Friday, May 3, 2013
Thursday, May 2, 2013
Hendra virus: A diary
by Katharine Sharon
This is the (fictitious) diary of Rosemarie
Wilson, a race horse trainer in Queensland, Australia. In the summer of 2012, Wilson lost one of her
four horses to Hendra virus. Here is the
account she kept as she experienced it:
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Created by Katharine Sharon
|
July 12, 2012: I’ve been instructed by Dr. Benton to keep this diary of
events for insurance purposes since all four of my race horses are
insured. It’s been a long day. Big Red didn’t eat his breakfast this morning
and seemed off – depressed.(1) He is training
well and enjoying his paddock time, but thinking back, he seemed a bit
lackluster yesterday, too. I moved him
to the stall at the end of the courtyard away from the other horses and called
Dr. Benton just to be safe. By the time
Doc got here – about 3 p.m. – Big Red was obviously uncomfortable, breathing a
little hard and seemed disoriented.(1)
The muscles over his rump and around his shoulders twitched.(1) Doc took one look at the colt and said that
due to the outbreak of Hendra virus (HeV) nearby, he had to consider it a
possibility. Doc said it was probably
overkill, but we both dressed in plastic overalls, boots and gloves, and then
put on protective glasses and a mask.(2)
Doc also had me place a footbath outside Red’s stall.(2) Doc completed a physical exam and found Red
had a fever (102°F), high heart and respiratory rates (64 bpm and 36 bpm,
respectively) and said his “oral mucous membranes were injected” (they were
bright red).(3) Doc took three tubes of
blood from Red to send to the government lab to test for HeV. He said they usually run three tests: PCR, indirect
ELISA and virus isolation.(4,5) He then
took nasal swab samples from each nostril, and also swabbed Red’s mouth, rectum
and conjunctiva.(5) He also gave Red a
shot of banamine, which seemed to help the colt get comfortable.(6)
Doc said he’d
also run a few standard tests – CBC and chemistry – to cover the basics. We should have results late tomorrow
afternoon. Doc gave me a pamphlet with
information on HeV (see above) and instructed me to use the highest biosecurity
standards – if we had to handle Red we should wear protective gear and wash our
hands afterward; no horses should go on or off the farm (he explained that this
is a self-imposed quarantine but he highly recommended taking the precaution);
keep the other horses away from Red; and handle Red only after dealing with the
healthy horses first.(4) He stressed
that Red’s definitive diagnosis is yet to be confirmed, but he wanted me to
take all precautions to ensure the safety of the people and horses on the farm. Because he believed this to be a possible HeV
case, Doc said he had to notify the regional government veterinarian.(4)
I felt compelled to tell Dr. Benton that
I didn’t know of any flying fox colonies in my neck of the woods. I also showed him my two paddocks – I wanted
him to see that only the far side of the paddocks had trees on the other side
of the fence and the water buckets were far from those trees.(9) He assured me that my farm was well managed,
but said that HeV is possible even at the best of farms because all horses have
to do is ingest the droppings, birthing excretions or other bodily fluids of
the bats.(5) He told me not to panic and
reminded me again that he was being extra careful.
After Doc
left, I called Dottie Richardson, Big Red’s owner, who wanted to come out
straight away to see her horse. I had to
tell her to stay where she was – no sense in possibly exposing the octogenarian
to HeV. I could hear the heartbreak in
her voice. I also spoke with my team –
Jeff, my assistant trainer, and Trudy, my groom. I told them that they had to protect
themselves as much as possible until we knew what we were dealing with – I
explained the importance of suiting up when working with Red, but I also said
not to go near him if they didn’t have to.
I sent them home and told them to be mindful of how they felt – to look
for flu-like symptoms, headaches or other signs of illness that Doc told me
about.(7)
 |
| Big Red winning at Ipswich in June. (www.testcountry.org) |
I called Doc later to ask a few more
questions: Trixie gets turned out in the same paddock as Red, though not at the
same time – did I have to worry about her?
Red and Subtle Foe share the same bridle, but we wash the bit between
horses – how likely is it that he too will come down with whatever Red
has? Doc told me the literature showed
that HeV usually presents in one horse in a paddock situation(10) and that
contaminated tack could transmit the virus(5), but reminded me that we didn’t
know if we were dealing HeV definitively.
July 13, 2012: I was awakened at 3 a.m. to a ruckus in the stable across the
yard. Big Red was thumping about his
stall. I suited up and tried to catch
him, but the colt was distraught – I don’t think he could see me. I called Dr. Benton who came right away. With the two of us suited up, Doc was able to
examine the colt and found his heart and respiration rates to be 120 bpm and
100 bpm, respectively, a fever of 104.8°F, abnormal swelling around his
throatlatch area and that Red was blind.(1,3)
Doc tried sedating Red and gave him some more banamine, hoping to help
calm him down, but it didn’t work. Red seemed
panicky and because he was so unstable and uncoordinated, he fell. He was too weak to get back up.(3) Doc suggested I call Dottie and tell her that
euthanasia was his recommendation. Once
I had explained the situation to her and how painful and scared her horse was,
Dottie gave the go ahead. Big Red died
at 4:30 a.m. Doc called one of his
friends at Queensland Biosecurity division who had previously handled HeV cases
to receive instruction on getting samples from a necropsy. Under Doc’s instruction, I dug a hole to bury
Red, but made it big enough so that Doc could climb in there and have enough
room to get samples to send to the lab.
Doc took pieces of Red’s submandibular lymph node and a blood clot
removed from the jugular vein. He also
took swabs from Red’s nose, tongue and rectum.(4,5) When he was done, I covered the colt with
dirt.
