Risk factors for the transmission of foot-and-mouth disease during the 2010 outbreak in Japan: a case-control study

Epidemiological study and dairy farmers' knowledge, attitudes, and practices on foot and mouth disease in central Ethiopia

Foot and mouth disease (FMD) is consistently ranked as the most economically significant viral disease and one of the top five livestock diseases in Ethiopia. Although FMD is endemic in Ethiopia, the epidemiology and the farmers' knowledge, attitudes, and practices regarding FMD were poorly quantified. Thus, a cross-sectional study was conducted from November 2021 to April 2022 to estimate the seroprevalence, identify the FMD serotypes, and assess the farmers' knowledge, attitudes, and practices on FMD in Addis Ababa city and Sebeta special zone, central Ethiopia. A total of 384 serum samples were collected from cattle and tested using a 3ABC enzyme-linked immunosorbent assay (ELISA). In this study, an overall 56% seroprevalence was recorded. Two types of FMD serotypes were detected in which serotype O was the dominant serotype (75.5%) followed by serotype A (45.5%). A significantly higher seroprevalence (P = 0.00) was recorded in Addis Ababa (85%) compared to Sebeta (28.7%). Seropositivity in older and semi-intensively managed cattle was 2.9 (95% CI: 1.36-6.50; P = 0.006) and 2.1 (95% CI: 1.34-3.26; P = 0.001) times higher compared to young and intensively managed cattle, respectively. A survey on knowledge, attitude, and practice of 103 farmers revealed that 90.2% knew of FMD and the majority of them can recognize its clinical pictures. However, 12.7% of farmers who knew FMD didn't practice any prevention methods. Additionally, 70% of the farmers responded that their cattle roamed outside of their farms for communal grazing, watering, breeding purposes, and vaccination which might put them more at risk of FMD. The current study demonstrated that the majority of farmers have gaps in biosecurity practices and vaccination of cattle against FMD. Therefore, educating farmers on FMD prevention measures is necessary for successful disease control programs.

Main factors associated with foot-and-mouth disease virus infection during the 2001 FMD epidemic in Uruguay

Large epidemics provide the opportunity to understand the epidemiology of diseases under the specific conditions of the affected population. Whilst foot-and-mouth disease (FMD) epidemics have been extensively studied in developed countries, epidemics in developing countries have been sparsely studied. Here we address this limitation by systematically studying the 2001 epidemic in Uruguay where a total of 2,057 farms were affected. The objective of this study was to identify the risk factors (RF) associated with infection and spread of the virus within the country. The epidemic was divided into four periods: (1) the high-risk period (HRP) which was the period between the FMD virus introduction and detection of the index case; (2) the local control measures period (LCM) which encompassed the first control measures implemented before mass vaccination was adopted; (3) the first mass vaccination, and (4) the second mass vaccination round. A stochastic model was developed to estimate the time of initial infection for each of the affected farms. Our analyses indicated that during the HRP around 242 farms were probably already infected. In this period, a higher probability of infection was associated with: (1) animal movements [OR: 1.57 (95% CI: 1.19-2.06)]; (2) farms that combined livestock with crop production [OR: 1.93 (95% CI: 1.43-2.60)]; (3) large and medium farms compared to small farms (this difference was dependent on regional herd density); (4) the geographical location. Keeping cattle only (vs farms that kept also sheep) was a significant RF during the subsequent epidemic period (LCM), and remained as RF, together with large farms, for the entire epidemic. We further explored the RF associated with FMDV infection in farms that raised cattle by fitting another model to a data subset. We found that dairy farms had a higher probability of FMDV infection than beef farms during the HRP [OR: 1.81 (95% CI: 1.12-2.83)], and remained as RF until the end of the first round of vaccination. The delay in the detection of the index case associated with unrestricted animal movements during the HRP may have contributed to this large epidemic. This study contributes to the knowledge of FMD epidemiology in extensive production systems.

