Hendra Virus Solutions
"Deleting Australia’s policy for Hendra Virus Infection!"
A postscript to
"What don’t you understand about snorting horses, Mr. Vet?"
Further discussion and analysis on Hendra Virus, the transmission scenario, epidemiological confusion and the unintended consequences for bat conservation.
Lee St.John Carter B.Sc. (Zool), Dip.Ed.
A contribution to the International year of the Bat 2011-2012
This postscript originated as a response to an email from Ron Glanville,CVO, Biosecurity Queensland, who was responding to my discussion paper "What don’t you understand about snorting horses, Mr. Vet?"
The following are cut and paste of relevant detail on Australia’s policy for Hendra Virus Infection from Ausvetplan Response Policy Briefs
----------------------------------------------------------------------------------------------------------------------------------------------
AUSVETPLAN is a series of technical response plans that describe the proposed Australian approach to an emergency animal disease incident. The documents provide guidance based on sound analysis, linking policy, strategies, implementation, coordination and emergency-management plans.
Primary Industries Ministerial Council
AUSTRALIAN VETERINARY EMERGENCY PLAN
AUSVETPLAN
Response Policy Briefs
Brief policy statements for emergency animal diseases that are subject to cost sharing between governments and livestock industries but not covered by full AUSVETPLAN disease strategies Version 3.3, 2009AUSVETPLAN is a series of technical response plans that describe the proposed Australian approach to an emergency animal disease incident. The documents provide guidance based on sound analysis, linking policy, strategies, implementation, coordination and emergency-management plans.
Primary Industries Ministerial Council
Approved citation: Animal Health Australia (2009). Response policy briefs (Version 3.3). Australian Veterinary Emergency Plan (AUSVETPLAN), Edition 3, Primary Industries Ministerial Council, Canberra, ACT.
The publishers give no warranty that the information contained in AUSVETPLAN is correct or complete and shall not be liable for any loss howsoever caused, whether due to negligence or other circumstances, arising from use of or reliance on this code.
These response policy briefs for the control and eradication of emergency animal diseases (EADs) not otherwise covered by AUSVETPLAN disease strategies are an integral part of the Australian Veterinary Emergency Plan, or AUSVETPLAN (Edition 3). AUSVETPLAN structures and functions are described in the AUSVETPLAN Summary Document.
This manual sets out the disease control principles that have been approved by the Primary Industries Ministerial Council (PIMC) out-of-session on 15 June 2006 for use in an animal health emergency caused by the occurrence in Australia of any of the diseases covered by this manual.
Diseases that are listed by the OIE (World Organisation for Animal Health) are diseases with the potential for international spread, significant mortality or morbidity within the susceptible species and/or potential for zoonotic spread to humans.1 The principles contained in this document for the control of such EADs conform with the OIE Terrestrial Animal Health Code where appropriate.2
In this manual, the placing of text in square brackets [xxx] indicates that that aspect of the manual remains contentious or is under development; such text is not part of the official manual. The issues will be worked on by experts and relevant text included at a future date.( Response policy briefs (Version 3.3)3)
Filename: RPB3.3-05FINAL(27Jul11).doc)
--------------------------------------------------------------------------------------------------------------------------------------
Australia’s policy for Hendra virus infection
Hendra virus infection is not an OIE-listed disease. The disease has proven to be only mildly contagious outside its natural hosts. Relapse and serious infection in clinically recovered or partially recovered horses can occur.
The policy is to eradicate Hendra virus infecion in terrestrial animals using:
•destruction and sanitary disposal of all horses or other terrestrial animals shown, through demonstration of antibodies, to be infected; •disinfection of the immediate contaminated environment; and
•quarantine of all in-contact animals until repeated serological tests have proven freedom.
These strategies will be supported by:
•tracing and limited surveillance to determine the source and extent of infection and to provide proof of freedom from the disease; and
•a public awareness campaign to encourage cooperation from industry and the public.
Hendra virus is currently included as a Category 2 disease in the EAD Response Agreement. The costs of disease control would be shared 80% by governments and 20% by the relevant industries.
----------------------------------------------------------------------------------------------------------------------------------------
Response policy briefs (Version 3.3)
43 AUSVETPLAN Edition 3
----------------------------------------------------------------------------------------------------------------------------------------
The statement "destruction and sanitary disposal of all horses or other terrestrial animals shown, through demonstration of antibodies, to be infected; " in the box titled Australia’s policy for Hendra Virus Infection needs to be deleted from the document. Also the word can should probably be changed to may in the first paragraph! The whole policy statement needs to be re edited!
The following was my statement on this policy in "What don’t you understand about snorting horses, Mr. Vet"………
" This ‘policy’ for Hendra virus is internally contradictory, unethical, Inhibits actual research towards successful treatments, causes vets to violate their duty of care to both their clients and their animals, has an impossible aim, implies the destruction of a protected native animal to achieve that aim and in reality, does nothing to achieve any result at all! It certainly has made no difference to the outcomes of any of the incidents so far. In fact, as the horse owners’ community becomes aware of this plan and its implications, there will be an understandable reluctance to involve any vets or DPI&F biosecurity in any suspected Hendra incident."
I also commented that"Since when was it appropriate to kill the recovered victims of a disease rather than cure the ones that did not?" and " It is quite a presumption to go from demonstrated response giving resistance, to implication of continued infection."
In further confirmation of the absurdity of this "policy" statement is the fact that researchers recently announced the discovery of a new Hendra type virus called "Cedar" Virus which was "different" because animals exposed to it, seroconverted (produced antibodies!) without clinical illness. That's exactly what dogs and some horses have done after exposure to Hendra!
A response to Ron Glanville (CVO), DEEDI, Qld.
Thanks for your prompt email response on September 10 2009, to my second draft discussion paper "What don't you understand about snorting horses, Mr. Vet?" published on 14 August 2009. Many of my responses to your email were drafted soon after receiving your response, but continuing events and my continuing research of issues raised, has delayed completion of my reply.
Contracting Ross River Fever in April 2011 meant that I was mostly a passive observer to the latest season of transmission events, although I did record some flying fox feeding behavior on my property that is directly relevant to the transmission scenario, as I understand it. These observations and others, lead to confirmation and further elucidation of my original analysis.
I also have a new contact email address and if any recipients' addresses have changed, I would hope that this would be forwarded on [to any interested party!]
I have been reviewing and re-evaluating some of the significant issues that I previously identified. These include details and implications on bat spat/splats and the transmission scenario, human health review concerns, euthanasia of healthy HeV antibody positive horses (and dogs), and the issues and questions concerning development of an antiserum (Gamma globulin).
I am still adding to my knowledge and understanding, and continue to review the current literature on the issues as well as conducting my own research, particularly on Flying fox feeding behaviors and their relevance to the novel transmission of Hendra virus to horses. There are some issues where I can clarify or quantify some essential aspects of the transmission scenario. There are other issues where serious questions, regarding appropriate behaviors, remain!
Subsequent to my initial enquiries about the report from Queensland Health, that was supposed to be produced after the Redlands incident, I have received a reply from Queensland Health referring me to their so-called "review" after the Redlands incident. The "debrief" can be found at http://www.health.qld.gov.au/ph/documents/cdb/hendradebrief.pdf
I was quite appalled at this "review" and QH's role in this issue, especially as Biosecurity refer to ' human health authorities' as an excuse for the current so called National Hendra Virus Policy. One major problem with the review, is that, in the list of issues and actions in this document, There is no mention of the fact that there is no current therapy for a Hendra case, either for horses or humans, and that there is an urgent need to develop one, as the likelihood of another transmission scenario is quite high,
The actual transmission of HeV to a horse is rare and indeed novel, but quite explainable and predictable. Unfortunately, the likelihood of further transmission to either other horses or humans in close contact with an infected horse is quite high, and likely to be fatal!
The possibility that surviving healthy horses, that were euthanized, could have been a source of antiserum, which could be a possible immediate therapy for a person suffering the effects of Hendra virus was not discussed. The possibility of other therapeutics, and a mechanism to investigate and advise of these possibilities was also not discussed.
An antiserum would still appear to be the most appropriate therapy to develop for a sufferer, even if a vaccine was developed and available. (For humans or horses). The monoclonal antibody therapy developed by A.A.H.L. is not a suitable treatment for a person already suffering the effects of Hendra virus. In fact, there was no discussion in the Queensland Health document, of patient management and the current lack of effective therapy, who was responsible for addressing that deficit, and how that goal might be achieved. It seems to be mostly concerned with managing publicity surrounding an incident!
It is not only Q.H. that is failing to comprehend that Hendra virus infection, although rare, will predictably continue, and developing an effective treatment should be an immediate priority. The following "reported strategy" by the AVA, I found quite disturbing! ---
Friday 21st May, 2010
Cobb Again Calls on Labor to Fund Hendra Virus Vaccine Trials
The Shadow Minister for Agriculture, John Cobb has called on the Rudd Government to immediately provide $600,000 to ensure a trial into a vaccine for horses to protect them from the deadly Hendra virus can proceed as planned in the second half of this year.............
"Mr Cobb said the AVA has stated the best strategy to prevent infection in humans is by the use of a safe, effective vaccine in animals rather than to try to treat this deadly virus once a person is infected."
I found the "rather than to try to treat this deadly virus..." part of the strategy, most disturbing!! The only thing that we know for sure is that you can get Hendra from an infected horse, which may be asymptomatic, and once the disease manifests, it has a high mortality rate because there is no effective therapy.
Surely, it follows, that the need for an effective therapy would be at the top of the list of issues and actions, not somehow relegated to the "rather than to try" and "leave the problem to Dept. of Primary Industries, Biosecurity", category of inaction!
I would have thought all concerned about Hendra virus infections would identify the paramount urgent need for an effective therapy in the case of a symptomatic Hendra infection in a human?
I continue to be disturbed by the reactions of a few ignorant persons in positions of power or authority, mostly politicians, fruit growers and horse industry persons, who are using the issue with other motives, or are still suffering from the illusion that something can, or should, be done about the Flying-foxes, and that they are going to remedy the situation! The idea that the issue can be "fixed" by dealing with the Flying-foxes has its origins in the "so called" National Ausvet Plan for Hendra Virus" which can be found in a little box in an AUSVETPLAN document. Some of the content in this box needs to be deleted as inappropriate, and a lot of bad things will go away, just like closing Pandora's box!
There continues to be a stream of ill informed comments. For Example, Bob Katter's comments about the "Deadly Flying-foxes", which should have been a reference to "Deadly Horses"! Member for Burnett, Rob Messenger was reported in the Fraser Coast Chronicle 11th December 2010, under the heading –"MP wants to kill sick Bats", as saying " "Any colonies of Flying foxes carrying the Hendra virus in Bundaberg would be wiped out, according to a plan by Member for Burnett Rob Messenger. Mr. Messenger yesterday called on both the government and the LNP to commit to a public health policy of destroying Flying fox colonies in urban areas, if they were found to be carrying deadly diseases." The newspaper heading, and the proposed "plan" are contradictory, counterproductive and have agendas’ that have little to do with Hendra Virus concerns! Rob Messenger is dangerously ill informed on Hendra Virus issues, as is Bob Katter.
