Table 2 Summary of main barriers to infection control and Hendra virus management in private veterinary practices in Queensland, Australia, up until September 2010

Work culture

• Longstanding observance of suboptimal IC practices;

• Veterinarians' perception that zoonotic risks in equine veterinary practice were low;

• Veterinarians' perception that they are more likely to be exposed to injury risks than infectious risks in equine practice;

• Mitigation of injury risks more readily implemented by veterinarians than mitigation of infectious risks in equine practice;

• Inadequate veterinary work habits perpetrated in some instances by poor professional mentorship during extramural undergraduate placement or during early career experiences.

Role of Government

• Suboptimal HeV testing pathways

• Slow response from government authorities to the emergence of HeV and to HeV outbreaks

• Suboptimal and conflicting communication of risk and risk mitigation from government authorities to veterinarians

• Inconsistent government support for veterinarians throughout the state, with rural remote areas receiving less skilled technical support

• Difficulties in complying and collaborating with WHS legislation and authorities

Managing animal and public health issues and a private business

• The logistical, financial and work time costs of implementing infection control changes within the context of running small private businesses

• Difficulty in interpreting and enforcing WHS regulation

• Mitigation of zoonotic risks interfering with the mitigation of injury risks

• Lack of WHS legal protection when a third party breaches the legislation

• Veterinarians' lack of experience choosing and using some of the PPE recommended

• Inadequate, insufficient and inconsistent training of undergraduate veterinarians about IC and HeV management

• Difficulty in implementing IC behavioural changes amongst veterinary staff

• Difficulty inefficiently communicating with clients about HeV-related risks and risk mitigation recommendations

Uncertainty about the epidemiology of an emerging disease

• Slow emergence and sporadic nature of HeV outbreaks

• Slow gathering and dissemination of epidemiological information

• Misinterpretation of epidemiological information

• Non-specific HeV case definition