Challenges and opportunities for using national animal datasets to support foot-and-mouth disease control

National level databases of animal numbers, locations and movements provide the essential foundations for disease preparedness, outbreak investigations and control activities. These activities are particularly important for managing and mitigating the risks of high-impact transboundary animal disease outbreaks such as foot-and-mouth disease (FMD), which can significantly affect international trade access and domestic food security. In countries where livestock production systems are heavily subsidized by the government, producers are often required to provide detailed animal movement and demographic data as a condition of business. In the remaining countries, it can be difficult to maintain these types of databases and impossible to estimate the extent of missing or inaccurate information due to the absence of gold standard datasets for comparison. Consequently, competent authorities are often required to make decisions about disease preparedness and control based on available data, which may result in suboptimal outcomes for their livestock industries. It is important to understand the limitations of poor data quality as well as the range of methods that have been developed to compensate in both disease-free and endemic situations. Using FMD as a case example, this review first discusses the different activities that competent authorities use farm-level animal population data for to support (1) preparedness activities in disease-free countries, (2) response activities during an acute outbreak in a disease-free country, and (3) eradication and control activities in an endemic country. We then discuss (4) data requirements needed to support epidemiological investigations, surveillance, and disease spread modelling both in disease-free and endemic countries.

Epidemiology of Classical Swine Fever in Japan-A Descriptive Analysis of the Outbreaks in 2018-2019

This study describes the epidemiological characteristics of classical swine fever (CSF) outbreaks in Japan. The first case was confirmed in September 2018, 26 years after the last known case. Outbreaks occurred on 39 farms, 34 commercial farms, and 5 non-commercial farms, between September 2018 and August 2019. In this study, a descriptive analysis was conducted of the epidemiological data on the characteristics of the affected farms, clinical manifestations, intra-farm transmission, association with infected wild boars, and control measures implemented on the farms. Twenty-eight of the 34 affected commercial farms were farrow-to-finish farms. It was assumed that the major risk factors were frequent human-pig interactions and the movement of pigs between farms. Fever and leukopenia were commonly observed in infected pigs. In 12 out of 18 farms where clinical manifestations among fattening pigs was the reason for notification, death was the most frequent clinical manifestation, but the proportion of dead animals did not exceed 0.5% of the total number of animals at most of the affected farms. Therefore, the clinical form of CSF in Japan was considered to be sub-acute. Twenty-three of the 29 farms (79%) with pigs at multiple stages (i.e., piglets, fattening pigs, and sows), had infection across the multiple stages. Many of these farms were within 5 km of the site where the first infected wild boars had been discovered, suggesting that infected wild boars were the source of infection. Infections still occurred at farms that had implemented measures at their farm boundaries to prevent the introduction of the virus into their farms, such as disinfection of vehicles and people, changing boots of the workers, and installation of perimeter fences. It is necessary to continue to strengthen biosecurity measures for farms located in areas with infected wild boars and to continue monitoring the distribution of infected wild boars so that any abnormalities can be reported and inspected at an early stage.

Cattle Manure Trade Network Analysis and the Relevant Spatial Pathways in an Endemic Area of Foot and Mouth Disease in Northern Thailand

Animal movement is one of the most important risk factors for outbreaks of foot and mouth disease (FMD) in cattle. Likewise, FMD can spread to cattle farms via vehicles contaminated with the FMD virus. In Northern Thailand, the movement of manure transport vehicles and the circulation of manure bags among cattle farms are considered as potential risk factors for FMD outbreaks among cattle farms. This study aimed to determine the characteristics and movement patterns of manure tradesman using social network analysis. A structured questionnaire was used to identify sequences of farms routinely visited by each tradesman. A total of 611 participants were interviewed, including 154 beef farmers, 407 dairy farmers, 36 tradesmen, and 14 final purchasers. A static weighted directed one-mode network was constructed, and the network metrics were measured. For the manure tradesman–cattle farmer network, the tradesman possessed the highest value of in- and out-degree centralities (71 and 4), betweenness centralities (114.5), and k-core values (2). These results indicated that the tradesman had a high frequency of farm visits and had a remarkable influence on other persons (nodes) in the network. The movement of vehicles ranged from within local districts, among districts, or even across provinces. Unclean manure plastic bags were circulated among cattle farms. Therefore, both vehicles and the bags may act as a disease fomite. Interestingly, no recording system was implemented for the movement of manure transport vehicles. This study suggested that the relevant authority and stakeholders should be aware of the risk of FMD spreading within this manure trading network. The findings from this study can be used as supporting data that can be used for enhancing FMD control measures, especially for FMD endemic areas.

