Foot and Mouth Disease

Ageing of Lesions
Foot and Mouth Disease
Ageing of Lesions
Revised January 2005
 Contents

PAGE No.
PREFACE 3
INTRODUCTION 4
PLATE No. ANIMAL SITE OF LESIONS AGE OF LESIONS
(DAYS)
1 Steer Tongue 1 7
2 Steer Mouth 1+2 8
3 Steer Mouth 2 9
4 Steer Mouth 2 10
5 Steer Tongue 3 11
6 Steer Mouth 4 12
7 Steer Tongue 10 13
8 Steer Foot 2 14
9 Steer Foot 2 15
10 Steer Foot 2 16
11 Steer Foot 3 17
12 Steer Foot 5 18
13 Steer Foot 7 19
14 Steer Foot 7 20
15 Steer Foot 11 21
16 Cow Teat 1 22
17 Sheep Dental pad 1 23
18 Sheep Dental pad and gum 2 24
19 Sheep Tongue 2 25
20 Sheep Dental pad 2 26
21 Sheep Dental pad 3 27
22 Sheep Tongue 12 28

1
 Foot and Mouth Disease
Ageing of Lesions

PAGE No.
PLATE No. ANIMAL SITE OF LESIONS AGE OF LESIONS
(DAYS)
23 Sheep Foot 1 29
24 Sheep Foot 2 30
25 Sheep Foot 2 31
26 Sheep Foot 2 32
27 Sheep Foot 3 33
28 Sheep Foot 4 34
29 Sheep Foot 6 35
30 Sheep Foot 10 36
31 Goat Mouth 2 37
32 Goat Foot 1 38
33 Pig Snout 1 39
34 Pig Snout, gum, lips 1 40
35 Pig Snout, lips 2 41
36 Pig Snout, lips 3 42
37 Pig Snout, lips 4 43
38 Pig Tongue 1 44
39 Pig Tongue 3 45
40 Pig Tongue 4 46
41 Pig Tongue 8 47
42 Pig Foot 1 48
43 Pig Foot 2 49
44 Pig Foot 3 50
45 Pig Foot 6 51
46 Pig Foot 8 52
47 Pig Foot 9 53
48 Pig Foot 9 54

2
 Preface

This booklet contains a series of photographs which illustrate the

lesions of Foot and Mouth disease in livestock, from their initial
appearance until their regression and healing. It is intended to assist
veterinarians carrying out clinical inquiries to estimate the age of
the lesions.

The photographs were taken at the Institute for Animal Health at

Pirbright and the booklet was compiled in collaboration with the
Veterinary Exotic Diseases Division and the State Veterinary Service.
Particular acknowledgement is made to Dr Alex Donaldson who
compiled the booklet and to Jennifer Ryder for the photographs.

3
 Introduction

When investigating Foot and Mouth Disease (FMD), the best estimate
of the age of lesions, particularly of the oldest, is an essential part of
the case history and a pre-requisite for epidemiological investigation
of the origin of infection. Furthermore, establishment of the age of
lesions and the number and species of animals affected is the basis
for any assessment of the duration and weight of virus excretion and
prediction of further spread.

The pictures in this booklet are those that might be expected under
certain circumstances, however the clinical manifestation of particular
strains of the virus may result in less typical lesions, especially in
sheep. In these cases, lesions may be transient and rapid secondary
infection or contamination can confuse the clinical picture.

The photographs have been taken of animals infected by contact

exposure. The examples are representative of the type of lesions
which might be expected at usual sites in the different species,
between the stages of vesicle (blister) formation, rupture and healing.
The age of the lesion in days is displayed below each image. Once
the vesicles have ruptured, the rate of healing can be influenced by
many factors. Therefore it is generally only possible to give an
approximate estimate of the age of a lesion. Between days 0 and 5 it
should be possible to date them accurately within a margin of one
day, but after this period the ability to date them precisely decreases.