Biosecurity advice needs to continue to clearly indicate, that any attempt to destroy or relocate Flying-fox camps would be inappropriate due to the risk of stressing the Flying-foxes and increasing active virus in the population, which would simply increase the likelihood of a transmission event!
Queensland Health, Biosecurity and Department of Environment and Resource Management, conducted a recent "online forum". It was promoted as an "online Forum" where you can have your questions about Hendra Virus answered by Flying fox experts". It was, in reality, a totally non-interactive, pre primed affair with a scripted agenda based on pre submitted questions that revisited old and irrelevant issues and questions. Two biosecurity vets admitting they still didn’t understand the transmission scenario, one Bureaucrat from Queensland Health with little understanding of the issues but trying to manage the publicity surrounding the confusion and one bureaucrat from the Dept. of Environment and Resource Management, trying to manage the calls for bat culls etc. but also with little understanding of the relevant issues, did not make up a " panel of Flying fox experts"!
Unfortunately, misguided conclusions about what to do about Hendra Virus still predominate discussions about Hendra Virus, particularly amongst the horse owners community and vets, and these are driven to a great extent by biosecurity's own misguided speculative conclusions, compounded by a continuation of media propagation of myths, misunderstanding and sensational speculation!!
There are still a number of speculations regarding possible transmission scenarios that do not sit well with the known facts about Hendra virus.
Also, based on these speculations, further misguided conclusions about what to do to minimize Hendra virus transmission. These are unreliable, unproven speculations based on no known science, but are fuelled by the very real fear of the possibility of transmission and the desire to minimize those possibilities. Unfortunately Biosecurity bureaucrats and scientists have continued to assert that they do not know what the transmission scenario is, but then go on to make speculative conclusions about possible [but actually quite unlikely] transmission routes, and how to avoid them.
My analysis of the facts, clearly leads to the conclusion that it is an infected "spat" produced by a [virus active] flying fox, and snorted up a horses nose, that is the only likely transmission scenario.
A "spat" is only produced when Flying foxes are feeding on certain high juice, high fiber fruits, as well as less favored food, such as leaves and high fiber, sometimes unripe, fruit. The "spat" produced can have an integrity which enhances its infective potential. If the spat is discharged at low altitude, it is more likely to remain in one piece and remain infective for longer. Little Red Flying–foxes particularly utilize food sources very close to the ground!
Note the "bat spat" photo at the end of this doc. It is broken although it has fallen less than two meters, from the Acerola Cherry bush where the bat was feeding!
It follows that this transmission scenario will happen with the highest degree of probability in an open, well grazed paddock, where a flying-fox might be traversing at a low altitude between food sources, or where there are, close to the ground, food sources near by, that are spat producing.
It also follows that a well grassed and treed paddock, with a healthy, non virus active population [as most Flying-foxes are!] of Flying-foxes feeding on nectar and pollen, or fruits such as figs (which are consumed and do not produce spats) will have a lower probably of a transmission scenario and be a relatively safe place for a horse, even if an infected spat is present! High trees used by Flying foxes for feeding or roosting are also unlikely to produce an infective spat, as the spat is more likely to break up on impact, which will reduce it's infective potential! The present advice by the Primary Industry, Biosecurity, Horse Owners associations, Vets, etc. regarding clearing trees, particularly Figs, keeping horses away from bats, moving feed and water troughs away from trees, etc. is just poor biosecurity advice based on wrong thinking assumptions. Some of these measures will essentially enhance the most likely scenario and predictably lead to more, rather than less, transmission events!
Because of the behavior of Flying foxes in the winter 2011 season, it was predictable that the likelihood of an increase in transmission events in S.E. Queensland would occur. After severe cyclones in the north there were far greater numbers of (nutritionally stressed) Little Red Flying Foxes in S.E. Qld. And northern NSW, and there were breeding females far further south that is usual!
Please see below for my comments on your email. I have used the rich text 'bold type' option to distinguish my responses from your comments..........
----- Original Message ----
From: "Glanville, Ron" <Ron.Glanville@deedi.qld.gov.au>
Sent: Thursday, September 10, 2009 7:49 AM
Subject: RE: Hendra Virus discussion paper update.
Lee,
Thank you for forwarding the second draft of your paper.
I agree with some of your comments, particularly about routine use of
protective equipment (masks) and that we should be managing hendra cases
as routine events.
However there are many statements in the paper that I disagree with, and
I comment on some of these below. I believe many of your statements are
not supported by the published scientific literature or unpublished
reports. Peer review of scientific findings is a cornerstone of
maintaining rigour within the scientific community, and the scientific
work undertaken by Australian scientists on Hendra virus has been
acknowledged internationally. However you do propose ideas that
warrant further scientific investigation (eg "splats").
My statements were all based on published literature and my analysis of it! There has been some excellent work done, particularly by A.A.H.L. on Hendra Virus. I have again recently reviewed the scientific literature and find further confirmation of my analysis. Also you do not peer review the unpublished reports, departmental meetings, emails and other departmental communications that drive bureaucratic actions. In fact, most departments maintain privacy and confidentiality provisions for their staff that usually only protect the opinionated from critical analysis of their own opinions. This tendency for bureaucrats not to publish reports but to keep them secret contributes to the general confusion. Adding to this confusion are "Fact Sheets" produced with no author and a disclaimer, which says that the contents should not be relied upon! This is the most relevant fact on some fact sheets, which are full of misunderstandings and false conclusions. This is the case for information on Hendra Virus by Biosecurity, Queensland health and the Queensland Horse Council.
The Australian Museum Complete Book of Australian Mammals refers to the ridged palate and associated feeding behavior of Flying foxes. It is important to understand that this mode of feeding and the modified palate in these herbivores with a short digestive tract is basic Flying-fox survival biology. I am now aware of some literature referring to "bat spats" and photo’s of "spats". I will attach one of my own photos of a probable "bat spat"(published on the home page of this blog!). "Bat spats" have also been described as "Rejecta Pellets" but the term "spat" is a useful description of the product. My reference to bat 'splats' was a description of what one type of "spat" did when it hit the ground!
It is important to understand that a "spat" is made up of small chewed up particles of fiber that have been compressed by the tongue and palate, into a pellet.
These pellets can have some integrity when spat out. This enhances the possibility of sustaining live virus [present in epithelial cell syncytia that have been shed by an infected Flying–fox], which has contaminated the spat.
It is only infectious fiber from a spat that could be snorted up a horses nose and onto the exposed epithelium of the respiratory system that is the only likely route of infection.
Flying-foxes are reported as 'eating' leaves as well as fruit. I have been informed that local Flying-foxes are stripping the leaves from Albizzia leucosternum, a [non native] tree found here in Hervey Bay. They produce a cigar shaped ‘spat’, which remains in one piece, even when discarded away from the tree. A 'spat' of this type would have the potential to remain infective for a longer period of time!
My Hypothesis on bat "spats" and snorting horses is just that, a hypothesis. I am an ecologist, not a vet or a virus researcher. Deductive hypotheses are based on observation and scientific evidence. You do not prove deductive hypotheses by undertaking a scientific experiment! You can validify or discredit by observation or experiment but not prove or disprove! This is science. Your beliefs/opinions do not represent the mechanisms, or art, of pure science but the mechanistics of applied science [Appropriate for a vet, but not an ecologist!] I draw your attention to a case of Tb transfer between cattle and possums, referred to by Nigel Perkins at a HeV transmission workshop. The transfer mechanism is quite irrelevant to HeV transmission, the relevance is, that the 'mystery' was solved by a hypothesis linking the observed behavior of sick possums with the observed behavior of livestock. The hypothesis was validated by observations of the linking scenario using infra red camera.[Beautiful pure science! and no need for peer review!]
Peer review is not about saying nice things about each other, it’s about critical analysis of research results and conclusions, and it is certainly not just relevant to journal articles. My paper is a critical analysis of some current HeV issues. I expect it to be critically analyzed by others, that is what science is all about!
There are number of considerations that continue to support maintenance
of the national policy for the euthanasia of serologically positive
horses:
I am not denying the validity of any concerns regarding recrudescence, It would not be appropriate for sero positive horses to be sold, moved freely around, or exported, at least until a time when it can be shown that sero positive horses have not only recovered, but are free of the virus. Constraints on them would be perfectly reasonable and appropriate. However the [well informed] owner should be the one to make the decision, and be responsible for implementing a safe handling and testing protocol, if taking responsibility for a live sero positive horse. The horse industry/ biosecurity/ health department should be paying any owner of a sero positive horse to be part of a blood donor program to try to produce an antiserum [for humans and horses!] from these horses. I can understand that when the welfare of others, or other horses, is involved, the prudent decision by the owner, may well be to euthanasia the horse.
However, If I thought my horse had Hendra virus I would not let a vet anywhere near it! What could they do except kill the horse or themselves? I might not be the only one thinking this way. No one has yet disputed my assertion that a healthy sero positive horse would be the obvious source of an effective antiserum in reasonable quantity. I understand that horses were used by the Commonwealth Serum Laboratories to produce snakebite anti venom. Why not use horses to produce a Hendra Antiserum? With my current knowledge of Hendra virus, I believe that, unless my assertions are demonstrated to be wrong thinking, that a healthy sero positive horse should not be put down! I would be very interested to hear from anyone who has considered this approach but disputes my conclusion!
* Recrudescence of infection has been known to occur with Hendra virus
(the 1995 human case - infected 12 months previously).
Is this recrudescence, since the original infection apparently produced only slight symptoms and obviously did not generate an effective immune response? It may imply a seasonal/cyclic behavior of the virus! Recrudescence of this virus, if it occurs, may not be like the re emergence of, for example, the malaria parasite which can lodge in tissue away from therapeutics, or the chicken pox virus which apparently can lodge in the nervous system, later re emerging as shingles. It maybe simply present at low levels due to an inadequate immune response. Further knowledge of how Hendra and Nipah virus behaves in bats as well as humans, and whether recrudescence or lingering infections occurs in bats, humans, and horses, is very important!
* This is known to occur in 10 percent of Nipah virus cases
Is it 'true' recrudescence, an inadequate primary response, cyclic or lingering infection? Is it recrudescence or lingering infection of Nipah that is occurring in pigs? The fever after a few days in horses suggests a 'general ' immune system response to viral invasion; the second stage of infection suggests that this is inadequate.
Testing pigs for susceptibility to HeV would be highly relevant if you are comparing Nipah and Hendra.[ I believe that this has now been done!] A relevant observation in this regard is that wild pigs routinely scavenge in Flying-fox colonies from Wide Bay north. If pigs were particularly susceptible, we would probably already see the evidence in wild pigs! Natural mortality in a large Flying-fox camp provides a significant resource to scavengers. In the incident mentioned in my paper, the reason we were in a rather inappropriate position in a large Flying-fox camp was because we were tracking wild dogs [from their vocalizations] within the camp. Also Peter Lusk, the ranger, told me that wild pigs were present periodically in this camp.
