FAO calls for action amid foot-and-mouth disease outbreaks

FMD is a highly contagious viral disease affecting cloven-hoofed animals, including cattle, pigs, sheep, goats, and various wild species. 

Europe is currently facing its worst outbreak so far this century at the same time as an exotic viral strain has been introduced in Iraq and other countries in the Near East.

Concern for potential spread

FAO is recommending urgent biosecurity measures and enhanced surveillance following the recent detection of foot-and-mouth disease (FMD) serotype SAT1 in Iraq and Bahrain,” the agency said in an alert.

“This serotype is exotic to the Near East and West Eurasia regions,” the agency continued – meaning the strain is not normally found there – which raises “serious concerns” about its potential spread.

FMD is typically characterized by fever and blisters in the mouth and on the feet of affected livestock, accompanied by lameness. Although few adult animals succumb to disease, young ones may die from sudden heart failure. 

The virus spreads rapidly and can affect large numbers of animals, especially in countries or regions that are usually free of the disease or do not regularly use vaccination.

Although FMD is not a public health threat, it severely impacts animal health and welfare, food security and incomes by reducing agricultural productivity, including through decreased milk and meat yields.

The economic impact is also substantial, with global direct production losses and vaccination costs in endemic regions estimated to be $21 billion annually. FAO noted that the true economic burden is likely much higher when disruptions to both international and local trade are taken into consideration. 

A major outbreak in the United Kingdom in 2001 led to the culling of more than six million animals and cost the economy billions, devastating the livestock industry and tourism. A series of new measures in response have reportedly reduced the risk and improved resilience, including local and national contingency plans for outbreaks.

Outbreaks and response

The FMD virus was recently detected in parts of Europe normally free of the disease and the continent is now experiencing its worst outbreak since 2001.  

Germany detected an outbreak this past January but has since been declared FMD-free, however subsequent outbreaks in Hungary and Slovakia have persisted.

In response, the UK recently announced that it has banned imports of meat or dairy products from European countries where the virus has been detected, as well as Austria due to the outbreak in neighbouring Hungary. 

FMD is endemic in the Near East, but the recent upsurge is due to an exotic serotype likely introduced from East Africa.  Cases have been reported in Bahrain, Iraq and Kuwait, although other countries are at high risk.

Many strains of the FMD virus continue to circulate in different parts of the world, and the recent outbreaks in both Europe and the Near East highlight the ongoing risk the disease poses to livelihoods, food security and safe trade, said FAO.

Raising awareness

While all governments are urged to be vigilant, the agency said affected and high-risk countries should consider awareness-raising measures among farmers and communities to protect livestock. 

Other recommendations include biosecurity measures such as separating sick animals from other livestock and having them examined by professionals, alongside checking vaccination records and verifying FMD contingency plans.

FAO said that by implementing these measures, countries can significantly reduce risks. 

 

Destitution and disease stalk Myanmar’s quake survivors

The UN World Health Organization (WHO) is just one of the UN agencies working to help the most vulnerable in worst-hit central areas, but much more help is needed.

“When it rains, they can’t sleep, and when the rain stops, they still can’t sleep because they feared the wind might have their only shelter away,” said Dr Thushara Fernando, WHO representative in Myanmar.

In an update from Yangon, the WHO medic warned that the risk of waterborne disease “is becoming a reality” for all those still living under plastic sheeting with stagnant water all around.

A cholera outbreak was already reported in Mandalay just a few months ago.

Survivors “feed their babies, they eat, they drink in their tents; they don’t have even a simple mosquito net to sleep under in the night,” Dr Fernando continued.

“Water sources are contaminated, temporary toilet facilities are overwhelmed, and acute watery diarrhoea has been reported in two areas,” he continued.

Two major earthquakes hit central Myanmar on 28 March killing at least 3,700 people. About 5,100 more were injured and 114 are still missing, according to WHO. The true toll is likely much higher because of underreporting.

Aftershocks continue

Survivors and aid teams have experienced more than 140 aftershocks – some as high as magnitude 5.9 – which have added to widespread trauma and impeded humanitarian assistance.

To help, the UN health agency has delivered around 170 tonnes of emergency medical supplies to help 450,000 people for three months.