Outbreak investigation of foot and mouth disease in Nangarhar province of war-torn Afghanistan, 2014

Afghanistan has long history of ongoing conflicts, resulting in massive destruction of the country's infrastructure. Illegal trade of livestock between Afghanistan and Pakistan boosted the spread of Foot & Mouth Disease (FMD). Current study was conducted to investigate outbreaks of FMD occurred between April-August 2014 in Nangarhar, Afghanistan. Descriptive data about suspected FMD cases were collected from the Civil Veterinary Hospital, Nangarhar to analyze spatio-temporal pattern of FMD. Case farms (n = 137) were selected from list of clinically confirmed FMD outbreaks available in the hospital. Control farms (n = 137) were enrolled from neighboring premises of case farms. The epidemic curve showed that the virus is continuously circulating among susceptible population. The mean age of the oldest lesion was 2.8 days. Foot & Mouth Disease was more likely to occur in female animals compared to male animals (p < 0.001). Farmers having no ability to clinically recognize FMD (OR 5.8, 95% CI 1.4-23.8); previously having any FMD case in herd (OR 11.8, 95% CI 3.0-45.8), farms where animals leave shed during day (OR 15.4, 95% CI 5.6-42.0), and farms, where neighboring farmers used to visit the premises (OR 3.5, 95% CI 1.2-9.9) were identified as risk factors. Current findings may be used to create awareness of concerned veterinary health authorities about FMD control.

Porcine reproductive and respiratory syndrome virus dissemination across pig production systems in the United States

Porcine reproductive and respiratory syndrome virus (PRRSV) remains widespread in the North American pig population. Despite improvements in virus characterization, it is unclear whether PRRSV infections are a product of viral circulation within production systems (local) or across production systems (external). Here, we examined the local and external dissemination dynamics of PRRSV and the processes facilitating its spread in three production systems. Overall, PRRSV genetic diversity has declined since 2018, while phylodynamic results support frequent external transmission. We found that PRRSV dissemination predominantly occurred mostly through transmission between farms of different production companies for several months, especially from November until May, a timeframe already established as PRRSV season. Although local PRRSV dissemination occurred mainly through regular pig flow (from sow to nursery and then to finisher farms), an important flux of PRRSV dissemination also occurred in the opposite direction, from finisher to sow and nursery farms, highlighting the importance of downstream farms as sources of the virus. Our results also showed that farms with pig densities of 500 to 1,000 pig/km² and farms located at a range within 0.5 km and 0.7 km from major roads were more likely to be infected by PRRSV, whereas farms at an elevation of 41 to 61 meters and surrounded by denser vegetation were less likely to be infected, indicating their role as dissemination barriers. In conclusion, our results demonstrate that external dissemination was intense, and reinforce the importance of farm proximity on PRRSV spread. Thus, consideration of farm location, geographic characteristics and animal densities across production systems may help to forecast PRRSV collateral dissemination.

Transmission network reconstruction for foot-and-mouth disease outbreaks incorporating farm-level covariates

Transmission network modelling to infer 'who infected whom' in infectious disease outbreaks is a highly active area of research. Outbreaks of foot-and-mouth disease have been a key focus of transmission network models that integrate genomic and epidemiological data. The aim of this study was to extend Lau's systematic Bayesian inference framework to incorporate additional parameters representing predominant species and numbers of animals held on a farm. Lau's Bayesian Markov chain Monte Carlo algorithm was reformulated, verified and pseudo-validated on 100 simulated outbreaks populated with demographic data Japan and Australia. The modified model was then implemented on genomic and epidemiological data from the 2010 outbreak of foot-and-mouth disease in Japan, and outputs compared to those from the SCOTTI model implemented in BEAST2. The modified model achieved improvements in overall accuracy when tested on the simulated outbreaks. When implemented on the actual outbreak data from Japan, infected farms that held predominantly pigs were estimated to have five times the transmissibility of infected cattle farms and be 49% less susceptible. The farm-level incubation period was 1 day shorter than the latent period, the timing of the seeding of the outbreak in Japan was inferred, as were key linkages between clusters and features of farms involved in widespread dissemination of this outbreak. To improve accessibility the modified model has been implemented as the R package 'BORIS' for use in future outbreaks.

Determination of Risk Factors Associated with Foot and Mouth Disease Outbreaks in Dairy Farms in Chiang Mai Province, Northern Thailand

Simple Summary

One hundred and 40 dairy farms that experienced foot and mouth disease (FMD) outbreaks and 307 farms without FMD outbreaks were investigated in this research study. Relevant farm owners were interviewed in order to determine the farm-level risk factors associated with the FMD outbreaks. We established that the risk factors for FMD outbreaks were (1) purchasing a new cow without following quarantine protocol, (2) FMD vaccination administration by non-official livestock personnel, (3) farms located within a 5 km radius of cattle abattoirs, (4) farms located near shared cattle grazing areas in a 10 km radius and (5) no history of FMD outbreaks in the previous year. Most of the risk factors were related to indirect transmissions of FMD and biosecurity practices, thus we have advised dairy farmers to strengthen management practices associated with FMD prevention protocols.