Incidentally, comparing Hendra and Nipah may be as inappropriate, in a practical sense, as comparing Lyssa and Rabies.
* Virus particles have been detected in serologically positive horses at
least 6 weeks post infection.
These were not recovered horses, but horses whose immune system had responded to the virus. This only indicates that the immune response has not yet fully dealt with the virus in these horses, maybe those horses with persistent infection never fully recover, maybe those horses that produced antibodies without symptoms of the disease have fully recovered.? You have not isolated virus from any horses that were antibody positive without disease! We will not know the answers to these questions until these 'survivors' are monitored long term!
* While I agree that we don't know for sure that this will occur with
horses, on balance scientific opinion is that the possibility is high.
* Human health authority advice was that human health considerations
were paramount and on the basis of human health risks, that horses with
evidence of the virus should be euthanized. This policy was carefully
reviewed and endorsed by the Consultative Committee for Emergency Animal
Diseases (CCEAD), and incorporated into AUSVETPLAN. CCEAD is made up of
the Chief Veterinary Officers of the Commonwealth, States and
Territories.
I think I have clearly expressed my opinion [and exactly why I have this opinion!] of the so-called AUSVET plan for Hendra Virus. This plan was based on false premises, (an exotic, epidemic organism rather than an endemic with a novel transmission potential). Is it a policy or a plan? Either way, it's a dud with profound unintended consequences and inappropriate implications.
I can now compare this observation with the fact that there is now an Ausvet Plan for Lyssa Virus titled
"AUSTRALIAN VETERINARY EMERGENCY PLAN, AUSVETPLAN, Disease Strategy, Australian bat lyssavirus Version 3.0, 2009." This is a reasoned document, which addresses concerns raised in my paper. I would expect to see a similar document for Hendra Virus. Where is this document? Who gave this human health authority advice?
It seems clear that "Human health authority" persons don’t have a plan [or a clue about the real issues!]. They seem to have missed the point entirely when it comes to the potential value of these horses for antiserum production! They certainly are not in possession of any special knowledge. If this so called AUSVET plan was implemented in a country like China we would not only see euthanasia of horses but mass culling of bats, chopping down of trees, and possibly euthanasia of sero positive humans [for the common good!]. We are not in China and should not be creating and implementing autocratic policies based on no particular science, and where those policies are counterproductive!
* This policy is also supported by horse industry organizations.
But not necessarily for the same, or any valid reasons [i.e. perceived threats to the export trade.] Some of the published reasons don't stand up to logical analysis. Testing and appropriate quarantine should protect against any Hendra fears! On the other hand, none of the reassurances with regard to the safety of humans or other horses, when there is an aggregation of horses, are appropriate.
I would also add that useful scientific advice has been gained from the
autopsies of these horses, probably more than could be gained from
ongoing observation of them.
And you did not even have to pay for the horses, cheap compared to doing an experiment at AAHL. I accept that you will gain useful information from autopsy, but I do not accept that the information gained from long-term observation is any less crucial. It is not a theoretical exercise. If there are natural survivors then the questions about recrudescence and when, why and how this might occur are crucial. It has been observed that most of the horses involved are thoroughbred. The direct relevance may only be that they have large lungs [big sorters!], are well fed, and on well-grazed pasture where they can snort up a bat spat. In future, you may be faced with destroying an extremely valuable horse, capable of producing or siring valuable offspring, even with the possible risk of recrudescence. The possibility that these survivors could also be producing antiserum that could be used as a therapeutic for humans, as well as horses, is also highly relevant [As is the possibility of a genetic disposition to resistance to HeV, which is what the bats have developed!].
It seems apparent that a vaccine would not be an appropriate therapeutic in any of the human transfer events that have occurred. The relevant comparison is the use of rabies antiserum for the symptoms of a rabies infection when it is too late to administer a vaccine! The human health authorities do not seem to have thought through the necessity of urgently producing a therapeutic that could be used in these scenarios that are likely to continue to occur!
I believe that it is relevant to observe that the facility that should have been working [urgently] to produce an antiserum, The Commonwealth Serum Laboratory, has been sold to private enterprise [now, reportedly, one of the most value added stocks on the market]! Unfortunately there is no profit in producing antiserum for a few victims, and they have no current brief to produce an antiserum. in fact, now that they are private enterprise, they have no research brief at all! It's a good thing that they produced Tiapan antivenin when they had a mandate that was not profit driven, because it was never going to be making anyone a profit, and neither should making hendra antiserum (that’s why we had a Commonwealth Serum Laboratory originally!) There are some political and bureaucratic policy decisions about this sale that need examination here but that’s another whole different issue! So we now have Animal Health workers working on a critical human health problem [And being financed by the USA Dept. of Defence for the most relevant research!]
With regard to the following words:
"This review, and other Hendra virus information on Queensland Health
and D.P.I&F web sites, which I have recently reviewed, have led me to
conclude that bureaucrats [biosecurity?] responsible for managing Hendra
virus outbreaks have failed to understand the critical issues [which
includes what we do now know about Hendra virus and conclusions based on
that knowledge] and have proceeded and continued with inappropriate
policies, legislation, and actions. This has led to more fatal outcomes,
and is likely to lead to events with further predictable fatalities of
persons handling horses as well as transmission between horses,
particularly in stables, and resulting multiple mortalities of horses."
I do not agree with your conclusion. The information on our web site is
consistent with the latest scientific information on Hendra virus.
While the mechanism of bat to horse transmission is still not clear,
practical measures that can be taken by horse owners and veterinarians
are available. Biosecurity Queensland has a long history of researching
hendra virus in collaboration with national and international
organisations and is internationally recognised in this regard. BQ has
recently reviewed the research work that is most likely to assist in the
prevention of future horse and human cases of Hendra virus infection.
My conclusion was exactly what happened in now multiple incidents, and it's still happening, complete with the inappropriate media references to urine, feed and water troughs, flowering trees, etc. that are completely irrelevant to the transmission scenario!!
Stating that the mechanism by which HeV is transferred to horses from bats is still not clear, is not very helpful 'scientific information'. Adding 'possible' transmission routes [that are mentioned in BQ, Horse Council and Queensland Health web pages], that do not include the only one that even hints at a likely transmission scenario, is also not based on any 'scientific information'. Your practical measures, like moving feed and water away from trees, presupposes that your speculative conclusions regarding bat to horse transmission are correct! But, they are not! According to scientists, no virus found in bat excreta and only very low levels or antibodies in urine! More importantly, no obvious mechanism has been suggested for the transfer from the 'possibly' infected urine, excreta, or fallen fruit to a horse.
Deborah Middleton has stated "Incidentally, I agree with your hypothesis on the "snorting" behaviour of horses. I, too, believe this is a likely way that the virus accesses the horses respiratory system."
All the suggested health precautions will not save you [or your other horse] from being 'snorted' and infected, unless you are wearing a mask! I was appalled by one recent TV documentary on the Hendra issue that demonstrated a vet in "appropriate" protective gear, looking like a space man, but the horse handler controlling the horse for the vet, and of course standing in the direct "snort" zone was not wearing any protection at all, demonstrating [and fortunately, it was only a demonstration!] a total lack of understanding of the very real and deadly Hendra virus transmission scenario between horses and humans.
My analytical opinion is that the critical behavioral keys in the transmission scenario are snorting horses and bat spat production and none of the information on your web site refers to either! And to make matters worse the Queensland Horse Council, has taken the most debatable of your conclusions and produced a website which is full of conclusions and recommendations that are exactly wrong thinking and will predictably lead to further transmission events by enhancing and recreating the very scenarios responsible for past transmission events! The fact that it has mostly been, well bred and looked after, but paddocked horses that have succumbed to Hendra, is not coincidental. It is predictable that a well-fed, curious thoroughbred in a cleared, well-grazed paddock, is going to find a bat spat [which will have an attractive odor] and snort it up it’s nose, with a far greater probability than a horse in a bush paddock! An infected bat spat is more likely to be produced if the bat is hungry and stressed and feeding on certain, low to the ground, food sources near open pasture lands. Flying-foxes retain food pulp in their mouth for varying times and often fly low, particularly over open paddocks. An infected bat spat, in a paddock where there are lots of trees and healthy bats producing non infected spats, or a paddock where the grass is long, is far less likely to result in a transmission scenario than an isolated spat in an open paddock.
It is important to remember that bats in flowering trees are usually not producing spats and neither are bats feeding on fruit such as figs! It is only certain leaves and fibrous fruit including juicy fruit such as apples where Flying-foxes harvest the juice with their ridged palate and eventually discard the fiber pulp left as a "spat". Spats are rarely found at all near possible spat producers, such as very ripe grapefruit (recent personal observation). Recent personal observations lead me to conclude that fruit or leaf pulp is retained in flight for processing while the individual is seeking other food sources or transiting to another known food source. There is literally no predictability in where spats will be found, but it is predictable that horses out at night or early morning on a well-grazed paddock will find a spat with a higher degree of success than in any other circumstance.
Your suggestions about investigating "splats" will be included in this
mix. I have a question here though - do you have any direct evidence of
horses snorting or chewing splats?
Chewing or eating "bat spats" [or faeces, urine or discarded fruit!] is irrelevant to the transmission scenario! [AAHL have fairly clearly demonstrated that ingestion is not a transmission route!] I have observed the stuff that is snorted/sniffed up a horses nose! There is a simple observational experiment [that does not involve bats!] to test bat spat, horse snorting behavior.... basically, chew (a potential candidate like an orange or apple) suck out all juices, and deposit a compressed ‘wad’ [which is what a spat is] on bare ground in front of your horse! A few people need to get back to me about this "test"!
You don't have any direct evidence, very little [if any] supporting evidence, and a lot of directly contradictory evidence, for any of the suggested alternatives!
Regarding your conclusion that Hendra in bats is an STD, we've long been
aware of an apparent association between HeV status and 'reproductive'
status in female bats, and we continue to explore the strength and
nature of this apparent association with an open mind and in a
scientific way, rather than jump to conclusions.
Deb Middleton picked up on this in my first draft and I was particular with my choice of words in the second draft. Your statement of "awareness" is not exactly accurate! Discovery of the female with twin [unusual!] aborted fetuses that were all Hendra positive, that confirmed the presence of Hendra in bats, and lead to the conclusion of an apparent association with reproductive status, was pure serendipity. I understand that she aborted the fetuses because she was hung up on a barbed wire fence, nothing to do with the Hendra virus! Carrying twin fetuses would be stressful! The only conclusion [apart from confirming the presence of Hendra in bats] that can be made from this event is that a female bat can transmit the virus to its fetus, and that is exactly what a "congenital" STD does! STD’s are also transmitted by intimate contact, not just during coitus. Read my statement again. I am not jumping to any conclusions, it’s the epidemiologists that have been jumping to conclusions (like a rain of deadly birthing products, infected urine or faeces) and most of them are wrong! Their conclusions are not supported by the facts at all!
