Hendra virus in Queensland, Australia, during the winter of 2011: Veterinarians on the path to better management strategies

Abstract

Following the emergence of Hendra virus (HeV), private veterinarians have had to adopt additional infection control strategies to manage this zoonosis. Between 1994 and 2010, seven people became infected with HeV, four fatally. All infected people were at a higher risk of exposure from contact with horses as they were either veterinary personnel, assisting veterinarians, or working in the horse industry. The management of emerging zoonoses is best approached from a One Health perspective as it benefits biosecurity as well as a public health, including the health of those most at risk, in this case private veterinarians. In 2011 we conducted a cross-sectional study of private veterinarians registered in Queensland and providing veterinary services to horses. The aim of this study was to gauge if participants had adopted recommendations for improved infection control, including the use of personal protective equipment (PPE), and the development of HeV specific management strategies during the winter of 2011. A majority of participants worked in practices that had a formal HeV management plan, mostly based on the perusal of official guidelines and an HeV field kit. The use of PPE increased as the health status of an equine patient decreased, demonstrating that many participants evaluated the risk of exposure to HeV appropriately; while others remained at risk of HeV infection by not using the appropriate PPE even when attending a sick horse. This study took place after Biosecurity Queensland had sent a comprehensive package about HeV management to all private veterinarians working in Queensland. However, those who had previous HeV experience through the management of suspected cases or had attended a HeV specific professional education programme in the previous 12 months were more likely to use PPE than those who had not. This may indicate that for private veterinarians in Queensland personal experience and face-to-face professional education sessions may be more effective in the improvement of HeV management than passive education via information packages. The role of different education pathways in the sustainable adoption of veterinary infection control measures should be further investigated.

The challenges of implementing an integrated One Health surveillance system in Australia

“…With improved interdisciplinary surveillance and earlier detection and reporting of disease outbreaks in animals, human infections may have been identified earlier and better managed, preventing localized cases from spreading (Bond et al., ; Crawford, Roth, & Grillo, ; Gubler et al., ; Halliday et al., ; Roest et al., ; van den Wijngaard et al., ). For example, Hendra virus causes a highly infectious disease with a high mortality rate, primarily infecting horses and, occasionally, humans and dogs that have contact with infected horses (Mendez, Buttner, & Speare, ). Between 1994 and 2010 Hendra outbreaks (in horses) in Australia saw seven veterinarians becoming infected, four fatally (Mendez et al., ).…”

“…For example, Hendra virus causes a highly infectious disease with a high mortality rate, primarily infecting horses and, occasionally, humans and dogs that have contact with infected horses (Mendez, Buttner, & Speare, ). Between 1994 and 2010 Hendra outbreaks (in horses) in Australia saw seven veterinarians becoming infected, four fatally (Mendez et al., ). Similarly, in the Netherlands between 2007 and 2009, Q fever in infected goat farms was linked to 3523 cases of human infection, following a time‐consuming epidemiological investigation (Roest et al., ; van den Wijngaard et al., ).…”

Difficulties experienced by veterinarians when communicating about emerging zoonotic risks with animal owners: the case of Hendra virus

“…Phase 2 of the study consisted of three cross-sectional studies (Phases 2a, 2b, 2c) (Fig. 1 ) which sought to further examine the barriers to HeV management and veterinary IC identified during Phase 1 [ 42 ]. The design of the survey tools used in the second phase of the study was informed by the results obtained during Phase 1 of the study [ 40 , 41 ].…”

“…As part of a larger mixed methods sequential exploratory study, which aimed to identify and understand the factors affecting veterinary IC and HeV management in private veterinary practices (Fig. 1 ), HeV-related risk communication issues were identified and further investigated [ 40 – 42 ]. The work presented here only focuses on the parts of the study that examined the relevant risk communication issues and the possible effect these may have on the management of HeV.…”

Survey of rabies vaccination status of Queensland veterinarians and veterinary students

“…Since then, governments have developed better HeV management strategies, which include providing information and technical support to veterinarians dealing with HeV outbreaks . Although the incidence of reported equine HeV cases has increased greatly, veterinarians have now improved their infection control practices with respect to HeV and no further cases have occurred in the veterinary profession . Rollout of an equine HeV vaccine is unlikely to decrease the level of infection control practised by equine veterinarians .…”