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Taking One Health Forward: Managing Hendra, an Example of a True One Health Approach

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GRF One Health Summit 2012, Davos: Presentation by Martyn Jeggo, Director, Australian Animal Health Laboratory

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Taking One Health Forward: Managing Hendra, an Example of a True One Health Approach

  1. 1. Taking One Health Forward Managing HendraAn example of a true One Health approach Professor Martyn Jeggo, Director, Australian Animal Health Laboratory Geelong, Australia
  2. 2. The complex of One Health disciplines PATHOGEN INFLUENCES HOST INFLUENCES• Quasispecies variation • Reservoir host• Genetic recombination spillover• Host adaptation • Intermediary hosts• Tissue tropism • Susceptible host range• Virulence determinants • Pathogenesis• Latency/persistence • Immune response PATHOGEN HOST DISEASE ENVIRONMENT ANTHROPOGENIC INFLUENCES • Globalisation GEOPHYSICAL INFLUENCES • Urbanisation • Climate change • Land use change • Climate variability • Behavioral/cultural change • Extreme weather events • Regional/global conflict
  3. 3. Hendra virus – the first BSL4 agent discovered in Australia
  4. 4. Transmission of Hendra Bats Horses Amplification in a secondary host Transmission Experimental to humans infection Direct transmission to humans? (no) Cats, ferrets, pigs, dogsHuman to human? (no)
  5. 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. 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”
  7. 7. Viral shedding in Hendra infected horsesCSIRO.ANU Biosecurity
  8. 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. 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
  10. 10. Lesson One“leave the bats alone!!!!!”
  11. 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. 12. Vaccine for humans or horses? Fusion (F)Attachment protein (G) • G protein main target for Nabs • Subunit vaccine • DIVA strategy
  13. 13. Post exposure treatment for humans Hendra virus particle Passive immunotherapy“fully human” monoclonal antibody
  14. 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

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