title: Human Hendra virus encephalitis associated with equine outbreak, Australia, 2008.
abstract: A recent Hendra virus outbreak at a veterinary clinic in Brisbane, Queensland, Australia, involved 5 equine and 2 human infections. In contrast to previous outbreaks, infected horses had predominantly encephalitic, rather than respiratory, signs. After an incubation period of 9-16 days, influenza-like illnesses developed in the 2 persons before progressing to encephalitis; 1 died. Both patients were given ribavirin. Basal serum and cerebrospinal fluid levels were 10-13 mg/L after intravenous administration and 6 mg/L after oral administration (isolate 90% inhibitory concentration 64 mg/L). Both patients were exposed to infected horses, 1 during the late incubation period in a horse. The attack rate for veterinary clinic staff exposed to infected horses was 10%. An isolate from this outbreak showed genetic heterogeneity with isolates from a concurrent, but geographically remote, outbreak and from previous outbreaks. Emergence of Hendra virus is a serious medical, veterinary, and public health challenge.
authors.affiliation: Pathology Queensland, Brisbane, Queensland, Australia.
authors.forename: Elliott G
authors.initials: EG
authors.lastname: Playford
authors.forename: Brad
authors.initials: B
authors.lastname: McCall
authors.forename: Greg
authors.initials: G
authors.lastname: Smith
authors.forename: Vicki
authors.initials: V
authors.lastname: Slinko
authors.forename: George
authors.initials: G
authors.lastname: Allen
authors.forename: Ina
authors.initials: I
authors.lastname: Smith
authors.forename: Frederick
authors.initials: F
authors.lastname: Moore
authors.forename: Carmel
authors.initials: C
authors.lastname: Taylor
authors.forename: Yu Hsin
authors.initials: YH
authors.lastname: Kung
authors.forename: Hume
authors.initials: H
authors.lastname: Field
mesh_terms: D000328:Adult; D000818:Animals; D016358:Contact Tracing; D004196:Disease Outbreaks / Q000662:veterinary*; D004660:Encephalitis / Q000453:epidemiology / Q000662:veterinary / Q000821:virology*; D017809:Fatal Outcome; D005260:Female; D045404:Hendra Virus; D045464:Henipavirus Infections / Q000453:epidemiology / Q000635:transmission / Q000662:veterinary*; D006734:Horse Diseases / Q000453:epidemiology* / Q000821:virology; D006736:Horses; D006801:Humans; D008297:Male; D011793:Queensland / Q000453:epidemiology; D055815:Young Adult