The recent absurd and sensational media claims that 60 or 70 percent of "bat poo" or flying-fox urine is infected by Hendra Virus and therefore the bats are threatening the health of all of us, is completely untrue, but given credibility by the media spectacle of the sight of your epidemiologists gathering samples around Flying fox camps, while wearing high security biohazard suits that scare the crap out of most people, then reporting that the urine shows the presence of Hendra virus but not mentioning that this is an antibody test and that extensive testing has failed to yield evidence of live virus at all in either urine or faeces! (Finding live virus on a urethral swab does not lead to a conclusion that the mode of transmission is through the urine!)
With regard to the following words: "If the transmission route were less
'intimate', then Hendra virus would be more infective than it apparently
is. "; your meaning is not clear, however I would point out that fruit
bat populations commonly have sero-prevalence for hendra as high as 70
percent, so it obviously does spread easily within populations.
Yes and so do some STD's! Especially in highly sexual polygamous social animals like Flying-foxes and humans! Of course we are all concerned about the transmission route, the fact is, that it is horses, vets and horse handlers that are being infected, not bat watchers, bat carers, tourists walking under bat colonies or students in schools near bat colonies etc.etc. Other researchers share my conclusion! [Halpin,Young,Field and Mackenzie]have stated that-"If the route of excretion made the virus more readily accessible (for example, in urine or faeces) one would expect an increased chance of exposure by susceptible hosts and hence an increase in the number of spillover infections and cases." which is exactly the point I was making!
Your conclusions about droplet transmission in a stable environment,
while making sense, do not fit with the observed data during last year's
hendra case at Redlands. In that event there were horses in stalls
adjoining infected horses, with only wire mesh between them at
"snorting" height, yet they never became infected. While I wouldn't
discount some horse to horse transmission, the pattern was better
explained by mechanical/assisted transmission.
In the Redlands case, I gleaned more understanding and confirmation of the likely bat and horse transmission routes, by listening to a TV interview with the owner of the Redlands Clinic, than from the Perkins review!
I understand that the Hendra stable was a stable of active working horses and transmission to a large number of horses took place! The Proserpine case shows evidence indicating an initial spat transmission, and subsequent, in paddock transmission, between horses, and in the Carrawal incident also there was also paddock transmission, and the evidence is still adding up.
If AAHL placed a set of facing exercise treadmills for horses in their transmission experiments I predict a transmission outcome from "snorting horses" with a very high probability!
Your comments on the last page about transmission terminology are unclear.
What is unclear to me is what do terms like "excreted into the air" and the" shedding of the virus" mean or imply? Carbon Dioxide is excreted into the air; we do 'shed' epithelial cells, but viruses? It is this 'terminology' that is unclear! [Compared to stating, for example, -The virus is known to be present in nasal mucus and saliva in shed epithelial cell syncytia, can be expelled from the horse when it snorts, and infected mucus 'droplets' can deposit on the respiratory system epithelium of other horses or humans. This is a descriptive statement of probabilities, a working hypothesis! Incidentally some papers refer to "fomites" without actually defining them, although maybe vets know what fomites are, the rest of us don’t!
Your comments about which Act we use to implement control measures is
not really relevant to the issue. In fact in the most recent event, the
Stock Act was used, but the policy was the same. We should be debating
disease control policy not what legislation we use. This is only a
mechanism to implement the policy.
This is exactly relevant to the issues of compulsory euthanasia and possible bat culling, and where there is a real danger of bureaucratic bastardy. I believe that I have blown the whistle on the inappropriateness of this act and the so-called Ausvet policy, fairly explicitly. What don't you understand about my analysis? If you use acts of Law that are illegitimate in application or interpretation, it’s Bastardly! As to debating disease control policy, I believe that I have made a reasonable start in pointing out the completely inappropriate 'eradication' AUSVET plan for Hendra virus! The probability is that a control policy is not even relevant! [We don't have a "control policy" to prevent snakebite, falling trees or Tetanus, sometimes bad things just happen, and sometimes they can be minimized!] The reality is that horses, vets and horse people are dying of this virus and all the carefully considered reviews of the scientific evidence have done nothing to save any of them. You can keep blaming vets for not using PPE(and that's appropriate!) until a horse handler is infected, then your "human health authorities" can explain to the victim why they have no antiserum or other therapy, to try to save them with! I believe this possibility was all too likely in some recent incidents!
In relation to compensation, your interpretation of the Exotic Diseases
in Animals Act is incorrect. No compensation is applicable in this
situation. The compensation is only applicable when an outbreak is
officially declared by the Minister. This did not occur and was not
envisaged for this sort of situation. Under the Stock Act, there is no
compensation payable for infected animals.
Actually I did interpret it correctly, I was just hoping I was wrong! My motive was to draw attention to this act and its inequities. It’s not just that compensation was "not envisaged for this sort of situation". It is precisely that the Exotic Diseases in Animals Act is inappropriate to invoke at all, in this sort of situation [The Stock Act may be inappropriate as well!? I was not wrong with my other conclusions about the inappropriateness of including Hendra virus in this act in the first place, or the complete inappropriateness of the so-called AUSVET plan for Hendra!
There is no contemplation of policy to destroy fruit bats from the
Queensland Government, in fact the government has strongly rejected
these suggestions
This is not at all reassuring, and we are not just talking about Queensland [see my comments above, about inappropriate politicians' plans]. Destruction of bats is implied in the so-called Ausvet Plan for Hendra Virus. This implication continues to be exploited by some. In the same TV program where you made a perfectly reasonable comment about wearing mask, gloves etc. and Hume Field was saying that the bats were ecologically important etc., an opposition member of parliament was being a political ignorant bastard and talking about "moving the bats on" etc. etc. Our bureaucracy and its processes, is supposed to protect us from ill informed politicians acting on their opinions. Unfortunately it does not always work well! Presently (late 2011) we have a potential future premier demonstrating his complete lack of understanding of the issues and proclaiming that the bats will be driven out of towns with helicopters and smoke bombs!! Well, that is NEVER GOING TO HAPPEN!! And biosecurity concerns are not going to be used by some people in Gayndar or anywhere else to justify relocating bats. You need to get this message out there!
Our local member was the Minister for Sustainability and the Environment, and he did help increase protective measures for bats. Unfortunately for Andrew, his political masters would not let him say anything about the unsustainability of the Traviston Crossing Dam. He had to talk about really important issues like the conservation of shopping trolleys! He was voted out at the last election. The Traviston Crossing Environmental Impact Statement, with no author, compiled by dam stupid engineers, conclusions that do not fit with the scientific evidence presented, and no actual environmental impact appropriately documented, was a classic example of bureaucratic bastardies aligning with political agenda. Sometimes we can rely on legislation and the law to protect the environment and us. Rarely can we rely on politicians with flawed agendas. It is quite inappropriate for the horse owners or Fruit Growers communities to be talking about "doing something about the Flying-foxes" when appropriate non-lethal protection measures are available that address any real concerns.
Regarding the existance of sero-positive horses in the general
population, while this is certainly possible, a large survey of the
Queensland horse population was conducted following the 1994 event and
all were negative.
This is nonsense Do the math...11 primary transmissions in 16 years...if 70% mortality in horses..= Approximately 3 survivors in 16 years and one of these already dead of old age! With figures this predictably low you would have to test the entire population not just a few thousand horses! Also, on these figures, if there were a 10% chance of recrudescence you would only see one natural recrudescence event in about 48 years! [This is grade 10-probability mathematics not University level statistical analysis!] Of course, this recent winter of Hendra virus infections has increased the chances of their being a number of survivors!
I consider the following sentence in your paper inappropriate if you are
trying to get people to listen and cooperate with you:
"Put power tripping, bureaucratic bastards, with tunnel vision and their
inappropriate invoking and manipulating of legislative powers, on notice
to be named and shamed!"
Give me a couple of hours and I will provide you with plenty of personal experiences of bureaucratic bastardies, including in DPI&F! The recent " Hendra Virus Report" by the Queensland Ombudsman has over 400 pages of documented, inappropriate behavior by Queensland bureaucrats!! I have not called anyone in particular, a bureaucratic bastard [yet!] [Just some ignorant political bastards!]. I believe that some of the implications of the so called AUSVET plan for Hendra Virus, and the Exotic Diseases in Animals act, as implemented, amounts to bureaucratic bastardy [or what ever you would like to call it]. Read the Ombudsman's report! What do you call it when inappropriate procedures are followed because someone in a bureaucracy has created a procedure that does not align with the reality of the situation? I believe that CCEAD needs to carefully consider my objections re. This plan and Act to insure that there is not a continuation of calls from ill informed politicians and others to "implement" the plan and "kill the bats"! Now you have an antibody positive dog threatened with destruction, now destroyed! and totally stupid SPECULATIVE statements about "possible" behavior changes in the dog making it a danger! This is just like all the other sensational speculations about virus mutation, potential epidemics, etc. etc. No bastardy here, just bloody sensational stupidity exploited by an ill informed media. It's easy to frighten people into doing things, but not necessarily right!
I am one of those bureaucrats and I'm happy to debate current policies
at any time in a reasonable and constructive manner.
This is your job and why I’m communicating with you. I don't think you are being a bureaucratic bastard! But you are one of the Mr. Vets that I am being fairly blunt to, about you and your colleges’ tunnel vision re. HeV issues and the inappropriate consequences for Flying-fox Conservation as well as inappropriate strategies for dealing with HeV ! I am blunt, iconoclastic and opinionated when it comes to environmental issues or human life issues. I can live with that! There are no 'sides' to environmental or human life issues. We are all in the same boat. I hope that a reasonable, constructive debate continues!
Having disagreed with many of your arguments, I do strongly agree with
your most important recommendation - that about veterinary hygiene or
personal protective practices. We have been pushing this strongly with
the profession in conjunction with the AVA and it is pleasing to see
that the vet in the most recent case this week did use protective
equipment. So it is likely that the efforts of biosecurity personnel has
saved human lives. However in the end this comes down to individual
responsibility.
This is not just individual responsibility. We have a medical doctor at the moment on trial for manslaughter as a result of inappropriate personal hygiene. Failure of duty of care with regard to appropriate personal hygiene, resulting in your own death, is an avoidable tragedy, If misinformation or misunderstanding results in the death of other persons, or other animals, It is a legal and ethical issue [manslaughter or compensation?!] It’s not the vets that I am particularly worried about. By now they should have got the general message, although some continue to misunderstand the necessities! It’s the horse owners who are not wearing even basic respiratory protection handling a potentially infected horse, that are the real concern! They presently have no real understanding of the critical issues. You have Vets and Biosecurity personnel wearing "space suits" and can’t even tell horse owners that wearing (almost any type of) face protection when examining a horse (whether sick or apparently well) will significantly protect them from breathing in some infected mucus that a Hendra infected horse could snort on them! Of course that was the exact predictable concern during recent incidents
Regards
Ron
PS
And yes, there was extensive communication with the pig industry warning
them to take appropriate precautions to prevent pigs catching H1N1 from
people.
