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

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

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. 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”

7. Viral shedding in Hendra infected horses
CSIRO.
ANU Biosecurity

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

10. Lesson One
“leave the bats
alone!!!!!”

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