4
 Foot and Mouth Disease
Ageing of Lesions

The following descriptions for estimating the age of legions are based
on those of Kitching and Mackay (State Veterinary Journal, 5,
Number 3, October 1995, pages 4 – 8).

Day of
Clinical Disease Appearance of lesion

Day 1 Blanching of epithelium followed by formation of

fluid filled vesicle

Day 2 Freshly ruptured vesicles characterised by raw

epithelium, a clear edge to the lesion and no
deposition of fibrin

Day 3 Lesions start to lose their sharp demarcation and

bright red colour. Deposition of fibrin starts to
occur.

Day 4 Considerable fibrin deposition has occurred and

regrowth of epithelium is evident at the periphery
of the lesion.

Day 7 Extensive scar tissue formation and healing has

occurred. Some fibrin deposition is usually still
present.

An estimation of the age of vesicular lesions can be made using the

table above. It is important to bear in mind that ageing of lesions can
only be approximate as other factors, such as secondary infection,
can alter the rate at which the lesions heal.

In pigs most information can be obtained by studying foot lesions,

especially those involving the coronary band. If the lesion is still at the

5
 Foot and Mouth Disease
Ageing of Lesions

coronary band it is unlikely to be more than about one week old,

thereafter the break in continuity of the horn gradually grows down
the claw at a rate of approximately 1 mm per week. Consequently by
allowing a week for the lesion to grow out of the coronary band and
then a week for each millimetre from the coronary band a very rough
estimate of the age of an old lesion can be made.

6
 Plates

Plate 1
Tongue of steer with 1-day-old vesicle which ruptured when the
tongue was drawn from the mouth.

7
 Foot and Mouth Disease
Ageing of Lesions

Plate 2
Steer with 2-day-old ruptured vesicle along upper gum and several
1-day-old unruptured vesicles on the tongue.

8
 Foot and Mouth Disease
Ageing of Lesions

Plate 3
Two-day-old ruptured vesicles on the tongue, lower gum and lower
lip of a steer. Note sharp edges to ulcerated areas.

9
 Foot and Mouth Disease
Ageing of Lesions

Plate 4
A further example of 2-day-old lesions in the mouth of a steer.
Again note sharp margins of lesions and red raw appearance of
exposed dermis.

10
 Foot and Mouth Disease
Ageing of Lesions

Plate 5
Tongue of steer with 3-day-old lesions. Sero-fibrinous exudation into
the lesions has resulted in a loss of earlier red raw appearance and
also sharpness of margination. Early granulation evident.

11
 Foot and Mouth Disease
Ageing of Lesions

Plate 6
Same animal as in plate 5 with 4-day-old lesions.
Note progressive loss of lesion margination and extensive fibrin
infilling.

12
 Foot and Mouth Disease
Ageing of Lesions

Plate 7
Steer’s tongue with a 10-day-old lesion characterised by loss of
papillae, indentation at the site of the lesion and fibrous tissue
proliferation.

13
 Foot and Mouth Disease
Ageing of Lesions

Plate 8
Foot of a steer with a 2-day-old unruptured vesicle in the inter-digital
space.

14
 Foot and Mouth Disease
Ageing of Lesions

Plate 9
A different steer also with a 2-day-old inter-digital vesicle.

15
 Foot and Mouth Disease
Ageing of Lesions

Plate 10
The heel bulbs of a steer’s foot with unruptured 2-day-old vesicles.

16
 Foot and Mouth Disease
Ageing of Lesions

Plate 11
The same foot as in Plate 10, 1 day later. The epithelium overlying the
vesicle is friable and easily stripped off.

17
 Foot and Mouth Disease
Ageing of Lesions

Plate 12
A 5-day-old lesion on a steer’s foot. Signs of early granulation are
evident.

18
 Foot and Mouth Disease
Ageing of Lesions

Plate 13
A 7-day-old lesion on a steer’s foot. Healing is progressing
underneath the necrotic epithelium.

