compared with that abroad ; thus in 1937 and 1938 there were 37,000 and 667,000 outbreaks in Germany, compared with 187 and 190 here. In this country attempts at curing the disease are not allowed ; when an outbreak is reported and confirmed all affected animals are destroyed and restricas
rabbits, rats, foxes,
1.
Sunday Times, Feb. 23, 1941.
tions are placed on the movements of all farm animals within a 15.mile radius. Before the war the carcasses of both cases and contacts were destroyed, but now although contacts must still be slaughtered their meat is saved for food. Compensation is paid by the Government for all animals slaughtered, but in the last fifteen years the cost of this has not averaged more than :E 100,000 a year. Compared with this figure the estimated losses abroad are gigantic : for instance, the Germans put theirs as 83,000,000 for 1937-38. Where the disease is endemic a slaughter policy is impracticable, but it seems that most European countries would adopt one if they could. The alternative is strict isolation of infected herds with the use of vaccines. Isolation in such a disease is extremely difficult-if dust and birds can really act as carriers, almost impossible ; and if slaughter was abandoned there would be great danger of dissemination. Ever since the Foot-and-Mouth Disease Research Committee was set up in 1924 intensive studies have been made of methods of immunisation, and much knowledge has been and is still being accumulated at the research station at Pirbright. The Germans, too, have been similarly engaged, and two years ago WALDEMANN and KoB]2reported a high degree of immunity in cattle injected with an attenuated virus. They claimed that there were only 3-3% of failures after the composition of the vaccine had been satisfactorily stabilised, but 1 animal in 108 developed the disease as the direct result of vaccination. In a country where foot-and-mouth disease is endemic even a partially successful vaccine would be valuable, but here its advantages must be offset by the added risks of introducing into the general animal population immunes which might act as carriers and imperil our vast export trade in pedigree livestock. The suggestion that adherence to a slaughter policy has led to neglect of research and experiment has been denied by Mr. R. S. HUDSON,3 and he makes it clear that it will need stronger arguments than those so far advanced to move the Government from their present
policy. ANDROGENS IN GYNÆCOLOGY TESTOSTERONE propionate has given satisfactory results in a number of gynaecological complaints, notably functional haemorrhage and painful chronic mastitis, and may prove useful in dysmenorrhoea and postpartum engorgement of the breasts. J. W. H UFFMAN4 of Chicago has made a critical experimental and clinical survey of the possibilities of androgenic therapy and largely agrees with previous workers. He treated 22 cases of functional uterine haemorrhage with 250-450 mg. of testosterone, given in doses of 25 mg. every other day. Some of these patients had been very stubborn bleeders, notably one who at the age of 24 had been curetted six times. He found the following sequence of events to be usual: for the first 10-14 days of treatment bleeding would continue as before ; after that the flow would gradually lessen and stop by the 18th day. When the flow ceased he gave three additional injections. The interval of amenorrhoea thus provoked varied in his cases according to the size of the dose used ; with doses up to 450 mg. the longest interval noted was 103 days. 2. See Lancet, 1938, 1, 1404. 3. Sunday Times, March 9, 4. Amer. J. Obstet. Gynec. 1940, 40, 675.
1941.