Diagnosis of Hendra virus in humans begins with a thorough review of symptoms and risk factors (e.g., occupational exposure, close contact with horses, recent travel to high-risk areas). Diagnosis is confirmed through a throat or nasal swab and/or cerebrospinal fluid sample. The sample is tested using reverse transcriptase polymerase chain reaction (RT-PCR), a sequencing method that detects the genetic material of a pathogen (e.g., RNA from Hendra virus) and subsequently produces a genetic code (i.e., DNA) of the detected pathogen. Enzyme-linked immunosorbent assay (ELISA), which utilizes specific antibodies that can bind to a protein derivative of Hendra virus, can also be used to confirm the disease. Samples taken from infected horses can also be sent to laboratories for further confirmation.
For humans, treatment consists of supportive care measures aimed at improving symptom burden in both respiratory and neurologic involvement. Supportive measures include adequate rest and hydration with oral fluids, and over-the-counter medications such as acetaminophen or ibuprofen to manage fever and alleviate muscle aches and pains. Saline nasal sprays and humidifiers may help with nasal congestion, and salt water rinses can help relieve sore throat. If symptoms worsen with significant respiratory compromise (e.g., shortness of breath, wheezing), individuals should seek emergency medical attention immediately, as they may require hospitalization for airway management. Treatment with ribavirin, an antiviral medication, and post-exposure therapy with Hendra virus-neutralizing antibodies are emerging strategies that are effective based on in vitro studies (i.e., studies conducted outside of a living organism). However, further clinical studies are needed to confirm their efficacy in humans. Even though Hendra virus infection is rare, mortality rates are high. Of the seven reported causes of Hendra virus infection in humans, four (57%) individuals did not survive. Of note, a vaccine against Hendra virus can be administered to horses to prevent re-infection and reduce the likelihood of human exposure.
Individuals who work closely with horses, especially in regions where Hendra virus is prevalent (e.g., coastal and forested regions in Australia), should take preventative measures to minimize risks by using protective equipment, avoiding contact with sick horses, and implementing good hygiene, all of which reduce the risk of disease exposure. Additionally, there is an emergency animal disease hotline at 1-800-675-888 for individuals who have come into contact with infected horses with signs of illness.