19
 Foot and Mouth Disease
Ageing of Lesions

Plate 14
Another example of a 7-day-old inter-digital foot lesion on a steer.

20
 Foot and Mouth Disease
Ageing of Lesions

Plate 15
An 11-day-old foot lesion on the heel bulb of a steer.
Note healing and under-running of horn tissue.

21
 Foot and Mouth Disease
Ageing of Lesions

Plate 16
One-day-old vesicles on the teat of a cow. Rupturing has not taken
place but several vesicles have coalesced.

22
 Foot and Mouth Disease
Ageing of Lesions

Plate 17
Sheep’s mouth with two small unruptured vesicles on the dental pad
at 1 day of age.
Note blanched, glistening appearance of lesions.

23
 Foot and Mouth Disease
Ageing of Lesions

Plate 18
Two-day-old lesion on the dental pad and upper gum of a sheep. The
margins of the lesion are sharp.

24
 Foot and Mouth Disease
Ageing of Lesions

Plate 19
Further examples of 2-day-old lesions, in this case on a sheep’s
tongue.

25
 Foot and Mouth Disease
Ageing of Lesions

Plate 20
A 2-day-old lesion on the dental pad of a sheep.

26
 Foot and Mouth Disease
Ageing of Lesions

Plate 21
The same sheep as in Plate 20, 1 day later.
Note rapid loss of edge definition of lesion.

27
 Foot and Mouth Disease
Ageing of Lesions

Plate 22
Sheep’s tongue with two 12-day-old lesions only discernible by loss of
papillae and indentation of tongue surface.

28
 Foot and Mouth Disease
Ageing of Lesions

Plate 23
Sheep’s foot with 1-day-old unruptured vesicle along the
coronary band.
Note necessity to reflect hair to view the lesion.

29
 Foot and Mouth Disease
Ageing of Lesions

Plate 24
Two-day-old lesions in the inter-digital space and along the coronary
bands of a sheep’s foot.
Note blanching and swelling.

30
 Foot and Mouth Disease
Ageing of Lesions

Plate 25
Sheep’s foot with coronary band vesicles of 2 days of age, one of
which has ruptured.

31
 Foot and Mouth Disease
Ageing of Lesions

Plate 26
Sheep’s foot with 2-day-old coronary band lesion.
Note the necessity to reflect the hair in order to view the lesion.

32
 Foot and Mouth Disease
Ageing of Lesions

Plate 27
Same foot as in Plate 26, one day later i.e. 3-day-old lesion.
Note sero-fibrinous exudate and swelling.

33
 Foot and Mouth Disease
Ageing of Lesions

Plate 28
A 4-day-old coronary band lesion on a sheep’s foot. Swelling has
decreased and signs of early healing are evident.

34
 Foot and Mouth Disease
Ageing of Lesions

Plate 29
A 6-day-old lesion on the coronary band of a sheep’s foot.
Note scab formation and rapid rate of healing.

35
 Foot and Mouth Disease
Ageing of Lesions

Plate 30
A sheep’s foot with a 10-day-old healed coronary band lesion.
Note under-running of horn tissue.

36
 Foot and Mouth Disease
Ageing of Lesions

Plate 31
Goat with 2-day-old lesions on tongue and upper and lower lips.

37
 Foot and Mouth Disease
Ageing of Lesions

Plate 32
Goat’s foot with 1-day-old unruptured coronary band vesicle.
Comment: foot-and-mouth disease vesicles in goats are generally less
pronounced than in sheep and heal and regress even more rapidly.

38
 Foot and Mouth Disease
Ageing of Lesions

Plate 33
One-day-old unruptured vesicles on the snout of a pig.

39
 Foot and Mouth Disease
Ageing of Lesions

Plate 34
One-day-old vesication of a pig’s snout, gum and lips.

40
 Foot and Mouth Disease
Ageing of Lesions

Plate 35
Same animal as shown in Plate 34, 1 day later, i.e. 2-day-old vesicles.
Note necrosis of epithelium at lesion sites.

