Infection prevention and control and biosecurity precautions
Warning: Hendra virus (HeV) infection of humans is rare, but it is a serious disease that can be fatal. Infection has occurred from high levels of exposure to the respiratory secretions and/or blood from horses infected with HeV (both live horses and dead horses at necropsy examination). Great care is needed to ensure the personal safety of the veterinarian and others who may be involved.
Learn more about precautions to take when Hendra virus is suspected.
Apply the precautionary principle to ensure personal safety and prevent zoonotic risk.
An infected horse can excrete Hendra virus (HeV) in nasal or nasopharyngeal secretions for several days before the onset of clinical signs. A horse with severe clinical signs poses the greatest transmission risk to other horses and humans through a range of body fluids and excretions.
HeV is often diagnosed retrospectively in horses after human exposure has occurred. This reinforces the need to consider HeV early in the investigation phase, and to establish appropriate infection control procedures for day-to-day situations.
A registered vaccine is available for horses. Vaccination of horses is the most effective way to help manage HeV disease. Vaccination of horses provides a public health and work health and safety benefit by reducing the risk of HeV transmission to humans and other susceptible animals.
Whenever HeV infection is suspected, even in vaccinated horses, appropriate biosecurity precautions including personal protective equipment (PPE) should be used as no vaccine can provide 100% guaranteed protection.
Standard precautions against infection
Standard precautions are a set of basic infection control practices used to prevent transmitting diseases through contact with blood, tissues, body fluids, non-intact skin and mucous membranes. You should use these measures when providing care to any animal. This includes all horses, even if they've been vaccinated for HeV, or don't appear infectious or symptomatic.
Standard precautions include, but are not limited to:
- hand hygiene
- aseptic non-touch technique
- sharps safety
- clinical waste management
- laundry management
- standard decontamination procedures
- appropriate reprocessing of equipment
- routine environmental cleaning.
In particular, you should:
- take precautions to prevent any direct contact with, splash back of, or accidental inoculation with blood, body fluids or excretions
- cover any open wounds with a waterproof dressing
- ensure sharps safety, never recap used needles and always use a sharps container to avoid sharps injuries
- perform hand hygiene
- after any exposure to blood and body fluids
- after contact with a horse, its environment and equipment, and before moving on to other activities
- during and after removal of PPE
- adopt appropriate cleaning processes for the environment and equipment, and reprocess reusable equipment used in clinical procedures in accordance with AS 4187
- ensure the safe handling, transport, storage and disposal of clinical waste (including sharps). Sharps must be disposed of in a container specifically designed for the disposal of sharps
- ensure the safe handling, transport, storage and cleaning of contaminated clothing and other laundry
- ensure the safe handling, transport, storage and disposal of pathology specimens
- ensure the safe handling and disposal of animal excreta
- maintain stable hygiene and conduct environmental cleaning using appropriate cleaning agents and disinfectants
- wear PPE.
You should adopt standard precautions as well as airborne precautions for procedures that are invasive or that generate aerosols. This includes procedures of the respiratory tract, and other high-risk procedures, such as endoscopy of the upper and lower respiratory tract, dentistry using power floats, necropsy, broncho-alveolar lavage and nasal lavage.
Airborne precautions are additional, transmission-based precautions to prevent inhalation of contaminated aerosols and dusts. They include:
- work practices that minimise the generation of aerosols and dust (e.g. avoiding the use of high-pressure water systems for cleaning)
- ventilation controls
- enhanced PPE. The minimum level of PPE for airborne precautions includes a properly fitted disposable P2 respirator.