Abstract

Foot and mouth disease (FMD) is considered a highly contagious transboundary disease of cloven-hoofed animals. FMD has become endemic to northern Thailand over the past decade. In 2016, FMD outbreaks were recorded in three districts in Chiang Mai Province. The objective of this study was to determine the farm-level risk factors associated with FMD outbreaks. This study was conducted via a face-to-face interview questionnaire survey at 140 FMD outbreak farms and 307 control farms. Univariable and multivariable logistic regression analyses were used to determine the association between potential risk factors and FMD outbreaks. The final logistic regression model identified factors associated with FMD outbreaks including the purchasing of a new cow without following quarantine protocol (odds ratio = 2.41, 95%CI = 1.45, 4.05), farms located near shared cattle grazing areas in a 10 km radius (OR = 1.83, 95%CI =1.11, 3.02), FMD vaccination administration by non-official livestock personnel (OR = 2.52, 95%CI = 1.39, 4.58), farms located in a 5 km radius of cattle abattoirs (OR = 1.83, 95%CI = 0.99, 3.40) and no history of FMD outbreaks over the previous 12 months in districts where farms were located (OR = 0.44, 95%CI = 0.22, 0.86). The risk factors identified in this study were related to farm biosecurity, FMD vaccination administration and distance from the farms to risk areas. Therefore, it was important to strengthen on-farm biosecurity and to improve farm management practices in order to reduce incidences of FMD at the farm level. Education or training programs for dairy farmers that would enhance knowledge and practices in relation to the assessed topics are needed.

Review of epidemiological risk models for foot-and-mouth disease: Implications for prevention strategies with a focus on Africa

Foot-and-mouth disease (FMD) is a highly infectious transboundary disease that affects domestic and wild cloven-hoofed animal species. The aim of this review was to identify and critically assess some modelling techniques for FMD that are well supported by scientific evidence from the literature with a focus on their use in African countries where the disease remains enzootic. In particular, this study attempted to provide a synopsis of the relative strengths and weaknesses of these models and their relevance to FMD prevention policies. A literature search was conducted to identify quantitative and qualitative risk assessments for FMD, including studies that describe FMD risk factor modelling and spatiotemporal analysis. A description of retrieved papers and a critical assessment of the modelling methods, main findings and their limitations were performed. Different types of models have been used depending on the purpose of the study and the nature of available data. The most frequently identified factors associated with the risk of FMD occurrence were the movement (especially uncontrolled animal movement) and the mixing of animals around water and grazing points. Based on the qualitative and quantitative risk assessment studies, the critical pathway analysis showed that the overall risk of FMDV entering a given country is low. However, in some cases, this risk can be elevated, especially when illegal importation of meat and the movement of terrestrial livestock are involved. Depending on the approach used, these studies highlight shortcomings associated with the application of models and the lack of reliable data from endemic settings. Therefore, the development and application of specific models for use in FMD endemic countries including Africa is encouraged.

Risk factors for recurrence of FMD outbreaks in Iran: a case-control study in a highly endemic area

BACKGROUND

Foot-and-mouth disease (FMD) is an acute viral disease of cloven-hoofed animals with high economic impact. FMD remains endemic in Iran particularly in the livestock-dense province of Khorasan Razavi in northeastern Iran where FMD outbreaks continuously occur. In this study, we aimed to quantify risk factors for the recurrence of FMD outbreaks in Iran by analyzing a time-series of FMD outbreak data from the province of Khorasan Razavi.

RESULTS

This study used FMD outbreak data collected from 2012 to 2014. Data were collected by local offices of the Iranian Animal Disease Department and the veterinarian of the veterinary council of the Khorasan Razavi province. An outbreak investigation questionnaire was delivered to 127 farms, including 46 case farms (FMD-infected) and 81 control farms (FMD-free). To quantify and compare the odds of exposure to a risk factor in FMD-infected farms versus FMD-free farms, logistic regression models were built using SPSS software version 16. Our results of multivariable logistic regression indicate that hygienic status of the farm (OR = 11.83; CI = 3.38-41.43), FMD vaccination status (OR = 0.06; CI = 0.01-0.68), transportation of livestock (OR = 0.40; CI = 0.163-0.981) and inhibition of livestock dealers' entry into the farm (OR = 0.36; CI = 0.12-1.09) were identified as important risk factors for farm-level FMD infection.

