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  Discussion on Hendra virus rears it's ugly head again in Queensland Australia
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Moderator:
DrO

Posted on Thursday, Sep 17, 2009 - 8:53 am:

Folks who live in the Queensland region of Australia have a special concern when dealing with horses with flu like symptoms. Besides a fatal infection of horses the disease appears to readily transmit to humans where it is equally fatal. First reported in 1994 the disease appears confined to this part of the world.

Here are two articles on this disease. The first concerning the most recent outbreak and the second a general overview from the CDC on what we know about this disease so far.
DrO

Eight potential Hendra infections found

September 09, 2009
Article from: Australian Associated Press

AUTHORITIES are monitoring eight people for signs of the deadly Hendra virus after a horse tested positive to the disease in north Queensland.

Bowen vet Dr Tim Annand euthanased the horse last week, believing it had contracted the disease, which can be transmitted to humans.

His fears were confirmed on last night when Biosecurity Queensland revealed blood samples taken from the horse had tested positive to the disease.

The property, located outside Bowen, has been placed under quarantine, and Queensland's chief health officer Dr Jeannette Young said half a dozen people who came into contact with the animal were being monitored.

It is believed the horse may have contracted the virus from bats that frequent melaleuca trees on the property.

Dr Annand said he donned protective clothing and was careful about what he came in contact with during and after his time with the horse.

"I had a very high level of suspicion (that this was Hendra) before I went into this," he said.

"I spent a couple of hours preparing for it."

Still, he is concerned he may have been exposed to the virus from another horse he treated on the same property, which died last month.

He said, though he wore some protective clothing in that instance, he did not take the same level of precautions because the horse's symptoms were not consistent with Hendra.

"(If I had it) you would have expected that I would have shown some symptoms, but there's very small chance of it developing down the track," he said.

Queensland deputy chief veterinary officer Rick Symons said Queensland Health officials were attempting to locate missing samples taken by the vet at the time.

Biosecurity Queensland officers are attempting to ascertain whether horses on a nearby property had been exposed to the horse that died most recently and have spoken to local residents about the disease.

The Queensland Horse Council (QHC) said the outbreak would not have the same impact as a recent episode at Cawarral, near Rockhampton.

"There's not the same level of worry that there was with the Cawarral case," she said.

This is the 13th known instance of Hendra virus infection since 1994.

Rockhampton vet Alister Rodgers died on September 1 after catching the virus from an infected horse he treated at the Cawarral property on July 28.

Dr Rodgers' funeral will be held in Rockhampton on tomorrow.


Hendra Virus Disease and Nipah Virus Encephalitis: Frequently Asked Questions

What are Hendra and Nipah viruses?

Hendra virus (formerly called equine morbillivirus) is a member of the family Paramyxoviridae. The virus was first isolated in 1994 from specimens obtained during an outbreak of respiratory and neurologic disease in horses and humans in Hendra, a suburb of Brisbane, Australia.
Nipah virus, also a member of the family Paramyxoviridae, is related but not identical to Hendra virus. Nipah virus was initially isolated in 1999 upon examining samples from an outbreak of encephalitis and respiratory illness among adult men in Malaysia and Singapore. Its name originated from Sungai Nipah, a village in the Malaysian Penninsula where pig farmers became ill with encephalitis.

Where are Hendra and Nipah viruses found?

The natural reservoir for Hendra virus is thought to be flying foxes (bats of the genus Pteropus) found in Australia. The natural reservoir for Nipah virus is still under investigation, but preliminary data suggest that bats of the genus Pteropus are also the reservoirs for Nipah virus in Malaysia.
Where are the diseases found?

Hendra virus caused disease in horses in Australia, and the human infections there were due to direct exposure to tissues and secretions from infected horses. Nipah virus caused a relatively mild disease in pigs in Malaysia and Singapore. Nipah virus was transmitted to humans, cats, and dogs through close contact with infected pigs.

How are Hendra and Nipah viruses transmitted to humans?

In Australia, humans became ill after exposure to body fluids and excretions of horses infected with Hendra virus. In Malaysia and Singapore, humans were infected with Nipah virus through close contact with infected pigs.

What are the signs and symptoms of Hendra virus disease and Nipah virus encephalitis?

Only three human cases of Hendra virus disease have been recognized. Two of the three individuals known to be infected had a respiratory illness with severe flu-like signs and symptoms. Infection with Nipah virus was associated with an encephalitis (inflammation of the brain) characterized by fever and DrOwsiness and more serious central nervous system disease, such as coma, seizures, and inability to maintain breathing.

Illness with Nipah virus begins with 3-14 days of fever and headache. This is followed by DrOwsiness and disorientation characterized by mental confusion. These signs and symptoms can progress to coma within 24-48 hours. Some patients have had a respiratory illness during the early part of their infections.

What laboratory tests are used to diagnose Hendra virus and Nipah virus?

Laboratory tests that are used to diagnose Hendra virus (HV) and Nipah virus (NV) include detection of antibody by ELISA (IgG and IgM), real time polymerase chain reaction (RT-PCR), and virus isolation attempts. Laboratory diagnosis of a patient with a clinical history of HV or NV can be made during the acute and convalescent phase of the disease by using a combination of tests including detection of antibody in the serum or the cerebrospinal fluid (CSF), viral RNA detection (RT-PCR) in the serum, CSF, or throat swabs, and virus isolation from the CSF or throat swabs.

