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Taking One Health Forward: Managing Hendra, an Example of a True One Health Approach
1. Taking One Health Forward
Managing Hendra
An example of a true One Health approach
Professor Martyn Jeggo,
Director, Australian Animal Health Laboratory
Geelong, Australia
3. Hendra virus – the first BSL4 agent discovered in Australia
4. Transmission of Hendra
Bats Horses
Amplification in a
secondary host
Transmission
Experimental
to humans
infection
Direct transmission
to humans?
(no)
Cats, ferrets, pigs, dogs
Human to human?
(no)
5. Clinical features in horses
• rapid onset of illness
• fever (over 40 ˚C)
• rapid deterioration in
health
• death in most cases
• respiratory signs
- increased rate
- frothy bloody discharge
• neurological signs
- depression
- loss of balance
- loss of vision
- loss of balance
- muscle twitching
6. Hendra in Humans
An influenza-like
illness, which can
progress to pneumonia; SYMPTOMS
Fever
or Headache
Encephalitis Dry cough
Sore throat
(inflammation of the Breathing difficulties
brain); i.e. headache, Dizziness
Unusual sleepiness
high fever, and Confusion.
drowsiness, which can
progress to convulsions
or coma.
“Currently only 3 out of 7 humans infected have survived”
8. Cases
• 19 incidents in horses from north Queensland in
to north New South Wales
2011
• all cases in horses associated with colonies
of bats
• practically all cases associated with
neurological signs
• most cases older horses (retired)
• no high risk human exposures
• one dog serologically converted (but
euthanized without any further investigation) ******
**
***
**
9. Infection Control Strategies
•Managing the risks from bats
•Managing the risk Health” horses
A “One to and from
approach
•Managing the risks to humans
from wildlife to
livestock to humans
11. Adopt basic biosecurity at all times handling
horses!!!!
Guidelines for veterinarians • impervious rubber boots
handling potential Hendra Virus • impervious overalls OR
infection in horses cotton or disposable
Queensland Department of overalls with impervious
Primary Industries apron or impervious
covering/coating
• disposable impermeable
gloves
• face shield or safety
eyewear
• a particulate respirator.
ANU Biosecurity
12. Vaccine for humans or horses?
Fusion (F)
Attachment protein (G)
• G protein main target for Nabs
• Subunit vaccine
• DIVA strategy
13. Post exposure treatment for humans
Hendra virus particle
Passive immunotherapy
“fully human” monoclonal
antibody
14. Added-value created by a One-
Health Approach
• Examples of the value add of a One Health approach are
critical to going forward
• Hendra is an excellent example of what can be achieved
• The outcomes in terms of protecting bats, managing the
disease in horses and reducing the risk to humans could
not have been achieved without a One Health approach
• This approach included operational/field activities, policy
setting and research prioritization and implementation
• Other examples like this are critically
needed
• Economic case examples (value add
in terms of costs saved) are now
urgently needed