Thanks for this info. Did these precautions include specific instructions, e.g. wearing a mask? Sometimes warning people to take 'appropriate' precautions without spelling out exactly what those precautions should be, does not produce a desired outcome. In the case of HeV,in the past, I believe that there has been far too much emphasis on the possibility of 'mechanical' transfer and the need to wash your hands and wear gloves, and no particular emphasis on wearing masks to protect from being snorted! I have referred to surgical masks as worn by doctors and dentists because standard medical practice seems to be a good starting point!
I believe that it is about time that vet practice was aligned with standard medical practice and the Hendra issue provides good evidence from both a legal as well as a personal health perspective as to why this should be mandated. Vets are reported to be exiting equine medicine for other animals. This is all very well until a vet contracts, for example, the pneumonic form of Bubonic Plague from a pet rat, because vets are not applying the same standard of barrier protection, as other health workers, then the shit will really hit the fan!
Below is my bat spat photo, hardly a "Bats out of Hell" death scenario. I imagine a small child could find and stuff a spat up their nose, but the likelihood of death by meteorite strike would be greater!
I believe that with the recent release of a vaccine for horses, that the real risks of lethal hendra incidents will be downplayed and continue to be misunderstood, untill another lethal incident predictably occurs, and another round of inappropriate responses occurs.Considering the balance of probabilities, I would be far more likely to vaccinate my horse against Teatnus than Hendra Virus, but that's because I lost my only horse to teatnus and I am already cautious of snorting horses!
I will publish this paper on my blog "Megabat Matters" http://megabatmatters.blogspot.com.au/
(The original discussion paper "What don’t you understand about snorting horses, Mr. Vet?" is also published on this blog)
as well as sending to former correspondents and those responsible for publishing AUSVETPLAN. This can be forwarded to other interested persons and I welcome any feedback on the contents or issues.
Lee St.John Carter
77 Wheeley Road, Booral, Hervey Bay, 4655.
Email.. batwatcher1@hotmail.com
Draft published 21 December 2012.
•quarantine of all in-contact animals until repeated serological tests have proven freedom.
These strategies will be supported by:
•tracing and limited surveillance to determine the source and extent of infection and to provide proof of freedom from the disease; and
•a public awareness campaign to encourage cooperation from industry and the public.
Hendra virus is currently included as a Category 2 disease in the EAD Response Agreement. The costs of disease control would be shared 80% by governments and 20% by the relevant industries.
----------------------------------------------------------------------------------------------------------------------------------------
(above is the "Policy" which is in a Box in the document-Lee S Carter.)
Response policy briefs (Version 3.3)
43 AUSVETPLAN Edition 3
----------------------------------------------------------------------------------------------------------------------------------------
The statement "destruction and sanitary disposal of all horses or other terrestrial animals shown, through demonstration of antibodies, to be infected; " in the box titled Australia’s policy for Hendra Virus Infection needs to be deleted from the document. Also the word can should probably be changed to may in the first paragraph! The whole policy statement needs to be re edited!
The following was my statement on this policy in "What don’t you understand about snorting horses, Mr. Vet"………
" This ‘policy’ for Hendra virus is internally contradictory, unethical, Inhibits actual research towards successful treatments, causes vets to violate their duty of care to both their clients and their animals, has an impossible aim, implies the destruction of a protected native animal to achieve that aim and in reality, does nothing to achieve any result at all! It certainly has made no difference to the outcomes of any of the incidents so far. In fact, as the horse owners’ community becomes aware of this plan and its implications, there will be an understandable reluctance to involve any vets or DPI&F biosecurity in any suspected Hendra incident."
I also commented that"Since when was it appropriate to kill the recovered victims of a disease rather than cure the ones that did not?" and " It is quite a presumption to go from demonstrated response giving resistance, to implication of continued infection."
In further confirmation of the absurdity of this "policy" statement is the fact that researchers recently announced the discovery of a new Hendra type virus called "Cedar" Virus which was "different" because animals exposed to it, seroconverted (produced antibodies!) without clinical illness. That's exactly what dogs and some horses have done after exposure to Hendra!
A response to Ron Glanville (CVO), DEEDI, Qld.
Thanks for your prompt email response on September 10 2009, to my second draft discussion paper "What don't you understand about snorting horses, Mr. Vet?" published on 14 August 2009. Many of my responses to your email were drafted soon after receiving your response, but continuing events and my continuing research of issues raised, has delayed completion of my reply.
Contracting Ross River Fever in April 2011 meant that I was mostly a passive observer to the latest season of transmission events, although I did record some flying fox feeding behavior on my property that is directly relevant to the transmission scenario, as I understand it. These observations and others, lead to confirmation and further elucidation of my original analysis.
I also have a new contact email address and if any recipients' addresses have changed, I would hope that this would be forwarded on [to any interested party!]
I have been reviewing and re-evaluating some of the significant issues that I previously identified. These include details and implications on bat spat/splats and the transmission scenario, human health review concerns, euthanasia of healthy HeV antibody positive horses (and dogs), and the issues and questions concerning development of an antiserum (Gamma globulin).
I am still adding to my knowledge and understanding, and continue to review the current literature on the issues as well as conducting my own research, particularly on Flying fox feeding behaviors and their relevance to the novel transmission of Hendra virus to horses. There are some issues where I can clarify or quantify some essential aspects of the transmission scenario. There are other issues where serious questions, regarding appropriate behaviors, remain!
Subsequent to my initial enquiries about the report from Queensland Health, that was supposed to be produced after the Redlands incident, I have received a reply from Queensland Health referring me to their so-called "review" after the Redlands incident. The "debrief" can be found at http://www.health.qld.gov.au/ph/documents/cdb/hendradebrief.pdf
I was quite appalled at this "review" and QH's role in this issue, especially as Biosecurity refer to ' human health authorities' as an excuse for the current so called National Hendra Virus Policy. One major problem with the review, is that, in the list of issues and actions in this document, There is no mention of the fact that there is no current therapy for a Hendra case, either for horses or humans, and that there is an urgent need to develop one, as the likelihood of another transmission scenario is quite high,
The actual transmission of HeV to a horse is rare and indeed novel, but quite explainable and predictable. Unfortunately, the likelihood of further transmission to either other horses or humans in close contact with an infected horse is quite high, and likely to be fatal!
The possibility that surviving healthy horses, that were euthanized, could have been a source of antiserum, which could be a possible immediate therapy for a person suffering the effects of Hendra virus was not discussed. The possibility of other therapeutics, and a mechanism to investigate and advise of these possibilities was also not discussed.
An antiserum would still appear to be the most appropriate therapy to develop for a sufferer, even if a vaccine was developed and available. (For humans or horses). The monoclonal antibody therapy developed by A.A.H.L. is not a suitable treatment for a person already suffering the effects of Hendra virus. In fact, there was no discussion in the Queensland Health document, of patient management and the current lack of effective therapy, who was responsible for addressing that deficit, and how that goal might be achieved. It seems to be mostly concerned with managing publicity surrounding an incident!
It is not only Q.H. that is failing to comprehend that Hendra virus infection, although rare, will predictably continue, and developing an effective treatment should be an immediate priority. The following "reported strategy" by the AVA, I found quite disturbing! ---
Friday 21st May, 2010
Cobb Again Calls on Labor to Fund Hendra Virus Vaccine Trials
The Shadow Minister for Agriculture, John Cobb has called on the Rudd Government to immediately provide $600,000 to ensure a trial into a vaccine for horses to protect them from the deadly Hendra virus can proceed as planned in the second half of this year.............
"Mr Cobb said the AVA has stated the best strategy to prevent infection in humans is by the use of a safe, effective vaccine in animals rather than to try to treat this deadly virus once a person is infected."
I found the "rather than to try to treat this deadly virus..." part of the strategy, most disturbing!! The only thing that we know for sure is that you can get Hendra from an infected horse, which may be asymptomatic, and once the disease manifests, it has a high mortality rate because there is no effective therapy.
Surely, it follows, that the need for an effective therapy would be at the top of the list of issues and actions, not somehow relegated to the "rather than to try" and "leave the problem to Dept. of Primary Industries, Biosecurity", category of inaction!
I would have thought all concerned about Hendra virus infections would identify the paramount urgent need for an effective therapy in the case of a symptomatic Hendra infection in a human?
I continue to be disturbed by the reactions of a few ignorant persons in positions of power or authority, mostly politicians, fruit growers and horse industry persons, who are using the issue with other motives, or are still suffering from the illusion that something can, or should, be done about the Flying-foxes, and that they are going to remedy the situation! The idea that the issue can be "fixed" by dealing with the Flying-foxes has its origins in the "so called" National Ausvet Plan for Hendra Virus" which can be found in a little box in an AUSVETPLAN document. Some of the content in this box needs to be deleted as inappropriate, and a lot of bad things will go away, just like closing Pandora's box!
There continues to be a stream of ill informed comments. For Example, Bob Katter's comments about the "Deadly Flying-foxes", which should have been a reference to "Deadly Horses"! Member for Burnett, Rob Messenger was reported in the Fraser Coast Chronicle 11th December 2010, under the heading –"MP wants to kill sick Bats", as saying " "Any colonies of Flying foxes carrying the Hendra virus in Bundaberg would be wiped out, according to a plan by Member for Burnett Rob Messenger. Mr. Messenger yesterday called on both the government and the LNP to commit to a public health policy of destroying Flying fox colonies in urban areas, if they were found to be carrying deadly diseases." The newspaper heading, and the proposed "plan" are contradictory, counterproductive and have agendas’ that have little to do with Hendra Virus concerns! Rob Messenger is dangerously ill informed on Hendra Virus issues, as is Bob Katter.
Biosecurity advice needs to continue to clearly indicate, that any attempt to destroy or relocate Flying-fox camps would be inappropriate due to the risk of stressing the Flying-foxes and increasing active virus in the population, which would simply increase the likelihood of a transmission event!
Queensland Health, Biosecurity and Department of Environment and Resource Management, conducted a recent "online forum". It was promoted as an "online Forum" where you can have your questions about Hendra Virus answered by Flying fox experts". It was, in reality, a totally non-interactive, pre primed affair with a scripted agenda based on pre submitted questions that revisited old and irrelevant issues and questions. Two biosecurity vets admitting they still didn’t understand the transmission scenario, one Bureaucrat from Queensland Health with little understanding of the issues but trying to manage the publicity surrounding the confusion and one bureaucrat from the Dept. of Environment and Resource Management, trying to manage the calls for bat culls etc. but also with little understanding of the relevant issues, did not make up a " panel of Flying fox experts"!
Unfortunately, misguided conclusions about what to do about Hendra Virus still predominate discussions about Hendra Virus, particularly amongst the horse owners community and vets, and these are driven to a great extent by biosecurity's own misguided speculative conclusions, compounded by a continuation of media propagation of myths, misunderstanding and sensational speculation!!
There are still a number of speculations regarding possible transmission scenarios that do not sit well with the known facts about Hendra virus.
Also, based on these speculations, further misguided conclusions about what to do to minimize Hendra virus transmission. These are unreliable, unproven speculations based on no known science, but are fuelled by the very real fear of the possibility of transmission and the desire to minimize those possibilities. Unfortunately Biosecurity bureaucrats and scientists have continued to assert that they do not know what the transmission scenario is, but then go on to make speculative conclusions about possible [but actually quite unlikely] transmission routes, and how to avoid them.
