Hendra virus infection

Disease in humans

While the Hendra virus can spread from horses to people, it is very rare.

However, people who do become infected may first get symptoms such as:

• fever
• cough
• sore throat
• headache.

In some cases, the illness can become more severe and cause:

• pneumonia
• meningitis (inflammation of the brain)
• convulsions
• coma.

Symptoms usually begin 5 to 21 days after contact with an infected horse.

Disease in horses

Infected horses may show a mix of symptoms, including:

• fever
• breathing problems, such as rapid or laboured breathing
• neurological signs, including muscle twitching, stumbling, walking clumsily, head tilting or circling.

There is no specific treatment for Hendra virus infection. People who become unwell are usually managed in hospital with supportive care.

If someone has had high level exposure to the body fluids of an infected horse, they may be offered a blood test and an “off label” antibody treatment that may help prevent infection.

While the exact route of infection is unknown, it is thought that horses may contract Hendra virus infection from sniffing or eating matter recently contaminated with flying fox urine, saliva or birth products. Spread of infection to other horses can then happen. Spread is possible wherever horses have close contact with body fluids of an infected horse. Small amounts of the virus may be present in a horse's body fluids, particularly nasal secretions, for a few days before they become sick.

The seven confirmed human cases all became infected following high level exposures to respiratory secretions and/or blood of a horse infected with Hendra virus, following activities such as assisting with post mortem examination of a dead horse without adequate personal protective equipment (PPE), performing certain veterinary procedures or having extensive exposure to respiratory secretions without adequate PPE. Other people have reported similar contact with infected horses but have remained well and their blood tests have shown no evidence of infection. No one with a lower level exposure (e.g. grooming, feeding, patting) has ever developed Hendra virus infection or shown evidence of infection in blood tests.

There is no evidence of human to human transmission. People who have had contact with a person with Hendra virus infection, including health care workers and family members, have been tested and shown no evidence of infection with the virus.

There is no evidence that the virus can be passed directly from

• flying foxes to humans
• dogs to humans
• the environment to humans, or,
• from humans to horses

There is no evidence of airborne spread (where tiny particles remain suspended in the air).

Hendra virus is killed by heat, drying and cleaning with detergents.

Control in horses

A registered vaccine is available to help prevent Hendra virus disease in horses. Vaccinating horses is the most effective way to help manage Hendra virus disease.

Vaccination of horses provides a public health and workplace health and safety benefit by reducing the risk of Hendra virus transmission to humans and other susceptible animals.

Talk to your veterinarian about vaccinating your horse.

Horse owners and handlers can reduce the risk by:

• keeping food and water covered to stop contamination from flying foxes
• contact your vet if a horse shows unusual symptoms or dies unexpectedly
• separate sick horses from others while awaiting test results
• using good hygiene and regular cleaning practices in stables and paddocks

Preventing human infection

A horse can be infectious before showing signs of illness. Follow these every day hygiene practices around horses:

• don’t kiss horses on the muzzle
• wash hands after contact, especially before eating or touching your face
• cover wounds with waterproof dressings
• wear personal protective equipment (PPE) if there’s a chance of contact with body fluids (e.g. gloves, mask, eye protection)

If you are exposed to horse body fluids or manure:

• wash skin thoroughly with soap and water
• if you have a wound, let it bleed gently, then wash it well with soap and water (alcohol-based gel if no water available)
• if it gets in your eyes, rinse gently with clean water or saline for at least 30 seconds
• if fluid enters your mouth, spit it out and rinse several times with clean water
• keep children away from unwell horses, and minimise the number of carers

Whenever Hendra virus infection is suspected, even in vaccinated horses, appropriate precautions including personal protective equipment (PPE) should be used.

Important:

If you’ve been exposed, do not donate blood or tissue until cleared by public health. If you’ve had confirmed Hendra virus infection, you should never donate blood or tissue in the future.

Notification

Hendra virus poses a serious biosecurity risk. As a horse owner or person who deals with horses, you have a legal obligation to take all reasonable and practical measures to reduce the risk of Hendra virus infection and limit the spread of Hendra virus when dealing with horses and other possible carriers.

Contact your veterinarian immediately if you suspect your animal may have Hendra virus infection. If you become aware of the presence of Hendra virus in any species of animal, you must report it to Biosecurity Queensland on 13 25 23 (during business hours) or 1800 675 888 (24-hour Emergency Animal Disease Hotline).

Public health response

If a horse is confirmed to have Hendra virus, Biosecurity Queensland will notify Queensland Health and take immediate steps to minimise the risk to others.

Public health staff will:

• identify anyone who may have been exposed
• assess the level of exposure
• provide clear information and guidance to those at risk

There are no restrictions on the movements or activities of people exposed to an infected animal or person, unless public health advises otherwise.

If you have had recent exposure to an infected horse and have not been contacted, please call your local public health unit or ring 13 HEALTH (13 43 25 84).

Information about Hendra virus for the general public, horse owners, horse handlers and veterinarians, Hendra virus | Business Queensland or call 13 25 23

Information and resources to support veterinarians, horse businesses and owners, and  disposal  of horse carcases to manage Hendra virus risks - Workplace Health and Safety Queensland or call 1300 369 915

For other information or assistance regarding Hendra virus infection in humans please contact 13 HEALTH (13 43 25 84) or your nearest local public health unit.