Hendra virus infection: Current insights into an emerging zoonotic disease

Hendra virus (HeV) is a highly pathogenic zoonotic Henipavirus maintained naturally in Pteropus flying foxes, with horses serving as the principal amplifying host for recognized human infection. Since its emergence in Australia in 1994, HeV has remained geographically restricted but continues to pose substantial public-health and veterinary risks because of its high mortality, severe respiratory and neurological manifestations, and sensitivity of spillover dynamics to ecological change. This review critically synthesizes current evidence on HeV etiology, epidemiology, pathogenesis, immune responses, diagnosis, transmission, vaccination, treatment, and control. Recent findings highlight the importance of endothelial and neural tropism, interferon-evasion mechanisms, and ecological drivers that shape bat-horse-human transmission. RT-PCR remains the reference diagnostic method, while emerging point-of-care molecular platforms offer faster detection but still require broader validation across genetically diverse HeV lineages. Equine vaccination provides strong protection against clinical disease and remains the most effective intervention for reducing zoonotic risk. Human vaccine development has progressed into Phase I evaluation, while monoclonal antibody m102.4 has shown strong post-exposure efficacy in animal models but limited clinical evidence in humans. Important gaps remain in genomic surveillance, rapid diagnostic validation, human vaccine efficacy assessment, and therapeutic translation. Future preparedness will therefore require integrated One Health surveillance combining wildlife ecology, veterinary monitoring, genomic data, vaccination, and targeted risk-reduction strategies.