Information delivery and the veterinarian-horse owner relationship in the context of Hendra virus in Australia.

Hendra virus (HeV) is an emerging bat-borne virus endemic in Australia that can be transmitted from horses to humans and has a high fatality rate for horses and people. Controversy surrounding HeV risk mitigation measures have strained the veterinarian-horse owner relationship. This study aimed to characterise the veterinarian-horse owner relationship in general and also in the context of HeV by analysing data derived from the 'Horse Owners and Hendra Virus: A Longitudinal Study to Evaluate Risk' (HHALTER) study. Australian horse owners were recruited via emails, social media and word-of-mouth for a series of five surveys that were administered online at six-monthly intervals over a two-year period to capture baseline knowledge, attitudes and practices of horse owners regarding HeV and any changes over time. In the current study, descriptive analyses of information sources were performed to understand the use of veterinarians as a HeV information source (Surveys 1 and 5; n = 1195 and n = 617). Ordinal logistic regression analyses were conducted to determine factors associated with the frequency of horse owner contact with a veterinarian (Survey 3; n = 636). This study found a relative increase over the study period in the proportion of horse owners who had used veterinarians as HeV information source in the last 12 months (from 51.9% to 88.3%). Owning more horses, being older, having a 'duty of care' for other people working with horses and deriving the main income from horse related business were factors associated with more frequent veterinary contact. Results suggest that traditional information sources such as workshops, information packs and risk training are likely to be used by horse owners. Smart phone applications should be considered for use in the future and require further investigation for horse health communication. The findings of this study may be helpful in optimising strategies for horse health information delivery.

Australian horse owners and their biosecurity practices in the context of Hendra virus.

In recent years, outbreaks of exotic as well as newly emerging infectious diseases have highlighted the importance of biosecurity for the Australian horse industry. As the first potentially fatal zoonosis transmissible from horses to humans in Australia, Hendra virus has emphasised the need to incorporate sound hygiene and general biosecurity practices into day-to-day horse management. Recommended measures are widely publicised, but implementation is at the discretion of the individual owner. This cross-sectional study aimed to determine current levels of biosecurity of horse owners and to identify factors influencing the uptake of practices utilising data from an online survey. Level of biosecurity (low, medium, high), as determined by horse owners' responses to a set of questions on the frequency of various biosecurity practices performed around healthy (9 items) and sick horses (10 items), was used as a composite outcome variable in ordinal logistic regression analyses. The majority of horse owners surveyed were female (90%), from the states of Queensland (45%) or New South Wales (37%), and were involved in either mainly competitive/equestrian sports (37%) or recreational horse activities (35%). Seventy-five percent of owners indicated that they follow at least one-third of the recommended practices regularly when handling their horses, resulting in medium to high levels of biosecurity. Main factors associated with a higher level of biosecurity were high self-rated standard of biosecurity, access to personal protective equipment, absence of flying foxes in the local area, a good sense of control over Hendra virus risk, likelihood of discussing a sick horse with a veterinarian and likelihood of suspecting Hendra virus in a sick horse. Comparison of the outcome variable with the self-rated standard of biosecurity showed that over- as well as underestimation occurred. This highlights the need for continuous communication and education to enhance awareness and understanding of what biosecurity is and how it aligns with good horsemanship. Overall, strengthened biosecurity practices will help to improve animal as well as human health and increase preparedness for future disease outbreaks.

"We've learned to live with it"-A qualitative study of Australian horse owners' attitudes, perceptions and practices in response to Hendra virus.

