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Hendra virus outbreak with novel clinical features, Australia.

Field H, Schaaf K, Kung N, Simon C, Waltisbuhl D, Hobert H, Moore F, Middleton D, Crook A, Smith G, Daniels P, Glanville R, Lovell D - Emerging Infect. Dis. (2010)

Bottom Line: To determine the epidemiologic and clinical features of a 2008 outbreak of Hendra virus infection in a veterinary clinic in Australia, we investigated the equine case-series.Clinical manifestation in horses was predominantly neurologic.Preclinical transmission appears likely.

View Article: PubMed Central - PubMed

Affiliation: Biosecurity Queensland, Brisbane, Queensland, Australia. hume.fi eld@dpi.qld.gov.au

ABSTRACT
To determine the epidemiologic and clinical features of a 2008 outbreak of Hendra virus infection in a veterinary clinic in Australia, we investigated the equine case-series. Four of 5 infected horses died, as did 1 of 2 infected staff members. Clinical manifestation in horses was predominantly neurologic. Preclinical transmission appears likely.

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Related in: MedlinePlus

Epidemic curve of Hendra virus infection in horses, Australia, 2008. White bars represent the 3 possible cases; black bars represent the 5 confirmed cases.
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Figure 2: Epidemic curve of Hendra virus infection in horses, Australia, 2008. White bars represent the 3 possible cases; black bars represent the 5 confirmed cases.

Mentions: Experimental studies suggest that horses may be infectious 48 hours before they show clinical signs (D. Middleton, unpub. data) At the time, case-patients 2–4 were housed in the clinic area or were being intensively treated, with daily or twice daily visits to the clinic, which would likely have increased their probability of becoming infected. Environmental swab samples from stalls 2, 3, and 4 yielded positive results by PCR, confirming that surfaces (walls, doors, wire mesh partitions between stalls) had been contaminated. Case-patient 5 had 3 possible sources of infection: most plausibly, case-patient 4, who had been in the adjacent stall until July 8; less plausibly, the recovered case-patient 2, who had been in stall 2 until July 18; and least plausibly, environmental contamination in stall 3 (occupied by case-patient 3 until July 5). The horse in yard 20, who had an extended opportunity for direct contact with case-patient 1, and the horses in stalls 6 and 7, who had extended opportunity for close contact with case-patients 2 and 5, respectively, did not acquire infection. These findings support previous observations that unassisted horse-to-horse transmission is inefficient. Three other horses died at the clinic without a definitive diagnosis before the death of case-patient 1, but the lack of clinical samples, conflicting epidemiologic evidence, and plausible alternative reasons for death precluded their inclusion as case-patients. However, they are considered possible case-patients (Figure 2).


Hendra virus outbreak with novel clinical features, Australia.

Field H, Schaaf K, Kung N, Simon C, Waltisbuhl D, Hobert H, Moore F, Middleton D, Crook A, Smith G, Daniels P, Glanville R, Lovell D - Emerging Infect. Dis. (2010)

Epidemic curve of Hendra virus infection in horses, Australia, 2008. White bars represent the 3 possible cases; black bars represent the 5 confirmed cases.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2958006&req=5

Figure 2: Epidemic curve of Hendra virus infection in horses, Australia, 2008. White bars represent the 3 possible cases; black bars represent the 5 confirmed cases.
Mentions: Experimental studies suggest that horses may be infectious 48 hours before they show clinical signs (D. Middleton, unpub. data) At the time, case-patients 2–4 were housed in the clinic area or were being intensively treated, with daily or twice daily visits to the clinic, which would likely have increased their probability of becoming infected. Environmental swab samples from stalls 2, 3, and 4 yielded positive results by PCR, confirming that surfaces (walls, doors, wire mesh partitions between stalls) had been contaminated. Case-patient 5 had 3 possible sources of infection: most plausibly, case-patient 4, who had been in the adjacent stall until July 8; less plausibly, the recovered case-patient 2, who had been in stall 2 until July 18; and least plausibly, environmental contamination in stall 3 (occupied by case-patient 3 until July 5). The horse in yard 20, who had an extended opportunity for direct contact with case-patient 1, and the horses in stalls 6 and 7, who had extended opportunity for close contact with case-patients 2 and 5, respectively, did not acquire infection. These findings support previous observations that unassisted horse-to-horse transmission is inefficient. Three other horses died at the clinic without a definitive diagnosis before the death of case-patient 1, but the lack of clinical samples, conflicting epidemiologic evidence, and plausible alternative reasons for death precluded their inclusion as case-patients. However, they are considered possible case-patients (Figure 2).

Bottom Line: To determine the epidemiologic and clinical features of a 2008 outbreak of Hendra virus infection in a veterinary clinic in Australia, we investigated the equine case-series.Clinical manifestation in horses was predominantly neurologic.Preclinical transmission appears likely.

View Article: PubMed Central - PubMed

Affiliation: Biosecurity Queensland, Brisbane, Queensland, Australia. hume.fi eld@dpi.qld.gov.au

ABSTRACT
To determine the epidemiologic and clinical features of a 2008 outbreak of Hendra virus infection in a veterinary clinic in Australia, we investigated the equine case-series. Four of 5 infected horses died, as did 1 of 2 infected staff members. Clinical manifestation in horses was predominantly neurologic. Preclinical transmission appears likely.

Show MeSH
Related in: MedlinePlus