WHO is also coordinating more than 220 emergency medical teams in earthquake affected areas and it has launched a targeted dengue prevention initiative in coordination with national and local partners.

This includes the distribution of about 4,500 rapid diagnostic test kits for frontline responders and hundreds of insecticide-treated nets to protect people in the hardest-hit areas, such as Mandalay.

The March 2025 earthquake caused widespread destruction Mandalay.

Critical moment

The WHO medic said that the agency continues to help deliver a range of services, albeit at a “very limited” scale. This includes trauma care, mental health and psychosocial support, along with maternal and child health services and non-communicable disease prevention.

Without urgent, sustained funding, the risks of secondary health crises will erupt,” said Dr Fernando.

Echoing those concerns, the UN Children’s Fund (UNICEF) noted that early signs of acute watery diarrhoea “are already emerging” in worst-hit areas.

Access to food and essential services have been disrupted, causing worsening nutrition conditions, “especially for young children”, the UN agency’s Eliana Drakopoulos told UN News.

“With low immunization coverage and the monsoon approaching, the risk of preventable disease outbreaks is rising fast,” Ms. Drakopoulos added. “Urgent action is needed.”

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‘Increased risk’ donor organs a tough sell to transplant patients

Increasingly, transplant surgeons must initiate a tough conversation: explaining to patients what it means to accept an organ from a person who died from a drug overdose.

Organ donors who recently injected drugs, as well those who were incarcerated or had sex for drugs or money, are among a growing group of people classified as being at “increased risk” of an infectious disease such as hepatitis C or HIV.

But the label may not be doing patients any favors, according to a study about transplant trends and organ discard.

National organ transplant numbers show the United States Public Health Service’s increased risk of infection label (PHS-IR) is associated with hundreds of available organs going unused each year.

Despite the very low risk of disease transmission, patients in need are saying no to these organs, which account for 1 in every 5 deceased donor organs today.

Better guidance is needed for surgeons and patients on how much risk an increased-risk label actually presents to patients, says study author Daniel Kaul, M.D., director of the Transplant Infectious Disease Service at Michigan Medicine.

For a study published in Transplantation, Kaul led an analysis of Organ Procurement and Transplantation Network (OPTN) data showing organs labeled as increased risk are 7 percent less likely to be used than organs without the label.

“Overall utilization was less despite the extraordinarily low risk of disease transmission,” says Kaul, a professor of internal medicine at the University of Michigan. “The organ may have gone to the next person on the transplant waiting list, but it might not have been used at all.”

Also troubling, utilization rates of PHS-IR organs varied dramatically by geography. Depending on the donation service area, transplantation of available adult kidneys from increased-risk donors ranged from 20 to 100 percent, the analysis found.

“What that tells us is there may be a different understanding of true risk associated with this label — from one center to another and even within a center, from one organ specialty to another,” Kaul says.

If the increased-risk label did not exist, an estimated 313 more transplants could be performed in the United States each year, according to the study.

All organs identified as increased risk were less likely to be used with the exception of livers, for which transplant rates were nearly identical.

A possible explanation? Patients with liver failure may be too sick to say no. By comparison, a patient needing a kidney may continue dialysis and wait for another organ offer.

Favorable Odds

For most patients with end-stage organ failure, the immediate risk of dying is greater than the risk of getting an organ with an infection.

After rigorous screening, the risk of HIV or hepatitis C transmission from organ donation is low, at less than 1 percent — much less, for example, than the lifetime chances of dying in a motor vehicle accident.

Co-authored by Michael Volk, M.D., a former U-M physician now practicing in Loma Linda, California, and others, the study was published in a special issue of Transplantation that looked at reducing organ discard while safely maximizing organ availability.

Researchers analyzed criteria of donors from 2010 to 2013. The rate of nonutilization of increased-risk organs, the authors write, is likely now even higher because of a 2015 change to the PHS-IR criteria. Combined with the opioid epidemic, the change resulted in an increase in the proportion of organs with this label from 12 percent to 20 percent.

With little guidance about magnitude of risk, the stigma surrounding drug addiction can lead someone to turn down an organ that could save his or her life.

As of early October, about 116,500 Americans are waiting for an organ transplant.