Hendra virus causes sporadic zoonotic disease in Australia following spill over from flying foxes to horses and from horses to people. Prevention and risk mitigation strategies such as vaccination of horses or biosecurity and property management measures are widely publicised, but hinge on initiative and action taken by horse owners as they mediate management, care and treatment of their animals. Hence, underlying beliefs, values and attitudes of horse owners influence their uptake of recommended risk mitigation measures. We used a qualitative approach to investigate attitudes, perceptions and self-reported practices of horse owners in response to Hendra virus to gain a deeper understanding of their decision-making around prevention measures. Data presented here derive from a series of in-depth interviews with 27 horse owners from Hendra virus 'hot spot' areas in New South Wales and Queensland. Interviews explored previous experience, perceptions and resulting behaviour as well as communication around Hendra virus. All interviews were recorded, transcribed verbatim and analysed in NVivo using thematic analysis. Analysis revealed four major themes: perception of Hendra virus as a risk and factors influencing this perception, Hendra virus risk mitigation strategies implemented by horse owners, perceived motivators and barriers of these strategies, and interaction of perceived risk, motivators and barriers in the decision-making process. Although Hendra virus disease was perceived as a serious threat to the health of horses and humans, individual risk perception diverged among horse owners. Perceived severity, likelihood and unpredictability as well as awareness and knowledge of Hendra virus, trust in information obtained and information pathways, demographic characteristics and personal experience were the main factors influencing Hendra virus risk perceptions. Other key determinants of horse owners' decision-making process were attitudes towards Hendra virus risk mitigation measures as well as perceived motivators and barriers thereof. Horse owners' awareness of the necessity to consider individual Hendra virus risk and adequate risk management strategies was described as a learning process, which changed over time. However, different perceptions of risk, barriers and motivators in combination with a weighing up of advantages and disadvantages resulted in different behaviours. These findings demonstrate the multifactorial determinants of cognitive mediating processes and facilitate a better understanding of horse owners' perspectives on preventive horse health measures. Furthermore, they provide valuable feedback to industry and government stakeholders on how to improve effective risk communication and encourage uptake of recommended risk mitigation measures.

A Q fever cluster among workers at an abattoir in south-western Sydney, Australia, 2015.

BACKGROUND: In September 2015, the Public Health Unit of the South Western Sydney Local Health District was notified of two possible Q fever cases. Case investigation identified that both cases were employed at an abattoir, and both cases advised that co-workers had experienced similar symptoms. Public Health Unit staff also recalled interviewing in late 2014 at least one other Q fever case who worked at the same abattoir. This prompted an outbreak investigation. METHODS: The investigation incorporated active case finding, microbiological analysis, field investigation and a risk factor survey. Included cases were laboratory definitive or suspected cases occurring from October 2014 to October 2015, residing or working in south-western Sydney. A suspected case had clinically compatible illness, high-risk exposure and was epidemiologically linked to another confirmed case. A confirmed case included laboratory detection of C. burnetti. RESULTS: Eight cases met the case definition with seven confirmed (including a deceased case) and one suspected. The eight cases were all males who had been employed at an abattoir in south-western Sydney during their incubation period; symptom onset dates ranged from November 2014 to September 2015. Field investigation identified multiple potential risk factors at the abattoir, and the majority (75%) of employees were not vaccinated against Q fever despite this high-risk setting. CONCLUSION: This cluster of Q fever in a single abattoir confirms the significance of this zoonotic disease as an occupational hazard among persons working in high-risk environments. Implementation of Q fever vaccination programmes should eliminate Q fever in high-risk occupational settings.

A Comparative Assessment of the Risks of Introduction and Spread of Foot-and-Mouth Disease among Different Pig Sectors in Australia.

Small-scale pig producers are believed to pose higher biosecurity risks for the introduction and spread of exotic diseases than commercial pig producers. However, the magnitude of these risks is poorly understood. This study is a comparative assessment of the risk of introduction and spread of foot-and-mouth disease (FMD) through different sectors of the pig industry: (1) large-scale pig producers; (2) small-scale producers (<100 sows) selling at saleyards and abattoirs; and (3) small-scale producers selling through informal means. An exposure and consequence assessments were conducted using the World Organization for Animal Health methodology for risk analysis, assuming FMD virus was introduced into Australia through illegal importation of infected meat. A quantitative assessment, using scenario trees and Monte Carlo stochastic simulation, was used to calculate the probabilities of exposure and spread. Input data for these assessments were obtained from a series of data gathering exercises among pig producers, industry statistics, and literature. Findings of this study suggest there is an Extremely low probability of exposure (8.69 × 10-6 to 3.81 × 10-5) for the three sectors of the pig industry, with exposure through direct swill feeding being 10-100 times more likely to occur than through contact with infected feral pigs. Spread of FMD from the index farm is most likely to occur through movement of contaminated fomites, pigs, and ruminants. The virus is more likely to spread from small-scale piggeries selling at saleyards and abattoirs than from other piggeries. The most influential factors on the spread of FMD from the index farm is the ability of the farmer to detect FMD, the probability of FMD spread through contaminated fomites and the presence of ruminants on the farm. Although small-scale producers selling informally move animals less frequently and do not use external staff, movement of pigs to non-commercial pathways could jeopardize animal traceability in the event of a disease outbreak. This study suggests that producers' awareness on and engagement with legislative and industry requirements in relation to biosecurity and emergency animal disease management needs to be improved. Results from this study could be used by decision-makers to prioritize resource allocation for improving animal biosecurity in the pig industry.