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Trixie, Subtle Foe and Imabiter on the gallops at the beginning of June. The
line of trees in the background abut my two paddocks and one of the samples taken from the ground of Big Red's paddock tested positive for HeV. (www.an-eventful-life.com.au) |
Just to be safe, Doc changed suits, washed up and did a
physical exam on all of the horses to make sure he had a baseline for
them. All of the other horses were
normal, which made me breathe a slight sigh of relief but I was still worried. I called Jeff and Trudy and told them the news
and said that I would take care of the three remaining horses today.
Dr. Benton
called about 4 p.m. and said that he was on his way to the farm – Red tested
positive for HeV. My heart fell. I called Jeff and Trudy to tell them more bad
news and asked them to come to the farm.
Doc and the authorities arrived about the same time. I was informed that my farm was under
quarantine for at least the next 35 days (the incubation period ranges from
5-16 days and they wanted the farm on lockdown twice as long), during which
time no horses could leave or enter the farm.(5) The authorities also informed me that they
would notify local and regional authorities, my neighbors and the race tracks
where my horses had run in the previous three weeks (Subtle Foe ran at Ipswich
Racecourse last week; Imabiter ran at Mackay Racecourse three days ago; neither
Red nor Trixie had run anywhere in that time).(4) Investigators took samples from the remaining
three horses as a baseline and I was told that all animals on the farm will be
assessed daily for signs of HeV and intermittently tested for the virus during
the quarantine period.(6) Lastly, Jeff,
Trudy and I were instructed to get baseline tests on ourselves, too, since we
all had close contact with Red.(4)
While Dr. Benton and the authorities
went about posting signs around the property and spraying the driveway down with
chlorine, I called the three other owners.
All were understandably alarmed and I did my best to play the role of a
comforting friend, but I know my fear and anxiety came through to them. I then called my neighbors so that I would be
the first to tell them, not the authorities.
They were very kind and understanding, considering the situation.
It was late by the time the
authorities left and I just pray that no more of my horses have HeV – it would
break my heart for the horses and the owners.
July 14, 2012: The
investigators arrived early, just after I had done the absolute minimum with
the horses – fed, watered and hayed.
They went out to the paddocks and took samples from the ground under the
trees, testing for flying fox secretions and excrement.(6) They also told me that two investigators
would be back tonight to spend the night under the trees outside the paddock to
make observations on flying fox activity – should there be any.(6)
 |
| Investigators take samples from my paddocks. (www.couriermail.com.au) |
For now, Imabiter, Trixie and Subtle Foe are all seemingly healthy. They seem a little desperate for the human
attention they’re used to getting on a daily basis, but otherwise, they’re
eating and drinking well, acting normally and making a mess of their
stalls. Jeff, Trudy and I are also
seemingly healthy. I cannot ask for
more.
July 20, 2012: I haven’t
written in a couple of days because there’s nothing to report –
thankfully. All horses and people are
doing just fine, and subsequent blood tests for HeV have all been negative. I’m feeling very fortunate.
However, the
investigators who took samples from the paddocks called to tell me that Red’s
paddock tested positive for the presence of HeV. The sample was taken from the ground near the
trees at the back. They advised me about
removing the trees or moving my paddocks altogether. I am lucky to have enough land around me that
I divided my one large pasture into four paddocks – all of which have no trees
anywhere around them. Doc told me that
move was a little drastic, but there’s so little I can do to protect my horses
and this is one thing that can make a difference. Once I add turnout sheds to two of the
paddocks, they will be ready for use.
July 30, 2012: All horses
are back in work and so are we! Trixie,
Subtle Foe and Imabiter got their last blood test today, but it has been longer
than 16 days and so they should have made it through the incubation time by
now. Same goes for me, Jeff and
Trudy. I cannot thank Dr. Benton enough
for everything he did during the outbreak – he was always right there to answer
my questions and help me protect my horses, my employees and friends, and
myself. Red was a big loss, but I feel
so fortunate to have three horses healthy and back in work.
Sources:
1.
Signs of Hendra
virus in horses. Available at: http://www.daff.qld.gov.au/4790_20805.htm.
Accessed 4/23/13.
2.
Personal
protective equipment. Available at: http://www.daff.qld.gov.au/4790_20810.htm.
Accessed 4/23/13.
3.
Symptom chart of
Proserpine horses. Available at:
http://www.hendravirus.org/Documents/Symptom%20chart%20of%20Proserpine%20Horses.pdf.
Accessed 4/24/13.
4.
Guidelines for
veterinarians handling potential Hendra virus infection in horses. Available
at:
http://www.daff.qld.gov.au/documents/Biosecurity_GeneralAnimalHealthPestsAndDiseases/Hendra-GuidelinesForVets.pdf.
Accessed 4/25/13.
5.
Hendra virus. Available
at:
http://www.dpi.nsw.gov.au/agriculture/vetmanual/specimens-by-disease-syndrome/diseases_of_livestock/hendra.
Accessed 4/25/13.
6.
Hendra diary:
John Michell. Available at:
http://www.abc.net.au/local/stories/2011/10/11/3336608.htm?site=northcoast. Accessed
4/25/13.
7.
Hendra virus.
Available at: http://www.who.int/mediacentre/factsheets/fs329/en/. Accessed
4/27/13.
8.
About me.
Available at: http://www.hendravirus.org/aboutme.htm. Accessed 4/27/13.
9.
Reducing the risk
of horses becoming infected with Hendra virus. Available at:
http://www.daff.qld.gov.au/4790_20806.htm. Accessed 4/27/13.
10. Overview
of Hendra virus – Merck Manual. Available at:
http://www.merckmanuals.com/vet/generalized_conditions/ hendra_virus_infection/overview_of_hendra_virus_infection.html.
Accessed 4/28/13.
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