My analysis of the facts, clearly leads to the conclusion that it is an infected "spat" produced by a [virus active] flying fox, and snorted up a horses nose, that is the only likely transmission scenario.
A "spat" is only produced when Flying foxes are feeding on certain high juice, high fiber fruits, as well as less favored food, such as leaves and high fiber, sometimes unripe, fruit. The "spat" produced can have an integrity which enhances its infective potential. If the spat is discharged at low altitude, it is more likely to remain in one piece and remain infective for longer. Little Red Flying–foxes particularly utilize food sources very close to the ground!
Note the "bat spat" photo at the end of this doc. It is broken although it has fallen less than two meters, from the Acerola Cherry bush where the bat was feeding!
It follows that this transmission scenario will happen with the highest degree of probability in an open, well grazed paddock, where a flying-fox might be traversing at a low altitude between food sources, or where there are, close to the ground, food sources near by, that are spat producing.
It also follows that a well grassed and treed paddock, with a healthy, non virus active population [as most Flying-foxes are!] of Flying-foxes feeding on nectar and pollen, or fruits such as figs (which are consumed and do not produce spats) will have a lower probably of a transmission scenario and be a relatively safe place for a horse, even if an infected spat is present! High trees used by Flying foxes for feeding or roosting are also unlikely to produce an infective spat, as the spat is more likely to break up on impact, which will reduce it's infective potential! The present advice by the Primary Industry, Biosecurity, Horse Owners associations, Vets, etc. regarding clearing trees, particularly Figs, keeping horses away from bats, moving feed and water troughs away from trees, etc. is just poor biosecurity advice based on wrong thinking assumptions. Some of these measures will essentially enhance the most likely scenario and predictably lead to more, rather than less, transmission events!
Because of the behavior of Flying foxes in the winter 2011 season, it was predictable that the likelihood of an increase in transmission events in S.E. Queensland would occur. After severe cyclones in the north there were far greater numbers of (nutritionally stressed) Little Red Flying Foxes in S.E. Qld. And northern NSW, and there were breeding females far further south that is usual!
Please see below for my comments on your email. I have used the rich text 'bold type' option to distinguish my responses from your comments..........
----- Original Message ----
From: "Glanville, Ron" <Ron.Glanville@deedi.qld.gov.au>
Sent: Thursday, September 10, 2009 7:49 AM
Subject: RE: Hendra Virus discussion paper update.
Lee,
Thank you for forwarding the second draft of your paper.
I agree with some of your comments, particularly about routine use of
protective equipment (masks) and that we should be managing hendra cases
as routine events.
However there are many statements in the paper that I disagree with, and
I comment on some of these below. I believe many of your statements are
not supported by the published scientific literature or unpublished
reports. Peer review of scientific findings is a cornerstone of
maintaining rigour within the scientific community, and the scientific
work undertaken by Australian scientists on Hendra virus has been
acknowledged internationally. However you do propose ideas that
warrant further scientific investigation (eg "splats").
My statements were all based on published literature and my analysis of it! There has been some excellent work done, particularly by A.A.H.L. on Hendra Virus. I have again recently reviewed the scientific literature and find further confirmation of my analysis. Also you do not peer review the unpublished reports, departmental meetings, emails and other departmental communications that drive bureaucratic actions. In fact, most departments maintain privacy and confidentiality provisions for their staff that usually only protect the opinionated from critical analysis of their own opinions. This tendency for bureaucrats not to publish reports but to keep them secret contributes to the general confusion. Adding to this confusion are "Fact Sheets" produced with no author and a disclaimer, which says that the contents should not be relied upon! This is the most relevant fact on some fact sheets, which are full of misunderstandings and false conclusions. This is the case for information on Hendra Virus by Biosecurity, Queensland health and the Queensland Horse Council.
The Australian Museum Complete Book of Australian Mammals refers to the ridged palate and associated feeding behavior of Flying foxes. It is important to understand that this mode of feeding and the modified palate in these herbivores with a short digestive tract is basic Flying-fox survival biology. I am now aware of some literature referring to "bat spats" and photo’s of "spats". I will attach one of my own photos of a probable "bat spat"(published on the home page of this blog!). "Bat spats" have also been described as "Rejecta Pellets" but the term "spat" is a useful description of the product. My reference to bat 'splats' was a description of what one type of "spat" did when it hit the ground!
It is important to understand that a "spat" is made up of small chewed up particles of fiber that have been compressed by the tongue and palate, into a pellet.
These pellets can have some integrity when spat out. This enhances the possibility of sustaining live virus [present in epithelial cell syncytia that have been shed by an infected Flying–fox], which has contaminated the spat.
It is only infectious fiber from a spat that could be snorted up a horses nose and onto the exposed epithelium of the respiratory system that is the only likely route of infection.
Flying-foxes are reported as 'eating' leaves as well as fruit. I have been informed that local Flying-foxes are stripping the leaves from Albizzia leucosternum, a [non native] tree found here in Hervey Bay. They produce a cigar shaped ‘spat’, which remains in one piece, even when discarded away from the tree. A 'spat' of this type would have the potential to remain infective for a longer period of time!
My Hypothesis on bat "spats" and snorting horses is just that, a hypothesis. I am an ecologist, not a vet or a virus researcher. Deductive hypotheses are based on observation and scientific evidence. You do not prove deductive hypotheses by undertaking a scientific experiment! You can validify or discredit by observation or experiment but not prove or disprove! This is science. Your beliefs/opinions do not represent the mechanisms, or art, of pure science but the mechanistics of applied science [Appropriate for a vet, but not an ecologist!] I draw your attention to a case of Tb transfer between cattle and possums, referred to by Nigel Perkins at a HeV transmission workshop. The transfer mechanism is quite irrelevant to HeV transmission, the relevance is, that the 'mystery' was solved by a hypothesis linking the observed behavior of sick possums with the observed behavior of livestock. The hypothesis was validated by observations of the linking scenario using infra red camera.[Beautiful pure science! and no need for peer review!]
Peer review is not about saying nice things about each other, it’s about critical analysis of research results and conclusions, and it is certainly not just relevant to journal articles. My paper is a critical analysis of some current HeV issues. I expect it to be critically analyzed by others, that is what science is all about!
There are number of considerations that continue to support maintenance
of the national policy for the euthanasia of serologically positive
horses:
I am not denying the validity of any concerns regarding recrudescence, It would not be appropriate for sero positive horses to be sold, moved freely around, or exported, at least until a time when it can be shown that sero positive horses have not only recovered, but are free of the virus. Constraints on them would be perfectly reasonable and appropriate. However the [well informed] owner should be the one to make the decision, and be responsible for implementing a safe handling and testing protocol, if taking responsibility for a live sero positive horse. The horse industry/ biosecurity/ health department should be paying any owner of a sero positive horse to be part of a blood donor program to try to produce an antiserum [for humans and horses!] from these horses. I can understand that when the welfare of others, or other horses, is involved, the prudent decision by the owner, may well be to euthanasia the horse.
However, If I thought my horse had Hendra virus I would not let a vet anywhere near it! What could they do except kill the horse or themselves? I might not be the only one thinking this way. No one has yet disputed my assertion that a healthy sero positive horse would be the obvious source of an effective antiserum in reasonable quantity. I understand that horses were used by the Commonwealth Serum Laboratories to produce snakebite anti venom. Why not use horses to produce a Hendra Antiserum? With my current knowledge of Hendra virus, I believe that, unless my assertions are demonstrated to be wrong thinking, that a healthy sero positive horse should not be put down! I would be very interested to hear from anyone who has considered this approach but disputes my conclusion!
* Recrudescence of infection has been known to occur with Hendra virus
(the 1995 human case - infected 12 months previously).
Is this recrudescence, since the original infection apparently produced only slight symptoms and obviously did not generate an effective immune response? It may imply a seasonal/cyclic behavior of the virus! Recrudescence of this virus, if it occurs, may not be like the re emergence of, for example, the malaria parasite which can lodge in tissue away from therapeutics, or the chicken pox virus which apparently can lodge in the nervous system, later re emerging as shingles. It maybe simply present at low levels due to an inadequate immune response. Further knowledge of how Hendra and Nipah virus behaves in bats as well as humans, and whether recrudescence or lingering infections occurs in bats, humans, and horses, is very important!
* This is known to occur in 10 percent of Nipah virus cases
Is it 'true' recrudescence, an inadequate primary response, cyclic or lingering infection? Is it recrudescence or lingering infection of Nipah that is occurring in pigs? The fever after a few days in horses suggests a 'general ' immune system response to viral invasion; the second stage of infection suggests that this is inadequate.
Testing pigs for susceptibility to HeV would be highly relevant if you are comparing Nipah and Hendra.[ I believe that this has now been done!] A relevant observation in this regard is that wild pigs routinely scavenge in Flying-fox colonies from Wide Bay north. If pigs were particularly susceptible, we would probably already see the evidence in wild pigs! Natural mortality in a large Flying-fox camp provides a significant resource to scavengers. In the incident mentioned in my paper, the reason we were in a rather inappropriate position in a large Flying-fox camp was because we were tracking wild dogs [from their vocalizations] within the camp. Also Peter Lusk, the ranger, told me that wild pigs were present periodically in this camp.
Incidentally, comparing Hendra and Nipah may be as inappropriate, in a practical sense, as comparing Lyssa and Rabies.
* Virus particles have been detected in serologically positive horses at
least 6 weeks post infection.
These were not recovered horses, but horses whose immune system had responded to the virus. This only indicates that the immune response has not yet fully dealt with the virus in these horses, maybe those horses with persistent infection never fully recover, maybe those horses that produced antibodies without symptoms of the disease have fully recovered.? You have not isolated virus from any horses that were antibody positive without disease! We will not know the answers to these questions until these 'survivors' are monitored long term!
* While I agree that we don't know for sure that this will occur with
horses, on balance scientific opinion is that the possibility is high.
* Human health authority advice was that human health considerations
were paramount and on the basis of human health risks, that horses with
evidence of the virus should be euthanized. This policy was carefully
reviewed and endorsed by the Consultative Committee for Emergency Animal
Diseases (CCEAD), and incorporated into AUSVETPLAN. CCEAD is made up of
the Chief Veterinary Officers of the Commonwealth, States and
Territories.
I think I have clearly expressed my opinion [and exactly why I have this opinion!] of the so-called AUSVET plan for Hendra Virus. This plan was based on false premises, (an exotic, epidemic organism rather than an endemic with a novel transmission potential). Is it a policy or a plan? Either way, it's a dud with profound unintended consequences and inappropriate implications.
I can now compare this observation with the fact that there is now an Ausvet Plan for Lyssa Virus titled
"AUSTRALIAN VETERINARY EMERGENCY PLAN, AUSVETPLAN, Disease Strategy, Australian bat lyssavirus Version 3.0, 2009." This is a reasoned document, which addresses concerns raised in my paper. I would expect to see a similar document for Hendra Virus. Where is this document? Who gave this human health authority advice?