CONCLUSION

This study generated much needed evidence on a set of modifiable risk factors for the recurrence of FMD outbreaks in the high risk province of Khorasan Razavi. This information can be used to improve existing national FMD control program and suggest new guidelines to prevent FMD outbreaks in the country.

U.K. Foot and Mouth Disease: A Systemic Risk Assessment of Existing Controls

This article details a systemic analysis of the controls in place and possible interventions available to further reduce the risk of a foot and mouth disease (FMD) outbreak in the United Kingdom. Using a research-based network analysis tool, we identify vulnerabilities within the multibarrier control system and their corresponding critical control points (CCPs). CCPs represent opportunities for active intervention that produce the greatest improvement to United Kingdom's resilience to future FMD outbreaks. Using an adapted 'features, events, and processes' (FEPs) methodology and network analysis, our results suggest that movements of animals and goods associated with legal activities significantly influence the system's behavior due to their higher frequency and ability to combine and create scenarios of exposure similar in origin to the U.K. FMD outbreaks of 1967/8 and 2001. The systemic risk assessment highlights areas outside of disease control that are relevant to disease spread. Further, it proves to be a powerful tool for demonstrating the need for implementing disease controls that have not previously been part of the system.

Inactivation of Foot-and-Mouth Disease Virus by Commercially Available Disinfectants and Cleaners

Foot-and-mouth disease virus (FMDV) is an animal pathogen of great concern. It is contagious to cloven-hoofed animals and affects animals in extensive areas worldwide. In general, the primary eradication strategies for foot-and-mouth disease (FMD) in Japan are stamping out the disease and restriction of movement. It is also important to completely disinfect the infected area to prevent the spread of FMDV, including vehicles and people as well. However, there is no report on the effect of commercially available disinfectants against FMDV in a short contact time. In this study, we evaluated the virucidal effect of thirteen commercially available products, and got the following results: acidic ethanol disinfectants, alkaline cleaners and sodium hypochlorite had great effect (>3.0 log10 reduction in titer) against FMDV. On the other hand, neutral ethanol disinfectants, hand soaps, and quaternary ammonium compound sanitizers did not show great effect against FMDV. Therefore, it is presumed that acidic ethanol disinfectants are effective for human use and alkaline cleaners are effective for use in the infected environment for the control of a FMD outbreak.

Quantitative effects of a declaration of a state of emergency on foot-and-mouth disease

OBJECTIVES

The law in Japan requires the declaration of a state of emergency and implementation of countermeasures for an epidemic of a new infectious disease. However, because a state of emergency has never been declared in Japan, its effects remain unknown. The required countermeasures are similar to those implemented in the foot-and-mouth disease epidemic in Miyazaki in 2010. This study aimed to quantitatively estimate the effect of the declaration in 2010 and investigate the nature of the epidemic based on the day on which the declaration took effect.

METHODS

Only publicly available data were used. Data for farms in the most affected town were analyzed. A modified susceptible-infected-recovered model was used to estimate the effect and for the simulation. Another model was used to estimate the effective reproduction number.

RESULTS

After the declaration, the intra-bovine transmission rate decreased by 18.1 %, and there were few days when the effective reproduction number was >1.0. A few weeks delay in the declaration significantly increased the possibility of epidemic, number of farms at peak, and final infection scale.

CONCLUSIONS

Based on the substantial decrease in the transmission rate after the declaration of a state of emergency in 2010, a future declaration will have a similar effect for a new infectious disease even though a direct extrapolation is not valid. Although a declaration should be carefully considered owing to the potential socioeconomic effects, it is essential to prepare for the implementation given that a delay of only a few weeks should be acceptable.