Are there any complications after recovery?

One of the three Hendra virus infections was marked by a delayed onset of progressive encephalitis. Serious nervous disease with Nipah virus encephalitis has been marked by some sequelae, such as persistent convulsions and personality changes.

Are the diseases ever fatal?

Two of the three human patients infected with Hendra virus died. During the Nipah virus disease outbreak in 1998-99, 257 patients were infected with the virus. About 40% of those patients who entered hospitals with serious nervous disease died from the illness.

How are Hendra virus disease and Nipah virus encephalitis treated?

The drug ribavirin has been shown to be effective against the viruses in vitro. Drug investigations to date have been inconclusive and the clinical usefulness of these drugs is uncertain.

Who is at risk for disease from Hendra and Nipah viruses?

People who have contact with body fluids or excretions of horses infected with Hendra virus are at risk for Hendra virus disease. Nipah virus infection is associated with close contact with Nipah virus-infected pigs. Neither disease has spread from human to human.

How are infections with Hendra and Nipah virus prevented?

These diseases can be prevented by avoiding animals that are known to be infected and using appropriate personal protective equipment devices when it is necessary to come into contact with potentially infected animals.

What needs to be done to address the threat of Hendra and Nipah viruses?

The distribution of these agents in their natural reservoirs will eventually define the geographic range of the threat the viruses pose. However, these viruses are recent discoveries, and much work remains to be done on their geographic distribution and the reservoir species. The occurrence of the disease in humans has been associated only with infection of an intermediate species such as horses with Hendra and swine with Nipah virus. Early recognition of the disease in the intermediate animal host is probably the most crucial means of limiting future human cases.

Suggested Reading

K Murray, P Selleck, P Hooper, et al. A morbillivirus that caused fatal disease in horses and humans. Science 1995, 268:94-7.

JD O'Sullivan, AM Allworth, DL Paterson, et al. Fatal encephalitis due to novel paramyxovirus transmitted from horses. Lancet 1997, 349:93-5.

Chua KB, Goh KJ, Wong KT, et al. Fatal encephalitis due to Nipah virus among pig-farmers in Malaysia. Lancet 1999; 3541257-9.

Paton NI, Leo YS, Zaki SR, et al. Outbreak of Nipah-virus infection among abattoir workers in Singapore. Lancet 1999; 3541253-6.

Lee KE, Umapathi T, Tan CB, et al. The neurological manifestations of Nipah virus encephalitis, a novel paramyxovirus. Ann Neurol 1999; 46428-32.

CDC, Outbreak of Hendra-like virus—Malaysia and Singapore, 1998-1999. MMWR. Apr 9, 1999; vol 48, no 3, 265-269.

CDC, Update: Outbreak of Nipah virus-- Malaysia and Singapore, 1999. MMWR, Apr 30, 1999; vol 48, no 16, 335-337.
Moderator:
DrO

Posted on Thursday, Sep 17, 2009 - 8:56 am:

More information on what is being done about this disease.
DrO

Hendra horse vaccine 'within 2 years'
Posted Fri Sep 4, 2009 7:10pm AEST
Updated Fri Sep 4, 2009 7:54pm AEST


With the right resources, CSIRO claims it could have a Hendra vaccine for horses within two years. (AAP: Dave Hunt)

Related Story: Govt trying to fast-track Hendra virus research: Bligh Related Story: Qld Health to retest workers for Hendra virus Related Story: Hendra death: vets want action The CSIRO says it could have a Hendra virus vaccine for horses ready for manufacturer trials within two years if adequate resources are devoted to its development.

The death of a Queensland vet this week from the Hendra virus has prompted calls for more money to be poured into research for a vaccine.

Dr Alister Rodgers died on Tuesday after contracting the virus from a horse he was treating at a central Queensland property.

In the past 15 years, four people in Australia have died after being infected with the Hendra virus. There is currently no treatment, vaccine or cure.

The man who developed the vaccine for cervical cancer, Professor Ian Frazer, says it will cost more than $1 billion to develop a vaccine for the Hendra virus.

The director of the CSIRO's Animal Health Laboratory, Dr Martyn Jeggo, says the latest death has increased the urgency to find a vaccine and animal model trials have been promising.

"This is a resource dependent issue. The more money you throw at it, to some extent, the quicker it can get done," he said.

"We reckon that if we had adequate resources we could probably have a candidate vaccine that would then need to be picked up by a manufacturer and taken into trials, but we think the research side of it could be completed in a couple of years with adequate resources."

He also says it would likely be easier and faster to license a vaccine for horses than it would be for a human one.

"Route to market would probably be a little bit quicker in that approach, so we would see that vaccinating the horses is probably something that would be achievable more rapidly," he said.

Dr Jeggo says Professor Frazer's $1 billion cost estimation probably assumes a vaccination for people, and likely does not take into account the CSIRO's existing work on an animal model.

"We are further down the road than he is probably aware and we estimate that around about $1 million over a two-year period would probably be sufficient to prepare something that would then need picking up by a manufacturer and taken through the licensing processes," he said.
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