It seems clear that "Human health authority" persons don’t have a plan [or a clue about the real issues!]. They seem to have missed the point entirely when it comes to the potential value of these horses for antiserum production! They certainly are not in possession of any special knowledge. If this so called AUSVET plan was implemented in a country like China we would not only see euthanasia of horses but mass culling of bats, chopping down of trees, and possibly euthanasia of sero positive humans [for the common good!]. We are not in China and should not be creating and implementing autocratic policies based on no particular science, and where those policies are counterproductive!
* This policy is also supported by horse industry organizations.
But not necessarily for the same, or any valid reasons [i.e. perceived threats to the export trade.] Some of the published reasons don't stand up to logical analysis. Testing and appropriate quarantine should protect against any Hendra fears! On the other hand, none of the reassurances with regard to the safety of humans or other horses, when there is an aggregation of horses, are appropriate.
I would also add that useful scientific advice has been gained from the
autopsies of these horses, probably more than could be gained from
ongoing observation of them.
And you did not even have to pay for the horses, cheap compared to doing an experiment at AAHL. I accept that you will gain useful information from autopsy, but I do not accept that the information gained from long-term observation is any less crucial. It is not a theoretical exercise. If there are natural survivors then the questions about recrudescence and when, why and how this might occur are crucial. It has been observed that most of the horses involved are thoroughbred. The direct relevance may only be that they have large lungs [big sorters!], are well fed, and on well-grazed pasture where they can snort up a bat spat. In future, you may be faced with destroying an extremely valuable horse, capable of producing or siring valuable offspring, even with the possible risk of recrudescence. The possibility that these survivors could also be producing antiserum that could be used as a therapeutic for humans, as well as horses, is also highly relevant [As is the possibility of a genetic disposition to resistance to HeV, which is what the bats have developed!].
It seems apparent that a vaccine would not be an appropriate therapeutic in any of the human transfer events that have occurred. The relevant comparison is the use of rabies antiserum for the symptoms of a rabies infection when it is too late to administer a vaccine! The human health authorities do not seem to have thought through the necessity of urgently producing a therapeutic that could be used in these scenarios that are likely to continue to occur!
I believe that it is relevant to observe that the facility that should have been working [urgently] to produce an antiserum, The Commonwealth Serum Laboratory, has been sold to private enterprise [now, reportedly, one of the most value added stocks on the market]! Unfortunately there is no profit in producing antiserum for a few victims, and they have no current brief to produce an antiserum. in fact, now that they are private enterprise, they have no research brief at all! It's a good thing that they produced Tiapan antivenin when they had a mandate that was not profit driven, because it was never going to be making anyone a profit, and neither should making hendra antiserum (that’s why we had a Commonwealth Serum Laboratory originally!) There are some political and bureaucratic policy decisions about this sale that need examination here but that’s another whole different issue! So we now have Animal Health workers working on a critical human health problem [And being financed by the USA Dept. of Defence for the most relevant research!]
With regard to the following words:
"This review, and other Hendra virus information on Queensland Health
and D.P.I&F web sites, which I have recently reviewed, have led me to
conclude that bureaucrats [biosecurity?] responsible for managing Hendra
virus outbreaks have failed to understand the critical issues [which
includes what we do now know about Hendra virus and conclusions based on
that knowledge] and have proceeded and continued with inappropriate
policies, legislation, and actions. This has led to more fatal outcomes,
and is likely to lead to events with further predictable fatalities of
persons handling horses as well as transmission between horses,
particularly in stables, and resulting multiple mortalities of horses."
I do not agree with your conclusion. The information on our web site is
consistent with the latest scientific information on Hendra virus.
While the mechanism of bat to horse transmission is still not clear,
practical measures that can be taken by horse owners and veterinarians
are available. Biosecurity Queensland has a long history of researching
hendra virus in collaboration with national and international
organisations and is internationally recognised in this regard. BQ has
recently reviewed the research work that is most likely to assist in the
prevention of future horse and human cases of Hendra virus infection.
My conclusion was exactly what happened in now multiple incidents, and it's still happening, complete with the inappropriate media references to urine, feed and water troughs, flowering trees, etc. that are completely irrelevant to the transmission scenario!!
Stating that the mechanism by which HeV is transferred to horses from bats is still not clear, is not very helpful 'scientific information'. Adding 'possible' transmission routes [that are mentioned in BQ, Horse Council and Queensland Health web pages], that do not include the only one that even hints at a likely transmission scenario, is also not based on any 'scientific information'. Your practical measures, like moving feed and water away from trees, presupposes that your speculative conclusions regarding bat to horse transmission are correct! But, they are not! According to scientists, no virus found in bat excreta and only very low levels or antibodies in urine! More importantly, no obvious mechanism has been suggested for the transfer from the 'possibly' infected urine, excreta, or fallen fruit to a horse.
Deborah Middleton has stated "Incidentally, I agree with your hypothesis on the "snorting" behaviour of horses. I, too, believe this is a likely way that the virus accesses the horses respiratory system."
All the suggested health precautions will not save you [or your other horse] from being 'snorted' and infected, unless you are wearing a mask! I was appalled by one recent TV documentary on the Hendra issue that demonstrated a vet in "appropriate" protective gear, looking like a space man, but the horse handler controlling the horse for the vet, and of course standing in the direct "snort" zone was not wearing any protection at all, demonstrating [and fortunately, it was only a demonstration!] a total lack of understanding of the very real and deadly Hendra virus transmission scenario between horses and humans.
My analytical opinion is that the critical behavioral keys in the transmission scenario are snorting horses and bat spat production and none of the information on your web site refers to either! And to make matters worse the Queensland Horse Council, has taken the most debatable of your conclusions and produced a website which is full of conclusions and recommendations that are exactly wrong thinking and will predictably lead to further transmission events by enhancing and recreating the very scenarios responsible for past transmission events! The fact that it has mostly been, well bred and looked after, but paddocked horses that have succumbed to Hendra, is not coincidental. It is predictable that a well-fed, curious thoroughbred in a cleared, well-grazed paddock, is going to find a bat spat [which will have an attractive odor] and snort it up it’s nose, with a far greater probability than a horse in a bush paddock! An infected bat spat is more likely to be produced if the bat is hungry and stressed and feeding on certain, low to the ground, food sources near open pasture lands. Flying-foxes retain food pulp in their mouth for varying times and often fly low, particularly over open paddocks. An infected bat spat, in a paddock where there are lots of trees and healthy bats producing non infected spats, or a paddock where the grass is long, is far less likely to result in a transmission scenario than an isolated spat in an open paddock.
It is important to remember that bats in flowering trees are usually not producing spats and neither are bats feeding on fruit such as figs! It is only certain leaves and fibrous fruit including juicy fruit such as apples where Flying-foxes harvest the juice with their ridged palate and eventually discard the fiber pulp left as a "spat". Spats are rarely found at all near possible spat producers, such as very ripe grapefruit (recent personal observation). Recent personal observations lead me to conclude that fruit or leaf pulp is retained in flight for processing while the individual is seeking other food sources or transiting to another known food source. There is literally no predictability in where spats will be found, but it is predictable that horses out at night or early morning on a well-grazed paddock will find a spat with a higher degree of success than in any other circumstance.
Your suggestions about investigating "splats" will be included in this
mix. I have a question here though - do you have any direct evidence of
horses snorting or chewing splats?
Chewing or eating "bat spats" [or faeces, urine or discarded fruit!] is irrelevant to the transmission scenario! [AAHL have fairly clearly demonstrated that ingestion is not a transmission route!] I have observed the stuff that is snorted/sniffed up a horses nose! There is a simple observational experiment [that does not involve bats!] to test bat spat, horse snorting behavior.... basically, chew (a potential candidate like an orange or apple) suck out all juices, and deposit a compressed ‘wad’ [which is what a spat is] on bare ground in front of your horse! A few people need to get back to me about this "test"!
You don't have any direct evidence, very little [if any] supporting evidence, and a lot of directly contradictory evidence, for any of the suggested alternatives!
Regarding your conclusion that Hendra in bats is an STD, we've long been
aware of an apparent association between HeV status and 'reproductive'
status in female bats, and we continue to explore the strength and
nature of this apparent association with an open mind and in a
scientific way, rather than jump to conclusions.
Deb Middleton picked up on this in my first draft and I was particular with my choice of words in the second draft. Your statement of "awareness" is not exactly accurate! Discovery of the female with twin [unusual!] aborted fetuses that were all Hendra positive, that confirmed the presence of Hendra in bats, and lead to the conclusion of an apparent association with reproductive status, was pure serendipity. I understand that she aborted the fetuses because she was hung up on a barbed wire fence, nothing to do with the Hendra virus! Carrying twin fetuses would be stressful! The only conclusion [apart from confirming the presence of Hendra in bats] that can be made from this event is that a female bat can transmit the virus to its fetus, and that is exactly what a "congenital" STD does! STD’s are also transmitted by intimate contact, not just during coitus. Read my statement again. I am not jumping to any conclusions, it’s the epidemiologists that have been jumping to conclusions (like a rain of deadly birthing products, infected urine or faeces) and most of them are wrong! Their conclusions are not supported by the facts at all!
The recent absurd and sensational media claims that 60 or 70 percent of "bat poo" or flying-fox urine is infected by Hendra Virus and therefore the bats are threatening the health of all of us, is completely untrue, but given credibility by the media spectacle of the sight of your epidemiologists gathering samples around Flying fox camps, while wearing high security biohazard suits that scare the crap out of most people, then reporting that the urine shows the presence of Hendra virus but not mentioning that this is an antibody test and that extensive testing has failed to yield evidence of live virus at all in either urine or faeces! (Finding live virus on a urethral swab does not lead to a conclusion that the mode of transmission is through the urine!)
With regard to the following words: "If the transmission route were less
'intimate', then Hendra virus would be more infective than it apparently
is. "; your meaning is not clear, however I would point out that fruit
bat populations commonly have sero-prevalence for hendra as high as 70
percent, so it obviously does spread easily within populations.
Yes and so do some STD's! Especially in highly sexual polygamous social animals like Flying-foxes and humans! Of course we are all concerned about the transmission route, the fact is, that it is horses, vets and horse handlers that are being infected, not bat watchers, bat carers, tourists walking under bat colonies or students in schools near bat colonies etc.etc. Other researchers share my conclusion! [Halpin,Young,Field and Mackenzie]have stated that-"If the route of excretion made the virus more readily accessible (for example, in urine or faeces) one would expect an increased chance of exposure by susceptible hosts and hence an increase in the number of spillover infections and cases." which is exactly the point I was making!
Your conclusions about droplet transmission in a stable environment,
while making sense, do not fit with the observed data during last year's
hendra case at Redlands. In that event there were horses in stalls
adjoining infected horses, with only wire mesh between them at
"snorting" height, yet they never became infected. While I wouldn't
discount some horse to horse transmission, the pattern was better
explained by mechanical/assisted transmission.
In the Redlands case, I gleaned more understanding and confirmation of the likely bat and horse transmission routes, by listening to a TV interview with the owner of the Redlands Clinic, than from the Perkins review!
