Henipaviruses-A constant threat to livestock and humans.

In this review, we highlight the risk to livestock and humans from infections with henipaviruses, which belong to the virus family Paramyxoviridae. We provide a comprehensive overview of documented outbreaks of Nipah and Hendra virus infections affecting livestock and humans and assess the burden on the economy and health systems. In an increasingly globalized and interconnected world, attention must be paid to emerging viruses and infectious diseases, as transmission routes can be rapid and worldwide.

A large-scale behavior change intervention to prevent Nipah transmission in Bangladesh: components and costs.

BACKGROUND: Nipah virus infection (NiV) is a bat-borne zoonosis transmitted to humans through consumption of NiV-contaminated raw date palm sap in Bangladesh. The objective of this analysis was to measure the cost of an NiV prevention intervention and estimate the cost of scaling it up to districts where spillover had been identified. METHODS: We implemented a behavior change communication intervention in two districts, testing different approaches to reduce the risk of NiV transmission using community mobilization, interpersonal communication, posters and TV public service announcements on local television during the 2012-2014 sap harvesting seasons. In one district, we implemented a "no raw sap" approach recommending to stop drinking raw date palm sap. In another district, we implemented an "only safe sap" approach, recommending to stop drinking raw date palm sap but offering the option of drinking safe sap. This is sap covered with a barrier, locally called bana, to interrupt bats' access during collection. We conducted surveys among randomly selected respondents two months after the intervention to measure the proportion of people reached. We used an activity-based costing method to calculate the cost of the intervention. RESULTS: The implementation cost of the "no raw sap" intervention was $30,000 and the "only safe sap" intervention was $55,000. The highest cost was conducting meetings and interpersonal communication efforts. The lowest cost was broadcasting the public service announcements on local TV channels. To scale up a similar intervention in 30 districts where NiV spillover has occurred, would cost between $2.6 and $3.5 million for one season. Placing the posters would cost $96,000 and only broadcasting the public service announcement through local channels in 30 districts would cost $26,000. CONCLUSIONS: Broadcasting a TV public service announcement is a potential low cost option to advance NiV prevention. It could be supplemented with posters and targeted interpersonal communication, in districts with a high risk of NiV spillover.

Intangible and Economic Impacts of Hendra Virus Prevention Strategies.

Hendra virus (HeV), a potentially fatal zoonotic disease spread by flying foxes, to date has always infected humans via a spillover event from equine HeV infection. In a theoretical case study, we compared the impacts of two different HeV prevention strategies - vaccination and flying fox roost removal - using a recently developed framework that considers different stakeholder group perspectives. The perspectives of the four selected stakeholder groups regarding intangibles were inferred from public discussions and coverage in the media. For all stakeholder groups, the option to vaccinate horses was found to add value to the economic results when the intangible impacts were included in the analysis, while the option for roost removal unanimously detracted from economic analysis value when the intangible impacts were included. Both the mean and median stakeholder-adjusted value ratios (2.25 and 2.12, respectively) for vaccination were inflated when intangible impacts were included, by value-adding to the results of a traditional economic analysis. In the roost removal strategy, these ratios (1.19 and 1.16, respectively) were deflated when intangible impacts were included. Results of this theoretical study suggest that the inclusion of intangible impacts promotes the value of a two-dose initial vaccination protocol using a subunit vaccination considered to offer complete protection for horses, as a strategy to control HeV, whereas roost removal becomes an even more costly strategy. Outcome of the analysis is particularly sensitive to the intangible value placed on human health. Further evaluation - via sociological methods - of values placed on intangibles by various stakeholder groups is warranted.