Evaluation of the Control Strategy for the 2010 Foot-and-Mouth Disease Outbreak in Japan Using Disease Simulation

In 2010, Japan experienced a foot-and-mouth disease (FMD) epidemic where 292 premises were infected over a period of 75 days. The epidemic was controlled by stamping-out and vaccination, applied 5 weeks after the first confirmation of disease within a 10 km radius of identified infected places. This study aimed at identifying the role of emergency vaccination to epidemic control while adjusting for the dynamic pattern of local spread, and assessing alternative vaccination strategies, using a disease simulation model. Our results indicate that the overall hazard of local spread remained high throughout the silent spread phase and the first two weeks post-detection, with significant reduction occurring from week 3 onwards. The estimated effectiveness of emergency vaccination quantified as reduction in the hazard of infection was at most 81% and 44% for cattle and pig farms, respectively. The vaccination strategy reduced the simulated median number of IPs by 22%, epidemic duration by 64% and culling duration by 52%, but increased the total number of infected or vaccinated premises subject to culling by 144% compared with no vaccination. The simulation indicated that vaccination starting 2 weeks earlier (3 weeks post-first detection) with a smaller vaccination radius (3 km) was more effective for eradication of the epidemic compared with the actually implemented strategy.

Early Detection of Foot-And-Mouth Disease Virus from Infected Cattle Using A Dry Filter Air Sampling System

Foot-and-mouth disease (FMD) is a highly contagious livestock disease of high economic impact. Early detection of FMD virus (FMDV) is fundamental for rapid outbreak control. Air sampling collection has been demonstrated as a useful technique for detection of FMDV RNA in infected animals, related to the aerogenous nature of the virus. In the current study, air from rooms housing individual (n = 17) or two groups (n = 4) of cattle experimentally infected with FDMV A24 Cruzeiro of different virulence levels was sampled to assess the feasibility of applying air sampling as a non-invasive, screening tool to identify sources of FMDV infection. Detection of FMDV RNA in air was compared with first detection of clinical signs and FMDV RNA levels in serum and oral fluid. FMDV RNA was detected in room air samples 1-3 days prior (seven animals) or on the same day (four animals) as the appearance of clinical signs in 11 of 12 individually housed cattle. Only in one case clinical signs preceded detection in air samples by one day. Overall, viral RNA in oral fluid or serum preceded detection in air samples by 1-2 days. Six individually housed animals inoculated with attenuated strains did not show clinical signs, but virus was detected in air in one of these cases 3 days prior to first detection in oral fluid. In groups of four cattle housed together, air detection always preceded appearance of clinical signs by 1-2 days and coincided more often with viral shedding in oral fluid than virus in blood. These data confirm that air sampling is an effective non-invasive screening method for detecting FMDV infection in confined to enclosed spaces (e.g. auction barns, milking parlours). This technology could be a useful tool as part of a surveillance strategy during FMD prevention, control or eradication efforts.

Epidemiological analysis of an outbreak of foot-and-mouth disease (serotype SAT2) on a large dairy farm in Kenya using regular vaccination

During August-September 2012, an outbreak of Foot-and-mouth Disease (FMD) due to serotype Southern African Territories-2 (SAT2) occurred on a large, extensively grazed dairy farm in Nakuru County, Kenya. Over 29 days, 400/644 (62.1%) cattle were recorded as displaying clinical signs consistent with FMD. Out of the 18 management groups present, 17 had clinical cases (weighted mean incidence rate 3.5 per 100 cattle-days, 95% CI 2.4, 5.1; range 0.064-10.9). Transmission may have been encouraged when an infected group was moved to a designated isolation paddock. A four to five day minimum incubation period was apparent in five groups for which a point source exposure was evident. Further transmission was associated with the movement of individual animals incubating infection, use of a common dip and milking parlour, and grazing of susceptible groups in paddocks neighbouring to infectious cases. Animals over 18 months old appeared to be at highest risk of disease possibly due to milder clinical signs seen among younger animals resulting in reduced transmission or cases not being recorded. Cows with a breeding pedigree containing a greater proportion of zebu appeared to be at lower risk of disease. The outbreak occurred despite regular vaccination (three times per year) last performed approximately three months before the index case. Incidence risk by the lifetime number of doses received indicated limited or no vaccine effectiveness against clinical disease. Reasons for poor vaccine effectiveness are discussed with antigenic diversity of the SAT2 serotype and poor match between the field and vaccine strain as a likely explanation. Detailed field-derived epidemiological data based on individual animals are rarely presented in the literature for FMD, particularly in East-Africa and with the SAT2 serotype. This study provides a detailed account and therefore provides a greater understanding of FMD outbreaks in this setting. Additionally, this is the first study to provide field-derived evidence of poor vaccine effectiveness using a SAT2 vaccine. Further field-based measures of vaccine effectiveness in line with evaluation of human vaccines are needed to inform FMD control policy which has previously relied heavily upon experimental data and anecdotal experience.