41
 Foot and Mouth Disease
Ageing of Lesions

Plate 36
Same animal as in Plate 35 with 3-day-old lesions.
Note extensive necrosis of affected epithelium.

42
 Foot and Mouth Disease
Ageing of Lesions

Plate 37
The same animal as in Plate 36, 1 day later i.e. 4-day-old lesions.
Scab formation and healing evident.

43
 Foot and Mouth Disease
Ageing of Lesions

Plate 38
Mouth of pig showing single, 1-day-old, unruptured vesicle at edge
of tongue.

44
 Foot and Mouth Disease
Ageing of Lesions

Plate 39
Three-day-old lesions on the tongue of a pig. Sero-fibrinous in-filling
and early healing are evident in the lesions at the edge.

45
 Foot and Mouth Disease
Ageing of Lesions

Plate 40
Four-day-old lesions on the tongue of a pig. Fibrinous in-filling
is extensive.
Note similarity with bovine lesions of same age in plate 6.

46
 Foot and Mouth Disease
Ageing of Lesions

Plate 41
Tongue of pig showing 8-day-old healed lesions.

47
 Foot and Mouth Disease
Ageing of Lesions

Plate 42
One-day-old coronary band lesions on a pig’s feet.

48
 Foot and Mouth Disease
Ageing of Lesions

Plate 43
Unruptured vesicle on the supernumerary digit of a pig’s foot. Two
days of age.

49
 Foot and Mouth Disease
Ageing of Lesions

Plate 44
Pig’s feet with 3-day-old lesions along the coronary bands of main
and supernumerary digits.

50
 Foot and Mouth Disease
Ageing of Lesions

Plate 45
Six-day-old lesions on a pig’s feet.
Note sero-fibrinous in-filling.

51
 Foot and Mouth Disease
Ageing of Lesions

Plate 46
Pig’s feet with 8-day-old lesions. Under-running of horn tissue is
evident as well as extensive scab formation and healing.

52
 Foot and Mouth Disease
Ageing of Lesions

Plate 47
Pig’s feet with 9-day-old lesions.

53
 Foot and Mouth Disease
Ageing of Lesions

Plate 48
The same pig’s feet as shown in Plate 47, also at 9 days.

54
Department for Environment, Food and Rural Affairs
Nobel House
17 Smith Square
London SW1P 3JR
Telephone 020 7238 6000
Website: www.defra.gov.uk
© Crown copyright 2004
Copyright in the typographical arrangement and design rests with the Crown.
This publication (excluding the logo) may be reproduced free of charge in any format or medium
provided that it is reproduced accurately and not used in a misleading context. The material must
be acknowledged as Crown copyright with the title and source of the publication specified.
Further copies of this publication are available from:
Defra Publications
Admail 6000
London
SW1A 2XX
Tel: 08459 556000
This document is also available on the Defra website.
Published by the Department for Environment, Food and Rural Affairs. Printed in the UK, January
2005, on material containing 80% post-consumer waste and 20% Elemental Chlorine Free pulp.
Product code PB 5547R
 Foot and Mouth Disease
Contact usLesions
Ageing of

This document is also available on the Defra website.

For telephone and email enquiries for information on any aspect of
Defra’s work, the Defra helpline can be contacted on: 08459 33 55 77.
The Helpline number is a local call rate number within the UK and is
available between 09:00 and 17:00 on working days.
• From outside the UK the telephone number is:
+44 (0) 20 7238 6951.
There is also a minicom/textphone number for the deaf and hard
of hearing: 0845 300 1998.
The helpline email address is: helpline@defra.gsi.gov.uk

Plate 5
Tongue of steer with 3-day-old lesions. Sero-fibrinous exudation into
the lesions has resulted in loss of earlier red raw appearance and also
sharpness of margination. Early granulation evident.

PB 5547R
Nobel House
17 Smith Square
London SW1P 3JR
www.defra.gov.uk