I understand that the Hendra stable was a stable of active working horses and transmission to a large number of horses took place! The Proserpine case shows evidence indicating an initial spat transmission, and subsequent, in paddock transmission, between horses, and in the Carrawal incident also there was also paddock transmission, and the evidence is still adding up.
If AAHL placed a set of facing exercise treadmills for horses in their transmission experiments I predict a transmission outcome from "snorting horses" with a very high probability!
Your comments on the last page about transmission terminology are unclear.
What is unclear to me is what do terms like "excreted into the air" and the" shedding of the virus" mean or imply? Carbon Dioxide is excreted into the air; we do 'shed' epithelial cells, but viruses? It is this 'terminology' that is unclear! [Compared to stating, for example, -The virus is known to be present in nasal mucus and saliva in shed epithelial cell syncytia, can be expelled from the horse when it snorts, and infected mucus 'droplets' can deposit on the respiratory system epithelium of other horses or humans. This is a descriptive statement of probabilities, a working hypothesis! Incidentally some papers refer to "fomites" without actually defining them, although maybe vets know what fomites are, the rest of us don’t!
Your comments about which Act we use to implement control measures is
not really relevant to the issue. In fact in the most recent event, the
Stock Act was used, but the policy was the same. We should be debating
disease control policy not what legislation we use. This is only a
mechanism to implement the policy.
This is exactly relevant to the issues of compulsory euthanasia and possible bat culling, and where there is a real danger of bureaucratic bastardy. I believe that I have blown the whistle on the inappropriateness of this act and the so-called Ausvet policy, fairly explicitly. What don't you understand about my analysis? If you use acts of Law that are illegitimate in application or interpretation, it’s Bastardly! As to debating disease control policy, I believe that I have made a reasonable start in pointing out the completely inappropriate 'eradication' AUSVET plan for Hendra virus! The probability is that a control policy is not even relevant! [We don't have a "control policy" to prevent snakebite, falling trees or Tetanus, sometimes bad things just happen, and sometimes they can be minimized!] The reality is that horses, vets and horse people are dying of this virus and all the carefully considered reviews of the scientific evidence have done nothing to save any of them. You can keep blaming vets for not using PPE(and that's appropriate!) until a horse handler is infected, then your "human health authorities" can explain to the victim why they have no antiserum or other therapy, to try to save them with! I believe this possibility was all too likely in some recent incidents!
In relation to compensation, your interpretation of the Exotic Diseases
in Animals Act is incorrect. No compensation is applicable in this
situation. The compensation is only applicable when an outbreak is
officially declared by the Minister. This did not occur and was not
envisaged for this sort of situation. Under the Stock Act, there is no
compensation payable for infected animals.
Actually I did interpret it correctly, I was just hoping I was wrong! My motive was to draw attention to this act and its inequities. It’s not just that compensation was "not envisaged for this sort of situation". It is precisely that the Exotic Diseases in Animals Act is inappropriate to invoke at all, in this sort of situation [The Stock Act may be inappropriate as well!? I was not wrong with my other conclusions about the inappropriateness of including Hendra virus in this act in the first place, or the complete inappropriateness of the so-called AUSVET plan for Hendra!
There is no contemplation of policy to destroy fruit bats from the
Queensland Government, in fact the government has strongly rejected
these suggestions
This is not at all reassuring, and we are not just talking about Queensland [see my comments above, about inappropriate politicians' plans]. Destruction of bats is implied in the so-called Ausvet Plan for Hendra Virus. This implication continues to be exploited by some. In the same TV program where you made a perfectly reasonable comment about wearing mask, gloves etc. and Hume Field was saying that the bats were ecologically important etc., an opposition member of parliament was being a political ignorant bastard and talking about "moving the bats on" etc. etc. Our bureaucracy and its processes, is supposed to protect us from ill informed politicians acting on their opinions. Unfortunately it does not always work well! Presently (late 2011) we have a potential future premier demonstrating his complete lack of understanding of the issues and proclaiming that the bats will be driven out of towns with helicopters and smoke bombs!! Well, that is NEVER GOING TO HAPPEN!! And biosecurity concerns are not going to be used by some people in Gayndar or anywhere else to justify relocating bats. You need to get this message out there!
Our local member was the Minister for Sustainability and the Environment, and he did help increase protective measures for bats. Unfortunately for Andrew, his political masters would not let him say anything about the unsustainability of the Traviston Crossing Dam. He had to talk about really important issues like the conservation of shopping trolleys! He was voted out at the last election. The Traviston Crossing Environmental Impact Statement, with no author, compiled by dam stupid engineers, conclusions that do not fit with the scientific evidence presented, and no actual environmental impact appropriately documented, was a classic example of bureaucratic bastardies aligning with political agenda. Sometimes we can rely on legislation and the law to protect the environment and us. Rarely can we rely on politicians with flawed agendas. It is quite inappropriate for the horse owners or Fruit Growers communities to be talking about "doing something about the Flying-foxes" when appropriate non-lethal protection measures are available that address any real concerns.
Regarding the existance of sero-positive horses in the general
population, while this is certainly possible, a large survey of the
Queensland horse population was conducted following the 1994 event and
all were negative.
This is nonsense Do the math...11 primary transmissions in 16 years...if 70% mortality in horses..= Approximately 3 survivors in 16 years and one of these already dead of old age! With figures this predictably low you would have to test the entire population not just a few thousand horses! Also, on these figures, if there were a 10% chance of recrudescence you would only see one natural recrudescence event in about 48 years! [This is grade 10-probability mathematics not University level statistical analysis!] Of course, this recent winter of Hendra virus infections has increased the chances of their being a number of survivors!
I consider the following sentence in your paper inappropriate if you are
trying to get people to listen and cooperate with you:
"Put power tripping, bureaucratic bastards, with tunnel vision and their
inappropriate invoking and manipulating of legislative powers, on notice
to be named and shamed!"
Give me a couple of hours and I will provide you with plenty of personal experiences of bureaucratic bastardies, including in DPI&F! The recent " Hendra Virus Report" by the Queensland Ombudsman has over 400 pages of documented, inappropriate behavior by Queensland bureaucrats!! I have not called anyone in particular, a bureaucratic bastard [yet!] [Just some ignorant political bastards!]. I believe that some of the implications of the so called AUSVET plan for Hendra Virus, and the Exotic Diseases in Animals act, as implemented, amounts to bureaucratic bastardy [or what ever you would like to call it]. Read the Ombudsman's report! What do you call it when inappropriate procedures are followed because someone in a bureaucracy has created a procedure that does not align with the reality of the situation? I believe that CCEAD needs to carefully consider my objections re. This plan and Act to insure that there is not a continuation of calls from ill informed politicians and others to "implement" the plan and "kill the bats"! Now you have an antibody positive dog threatened with destruction, now destroyed! and totally stupid SPECULATIVE statements about "possible" behavior changes in the dog making it a danger! This is just like all the other sensational speculations about virus mutation, potential epidemics, etc. etc. No bastardy here, just bloody sensational stupidity exploited by an ill informed media. It's easy to frighten people into doing things, but not necessarily right!
I am one of those bureaucrats and I'm happy to debate current policies
at any time in a reasonable and constructive manner.
This is your job and why I’m communicating with you. I don't think you are being a bureaucratic bastard! But you are one of the Mr. Vets that I am being fairly blunt to, about you and your colleges’ tunnel vision re. HeV issues and the inappropriate consequences for Flying-fox Conservation as well as inappropriate strategies for dealing with HeV ! I am blunt, iconoclastic and opinionated when it comes to environmental issues or human life issues. I can live with that! There are no 'sides' to environmental or human life issues. We are all in the same boat. I hope that a reasonable, constructive debate continues!
Having disagreed with many of your arguments, I do strongly agree with
your most important recommendation - that about veterinary hygiene or
personal protective practices. We have been pushing this strongly with
the profession in conjunction with the AVA and it is pleasing to see
that the vet in the most recent case this week did use protective
equipment. So it is likely that the efforts of biosecurity personnel has
saved human lives. However in the end this comes down to individual
responsibility.
This is not just individual responsibility. We have a medical doctor at the moment on trial for manslaughter as a result of inappropriate personal hygiene. Failure of duty of care with regard to appropriate personal hygiene, resulting in your own death, is an avoidable tragedy, If misinformation or misunderstanding results in the death of other persons, or other animals, It is a legal and ethical issue [manslaughter or compensation?!] It’s not the vets that I am particularly worried about. By now they should have got the general message, although some continue to misunderstand the necessities! It’s the horse owners who are not wearing even basic respiratory protection handling a potentially infected horse, that are the real concern! They presently have no real understanding of the critical issues. You have Vets and Biosecurity personnel wearing "space suits" and can’t even tell horse owners that wearing (almost any type of) face protection when examining a horse (whether sick or apparently well) will significantly protect them from breathing in some infected mucus that a Hendra infected horse could snort on them! Of course that was the exact predictable concern during recent incidents
Regards
Ron
PS
And yes, there was extensive communication with the pig industry warning
them to take appropriate precautions to prevent pigs catching H1N1 from
people.
Thanks for this info. Did these precautions include specific instructions, e.g. wearing a mask? Sometimes warning people to take 'appropriate' precautions without spelling out exactly what those precautions should be, does not produce a desired outcome. In the case of HeV,in the past, I believe that there has been far too much emphasis on the possibility of 'mechanical' transfer and the need to wash your hands and wear gloves, and no particular emphasis on wearing masks to protect from being snorted! I have referred to surgical masks as worn by doctors and dentists because standard medical practice seems to be a good starting point!
I believe that it is about time that vet practice was aligned with standard medical practice and the Hendra issue provides good evidence from both a legal as well as a personal health perspective as to why this should be mandated. Vets are reported to be exiting equine medicine for other animals. This is all very well until a vet contracts, for example, the pneumonic form of Bubonic Plague from a pet rat, because vets are not applying the same standard of barrier protection, as other health workers, then the shit will really hit the fan!
Below is my bat spat photo, hardly a "Bats out of Hell" death scenario. I imagine a small child could find and stuff a spat up their nose, but the likelihood of death by meteorite strike would be greater!
I believe that with the recent release of a vaccine for horses, that the real risks of lethal hendra incidents will be downplayed and continue to be misunderstood, untill another lethal incident predictably occurs, and another round of inappropriate responses occurs.Considering the balance of probabilities, I would be far more likely to vaccinate my horse against Teatnus than Hendra Virus, but that's because I lost my only horse to teatnus and I am already cautious of snorting horses!
I will publish this paper on my blog "Megabat Matters" http://megabatmatters.blogspot.com.au/
(The original discussion paper "What don’t you understand about snorting horses, Mr. Vet?" is also published on this blog)
as well as sending to former correspondents and those responsible for publishing AUSVETPLAN. This can be forwarded to other interested persons and I welcome any feedback on the contents or issues.
Lee St.John Carter
77 Wheeley Road, Booral, Hervey Bay, 4655.
Email.. batwatcher1@hotmail.com
Draft published 21 December 2012.
