Hendra virus - Information for veterinarians

Published: 26 August 2009
Last Updated: 2 September 2009

Purpose
Risk
Prevention
Notification
Further information
Reference

Purpose

Hendra virus is a rare disease of horses and humans that can cause serious and life threatening illness. Human infection results from close contact with infected horses and their blood, body fluids and tissues. Veterinarians and veterinary nurses are particularly at risk of exposure to Hendra virus and this creates important workplace health and safety considerations for veterinarians and their staff.

Risk

Hendra virus has the potential to be a serious zoonotic disease for which stringent biosecurity and workplace health and safety measures are necessary. Hendra virus prevention requires careful professional risk management including safe systems of work, staff training and the use of personal protective equipment (PPE).

Evidence from previous Hendra virus outbreaks¹ and Hendra virus research² indicates that infected horses can potentially excrete Hendra virus through their nasal/naso-pharyngeal secretions before showing clinical signs of illness, and that by the time a horse is showing clinical illness there may systemic spread of Hendra virus throughout the horse’s tissues and body fluids.

In all previous human cases of Hendra virus, exposure occurred before the horse was confirmed to have Hendra virus. You should therefore ensure the precautionary principle and adopt veterinary standard precautions for infection control for all contact with horses. You should also be aware that certain routine equine procedures such as endoscopy of the respiratory system may increase your risk, and you should adopt additional precautions as indicated by your professional risk assessment. You should also ensure early diagnostic consideration of Hendra virus based on known clinical indicators and ensure that you protect yourself, your staff and others whenever uncertainty exists.

Prevention

Workplace health and safety precautions for Hendra virus are detailed in the Guidelines for veterinarians handling potential Hendra virus infection in horses which is accessible from the Queensland Primary Industries and Fisheries website at www.dpi.qld.gov.au. Following these guidelines will assist you to prevent or minimise the risk of exposure to Hendra virus for yourself, your workers and others.

Workplace health and safety precautions for Hendra virus include the following key elements:

Develop a plan for responding to a suspect, highly suspect or confirmed Hendra case including the minimisation of risk to veterinarians, veterinary nurses,and other persons (including veterinary students and clients) and train workers in the implementation of this plan.
Ensure workplace health and safety precautions including appropriate infection control practices for use in routine situations. This is the primary defence to protect veterinarians and their staff from exposure to Hendra virus in the pre-clinical phase when infected horses may shed Hendra virus but appear clinically well.
Ensure high standards of hand hygiene, general hygiene and stable hygiene.
Ensure early diagnostic consideration of Hendra virus cases and implement appropriate response procedures including workplace health and safety and associated infection control precautions; do not wait for confirmation of diagnosis.
Provide and use appropriate PPE and provide training if this PPE is not routinely used at your practice. PPE may include gloves, overalls, boot covers, facial shields, safety eyewear and respiratory protective devices. The minimum level of respiratory protection for exposure to bio-aerosols is a P2 particulate respirator and it is important to note that surgical masks do not provide respiratory protection. The correct fitting of a respirator is important because airborne infectious agents can enter the breathing zone if the facial seal is compromised. It is therefore essential that a fit check is performed upon donning a respirator to ensure the integrity of the facial seal. In addition, respirator fit testing can be used to determine the brand and size of respirator that is best suited to an individual’s facial characteristics. Veterinarians who regularly care for horses should conduct respirator fit testing to ensure that they and their workers know which respirator will best protect them. You should contact your local supplier for more information about respirator fit checking and fit testing.
To minimise the risk of being caught on a property with no prior suspicion of Hendra virus, consider having a dedicated Hendra virus field kit which includes appropriate PPE, hand cleansers, cleaning agents, disinfectants and waste disposal bags.

Please refer to the Guidelines for veterinarians handling potential Hendra virus infection in horses for comprehensive information on workplace health and safety precautions for Hendra virus.

In addition, ensure that you exercise appropriate biosecurity controls when visiting properties. Further information on biosecurity can be obtained from Queensland Primary Industries and Fisheries by phoning 13 25 23 or contacting your local Biosecurity Queensland Service Centre.

Notification

Occupationally acquired zoonoses must be notified as a work-caused illness to Workplace Health and Safety Queensland. For more information on reporting incidents please refer to the WHSQ website at www.worksafe.qld.gov.au.

Further information

For more information visit www.worksafe.qld.gov.au or contact the WHS Infoline on 1300 369 915.

For more information on Hendra virus in horses contact the Queensland Primary Industries and Fisheries at www.dpi.qld.gov.au or 13 25 23 or your veterinarian.

For more information on Hendra virus in humans contact Queensland Health at www.health.qld.gov.au or 13 HEALTH (1300 43 25 84).

Reference

Perkins, N. 2008, Independent Review of Hendra Virus Cases www.dpi.qld.gov.au.
Middleton, D. 2009, Initial experimental characterisation of HeV (Redland Bay 2008) infection in horses. www.dpi.qld.gov.au.