Identifying and Understanding the Factors Affecting Infection Control and Hendra Virus Management in Private Veterinary Practices in Queensland, Australia

Saturday, 28 March, 2015

Don't miss Diana Mendez's PhD seminar. All are welcome to attend.

Date: Wednesday, 1st April
Venue: James Cook University, Townsville: B145, Room 030
Time: 11:00am

Abstract: In September 1994, a mysterious illness caused the death of 13 horses and their trainer in the Brisbane suburb of Hendra. This illness was due to a novel paramyxovirus: Hendra virus (HeV). Since then, this newly emerging zoonosis has been found to occasionally spill over from Australian pteropid bats, or flying foxes, to horses to humans with high mortality rates in both species (75 % and 57% respectively). Humans become infected when exposed to bodily fluids, including blood, from an infected horse, which represents a significant occupational risk for veterinarians. Of the seven people so far infected with HeV, all were from Queensland (Qld), five became infected while carrying out veterinary procedures on horses and three of these eventually dying of their infection. The last person who died of HeV in 2009 was an experienced equine veterinarian who had had HeV management training but still failed to use the recommended personal protective equipment. The management of zoonoses is based on veterinary infection control (IC) which has been deemed substandard in many countries, including Australia. The aim of this project was to identify and understand the factors affecting IC and HeV management in private veterinary practices.

An exploratory qualitative study about the barriers to HeV management in private equine veterinary practices in Qld, followed by three confirmatory cross-sectional studies of veterinarians and veterinary students about their zoonotic risk perceptions and related IC strategies showed that veterinarians were unprepared to deal with the slow, unpredictable emergence of HeV. This was in part due to a lack of support and leadership from biosecurity authorities, to a veterinary work culture which seldom prioritised zoonotic risks and a private business operating model which entails financial, time and legal constraints on veterinary practice which were perceived incompatible with good IC standards. All these factors affected the veterinarians’ perceptions of zoonotic risks and thus determined their risk mitigation choices. Unlike in the medical sector, IC leadership was fragmented within and between veterinary practices hampering the overhaul of IC standards. Furthermore, veterinarians were more likely to develop suboptimal IC habits if they transitioned into the workforce under poor professional mentorship.

Veterinary IC is therefore likely to benefit from: (1) improved consultation between government and veterinarians; (2) increased support to private veterinarians dealing with an emerging zoonosis; (3) improved undergraduate and professional theoretical and practical IC and zoonoses management preparedness veterinary education; and (4) collaboration between veterinary academics and positive private veterinarian role models to help early career veterinarians transition into the workforce with confidence in their IC skills.

Cartoon: Drawn by Ken Miller, Townsville.

Posted by Rick Speare