, 2025-05-09 11:16:00
Germany, Hungary, and Slovakia reported cases of foot-and-mouth disease (FMD) in livestock in early 2025, prompting Medscape Medical News to ask if healthcare practitioners need to be alert to the human consequences of the disease.
In addition to the potentially devastating economic impacts of control measures on farmers and those living and working in rural areas, there can also be mental health consequences for the wider community. Patients may need reassurance about their personal risk for disease, the safety of food supplies, and potential contamination of crops and water from disinfection measures and enforced culling disposals.
For example, villagers living near mass graves of culled cattle in Hungary have expressed concerns about their water supply, as well as the smell as the bodies decompose.
Physicians may need to offer psychologic support and promote community initiatives to mitigate the socioeconomic impacts of an outbreak.
What Practical Advice Can Clinicians Offer?
Patients who work in rural or agricultural settings or animal processing facilities should avoid direct contact with potentially susceptible animals unless necessary, said Sonja Hartnack, who has an MD in veterinary medicine and is a scientific collaborator with the Veterinary Epidemiology Group at the University of Zurich, Zurich, Switzerland. She told Medscape Medical News that it’s vital that occupational groups are made aware of biosafety measures. They should be advised to disinfect, shower, and change clothes and footwear before leaving the site. Decontamination measures are also needed for potentially contaminated vehicles and equipment.
What Are the Risks?
Although FMD does not directly infect people, it is devastating to cloven-hoofed animals, including cattle, pigs, sheep, and goats. Morbidity, including blisters, fever, anorexia, lameness, and reduced milk yield, can reach 100%. Mortality is usually less than 5% in adult animals but may reach 20% or more in young animals.
As FMD is highly transmissible and infected animals secrete virus particles before clinical signs appear, precautions to prevent spread may be draconian, including culling of healthy animals, protection zones, animal movement restrictions, closures of zoos and wildlife parks, and trade bans.
The Human Role in Spreading the Disease
Moving infected animals may bring them into contact with virus-naive animals or contaminate land and roads, and people may transmit the virus via contaminated food, clothing, shoes, tools, and vehicles. There is no risk to the human food chain, but inadvertent animal consumption of infected meat could lead to an outbreak.
A 2019 review published in Frontiers in Veterinary Science showed transmission risks associated with hunting, shooting, stalking, and equestrian activities, especially those involving large groups of people, vehicles, dogs, horses, or susceptible wildlife.
Potential fomites also include boats, bicycles, riding gear, fishing tackle, and guns. The virus can also be carried on wind, with airborne transmission possible up to 60 km.
Which Countries Are Affected?
FMD first appeared in Asian buffalo in Germany in January. Hungary reported affected livestock in March, and by April, neighboring Slovakia was facing a significant outbreak. Last month, Austria closed dozens of border crossings and imposed disinfection for cars and pedestrians at others in an attempt to stop the spread. The Czech Republic, although so far unaffected, introduced disinfection measures at border crossings used by freight trucks.
Thousands of animals have been culled in central Europe, and the authorities face twin challenges from the disposal of tons of potentially infectious carcasses and locals anxious about disease spread and contamination. There have been public protests about the enforced slaughter of healthy animals and pleas for quarantine and testing rather than the culling of healthy animals.
Knock-on Effects
Control measures have devastating economic impacts, including direct financial losses due to herd culls and shortfalls in livestock sales and meat and dairy production, which may cause shortages or price gouging. The costs can ripple through the economy; trade and export bans lead to loss of access to foreign markets, and restrictions on movement in rural areas may have dire consequences for tourism.
The potential fallout was highlighted last month when the United Kingdom followed Germany, Hungary, Slovakia, and Austria in prohibiting food imports, banning travelers from bringing cheese and meat products back from the European Union.
Mental Health Consequences
A study of people affected by the 2001 UK FMD outbreak, in which authorities mandated culling millions of animals, found “profound psychosocial effects,” describing it as “a human tragedy, not just an animal one.”
Respondents reported tensions and conflict within communities; deteriorating health; and feelings of distress, bereavement, fear, social isolation, and loss of trust in authority, as well as sleep disruption, flashbacks, nightmares, and loss of concentration more than a year later. Pyres of culled animals caused headaches, nausea, and respiratory problems.
Researchers said that the event affected many rural health practitioners’ work for years, with distress experienced “well beyond the farming community.” They noted that those affected need “careful and appropriate support to rebuild lives and regain confidence.”
Hartnack said that healthcare practitioners could do much to foster resilience in the current outbreak. “Communication and empathy with farmers and [understanding] their activities is key,” she said.
