Credit CDC
#16,072
With only few dozen known cases over the past 90 years (the CDC cites 50 cases, 21 fatal) - and most of those among lab personnel working with macaques - human Monkey B Virus (Herpesvirus simiae) infection remains more of a medical rarity than a public health concern.
It is, however, a serious illness, and close to half of known cases have been fatal.
And there are concerns that as opportunities for human-simian contact increase, that species jumps could become more common.
The CDC warns:Increasingly, free-ranging macaque monkeys infected with B virus are a common source for potentially exposing people to this virus. Large colonies of these monkeys are present in some parks in Florida and Puerto Rico. However, CDC has not received reports of people getting infected with B virus from these monkeys. If you are in a place where there are macaque monkeys, you should stay away from them so that you do not get bitten or scratched. You should not touch or feed monkeys.
They then go on to say:
Most people will not come in contact with monkeys, so their risk of getting infected with B virus is very low. However, laboratory workers, veterinarians, and others who may be exposed to monkeys or their specimens have a higher risk of getting B virus infection. In recent years, many macaque attacks have been reported by people visiting temple parks in some countries in Asia, where macaques commonly roam freely. About 70 to 80% of these macaques have been found to be B virus positive, but there have not been any documented cases of B virus spreading to humans.
You can get infected with B virus if you:Only one case has been documented of an infected person spreading B virus to another person.
- are bitten or scratched by an infected monkey
- get an infected monkey’s tissue or fluid on your broken skin or in your eyes, nose, or mouth
- have a needle stick by a contaminated syringe
- scratch or cut yourself on a contaminated cage or other sharp-edged surface
- are exposed to the brain (especially), spinal cord, or skull of an infected monkey
Despite the rarity of simian-to-human transmission, the Monkey B virus continues to inspire headlines - particularly here in Florida - where reports of packs of wild monkeys roaming neighborhoods are becoming more common. A few include:
These wild monkeys thrive in Florida—and carry a deadly virus - Nat GeoThey're here! Invasive, herpes-carrying monkeys reach the First Coast - First Coast News
Eye-catching headlines aside, the Monkey B virus ranks pretty far down my personal list of things in the wilds of Florida that can kill you (think: mosquitoes, sharks, alligators, snakes, Naegleria fowleri, etc.).
Exceedingly rare, the Monkey B virus is still considered a zoonotic disease threat, and so the following report from China's CDC Weekly may be of interest to some of my readers.
First, some excerpts from the report (follow the link for full text & graphics), then I'll have a brief postscript.
First Human Infection Case of Monkey B Virus Identified in China, 2021
Wenling Wang1, Wenjie Qi2,; Jingyuan Liu3, Haijun Du4, Li Zhao1; Yang Zheng5; Guoxing Wang2; Yang Pan5; Baoying Huang1; Zhaomin Feng5; Daitao Zhang5; Peng Yang5; Jun Han4, ;Quanyi Wang5, , ;Wenjie Tan1, , View author affiliations
Control, Beijing, China
Corresponding authors:
Jun Han, hanjun@ivdc.chinacdc.cn; Quanyi Wang, bjcdcxm@126.com; Wenjie Tan, tanwj@ivdc.chinacdc.cn
Online Date: July 03 2021
doi: 10.46234/ccdcw2021.154
Monkey B virus (BV), initially isolated in 1932, is currently designated as Macacine alphaherpesvirus 1 by the International Committee on Taxonomy of Viruses (1). BV is an alphaherpesvirus enzootic in macaques of the genus Macaca, normally transmitted horizontally via direct contact and exchange of bodily secretions, just like herpes simplex virus (HSV) in humans. BV is not evident in its natural macaque hosts, but about 60 additional cases of pathogenic zoonotic BV infection have occurred sporadically and the fatality rate of zoonotic BV infections is 70%–80%.Although the risk for secondary transmission appears to be minimal, one case of human-to-human transmission of herpes B virus has previously been documented (2). Zoonotic BV infections have mainly involved primate veterinarians, animal care personnel, or laboratory researchers in North America. However, there were no fatal or even clinically evident BV infections in China before 2021. Here, we reported the first human infection case with BV identified in China.
This case of BV occurred in a veterinary surgeon (53 years old, male) who worked in an institute specialized in nonhuman primate breeding and experimental research in Beijing. He dissected two dead monkeys on March 4 and 6, 2021 and experienced nausea and vomiting followed by fever with neurological symptoms one month later. As a result, the patient visited doctor in several hospitals but eventually died on May 27.
On April 17, cerebrospinal fluid (CSF) was collected from this patient for next generation sequencing (NGS), 285 reads obtained suggesting possible alphaherpesvirus infection. To further identify the etiological agent, several specimens (including CSF, blister fluid, blood, airway aspirates, nasal swab, throat swab, and plasma) were collected from this patient and 2 close contacts (1 doctor, 47 years old, male; 1 nurse, 25 years old, female), then sent to National Institute for Viral Disease Control and Prevention (IVDC) of China CDC on April 19.Four sets of real-time polymerase chain reaction (rtPCR) were performed to detect BV (3), varicella zoster virus (VZV) (4), monkeypox virus and orthopoxvirus (5). For BV detection, the forward primer was 5′-TGGCCTACTACCGCGTGG-3′, the reverse primer was 5′-TGGTACGTGTGGGAGTAGCG-3′; and the TaqMan probe was 5′-FAM-CCGCCCTCTCCGAGCACGTG-TAMRA-3′. The rtPCR results showed that only BV genome was detected as positive (Cycle of threshold: 34) in the CSF specimen of the patient, while BV negative in other specimens from the patient and all specimens from close contacts; moreover, all tests were negative for VZV, monkeypox virus, and orthopoxvirus (Figure 1).This result confirmed the first human infection case with BV in China.
The first human infection case with BV was identified by NGS and rtPCR in China, 2021. This implied that BV in monkeys might pose a potential zoonotic threat to the occupational workers. It is necessary to eliminate BV during the development of specific pathogen-free rhesus colonies and to strengthen surveillance in laboratory macaques and occupational workers in China.
If you are exposed to a macaque monkey, begin first aid immediately.
- First, thoroughly wash and gently scrub the wound or area on your body that had contact with the monkey with soap, detergent, or iodine for 15 minutes.
- After, run water over the wound or area for 15 to 20 minutes more.
Then, immediately see a healthcare provider for treatment. Tell the healthcare provider that you have been exposed to a macaque monkey that may be infected with B virus.
