An outbreak of foot-and-mouth disease (FMD) in Cambodia in 2010 provided an opportunity to investigate the effectiveness of FMD vaccination in the face of an outbreak. A limited vaccination program using donated FMD vaccine was managed by local veterinary authorities in Kampong Cham province. Because the vaccination program was not supervised by the central veterinary authorities and did not take place in the controlled environment of a research project, results provide a 'real world' indication of vaccination effectiveness in Cambodia. Investigations of livestock movements and the spread of FMD were conducted in seven villages in Kampong Cham province that were affected by the 2010 FMD outbreak, two of which had received a quantity of donated FMD vaccine to use as a protective measure against the advancing outbreak. In Chrey Vien village, there was a statistically significant difference (P ＜ 0.001) between the proportion of vaccinated (51.4%) and unvaccinated (71.5%) animals showing signs of FMD. In Tropeang Ampil village, the difference in FMD attack rates between vaccinated (57.2%) and unvaccinated (61.5%) animals was not statistically significant (P = 0.524). Likely reasons for the poor results included inadequate vaccination coverage to produce herd immunity, uncontrolled movement of sick animals during the outbreak, overwhelming infection challenge created by roadside tethering and communal grazing of livestock, and weaknesses in planning and carrying out the vaccination process. Implications for the management of donated FMD vaccine in Cambodia are discussed, with recommendations that future vaccine donations allow for an observer to monitor planning, storage, handling, vaccine quality and administration of donated vaccine in response to an FMD outbreak. In addition, disease control measures including movement restrictions, alternative feeding strategies to communal grazing, controlling trade of sick animals, and biosecurity education for village animal health workers and farmers are proposed.
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