Foot-and-mouth and people: the truth

A The chances of catching foot-and-mouth are remote and, even for those people who do become infected, the disease is not serious, according to Dr John Woodhouse, director of public health for County Durham and Darlington Health Authority.

"The only people at risk of getting foot-and-mouth would be people who are dealing with infected animals or carcasses and even that must be fantastically small," he says. "And there is no suggestion that there has ever been a person-to-person spread. Those people who have it cannot pass it on."

One of the three people who are being tested for suspected foot-and-mouth, Cumbrian taxi driver Paul Stamper, is thought to have been at risk after he was sprayed with material from a carcass. But, even if he is found to have been infected, the effects will be similar to those of a common cold.

Agricultural salesman Robert Brewis was the only previously recorded human foot-and-mouth victim, contracting the disease on his brother's farm in Northumberland in 1966. His symptoms disappeared after several weeks, only to come back a week later and again after five months.

"It is like having a bad cold, it is not a serious disease and it is self-limiting, disappearing by itself," says Dr Woodhouse. "I don't think people should be worried about catching foot-and-mouth."

Q Is there a link with hand-foot-and-mouth, which commonly affects children?

A No, the two diseases are completely separate, according to Dr Phil Kirby, public health consultant for North Yorkshire Health Authority. "It is a very common and very mild flu which gets better on its own in a few days," he says. "It is a completely different virus to the foot-and-mouth virus in animals. It can cause small blisters on the hands and feet and small ulcers in the mouth, but it improves without treatment.

"Most children will have it at some stage in their life and it is no more serious that the common cold. Often, children don't even have to stay off school but it is quite infectious and some years there are more outbreaks than others. Once you have had it you become immune and don't get it again and you don't often hear of adults having it."

One adult who did contract hand-foot-and-mouth disease was Tim Stahl, orthopaedic surgeon at Darlington Memorial Hospital, who became infected along with other staff at the hospital in the early 1980s.

"It was a very minor illness and it was less troublesome than flu," he says. "The mouth ulcers are less severe than ordinary mouth ulcers."

Q What are the risks of burning animal carcasses on funeral pyres?

A Expert opinion is split on the risk to human health from the pyres. Friends of the Earth has highlighted the dangers of dioxins, cancer-causing chemicals released into the air, but other experts say the risk has been exaggerated.

"Large amounts of dioxins are being released in very limited areas, so potentially it is a significant health threat," says FoE campaigns director Mike Childs. "It is recognised that dioxins can transfer into the hormone system and can lead to genital malformation and falling sperm counts and some of them have been linked to cancer. Chemicals like dioxins are relatively persistent and toxic in very small amounts so there is clearly a need to reduce the risk by using other means to dispose of carcasses."

Department of Health guidance says pyres burning less than 250 cattle should be more than 2km from local communities, with pyres burning 1,000 or more cattle at least 3km away. But dioxins in the soil would not contaminate crops and, once burning has stopped, dioxin levels in grass are expected to fall.

"Dioxins are a substance around us all the time and the majority of human exposure is through food," says Dr Woodhouse. "They are potentially harmful to health, but only in large quantities, and any risk is associated with lifetime exposure. Exposure to the pyres is not unlike exposure to ordinary bonfires and, although it appears alarming, it is something which is not a cause for concern."

As well as dioxins, the smoke carries other pollutants, including sulphur dioxide which causes acid rain. "It is the sort of pollution you get from a bonfire or traffic fumes or coal smoke," says Dr Woodhouse. "And the risk that causes to human health is that prolonged exposure to large amounts for people with chronic lung or heart disease could potentially be quite harmful."

Q Isn't it dangerous to bury infected animals in the ground?

A Not if proper precautions are taken to ensure there is no seepage into water supplies, says David Manning, professor of soil science at Newcastle University. "We have heard about the loss of fluids from rotting animals and the concern is where that goes when the carcasses are buried," he says.

"Ammonia is one of the decomposing products in cattle and sheep and if you get above a certain level of ammonia in water it is not fit to drink. On its own it is supposed not to harm health, although it does make the water smell. What we don't know is whether there are any pathogenic bacteria, which cause disease, and these could be harmful."

He says risk assessments carried out by the Environment Agency before burial sites are chosen should ensure there is no risk of contaminating water supplies. Lining burial pits with plastic sheets should prevent potentially harmful fluids leaking out. "I think they're doing the best job they can in the circumstance and I haven't come across any grounds for concern," he says.

Q What about the risk from rotting carcasses left unburned and unburied?

A This is a genuine cause for concern, says Dr Woodhouse. "It is a fairly conspicuous threat to health, to have rotting carcasses potentially contaminating the ground or ground water, or people who have contact with them." He says pigs are often contaminated with salmonella, sheep with cryptospiridium and cows with E.coli 0157.

"They all have bacteria which is dangerous to humans and bacteria which causes things like food poisoning, so rotting carcasses lying around farmyards are definitely not a good thing."

Q Are there any other health risks from foot-and-mouth?

A One long-term consequence of the epidemic could be the effect on psychological well-being, according to David Haynes, director of the Samaritans' Northallerton branch. "To have your animals destroyed can be emotionally disturbing, but to lose them all at once, especially on the back iof the hard years farmers have had, can make things worse," he says.

"For people who live in the community, even if they don't earn their living from agriculture or tourism, to be greeted by the sight and smell of a burning pyre can be distressing in the extreme. And for those who depend on agriculture or tourism, it can be the final straw.

"As the penny drops, people say they didn't really notice the sheep before but they notice now they are not there. People are suffering, and because there is so little information it makes it harder - farmers don't know what to do to protect their animals."

The effect of the outbreak on the rural economy could have long-term health implications, according to Dr Woodhouse.

"The one thing I'm absolutely sure of is that the long-term impact on health we should be worried about is the impact on the rural economy.

"People are poorer and exposed to financial stress, so they are more vulnerable to illness and live shorter lives. There is very good evidence that the poorer people are, the less healthy they are, although it is hard to say exactly why. For the next five, ten, 15 years that is the issue we need to address.