Cercopithecine herpesvirus type I (Herpesvirus simiae, B virus)

Cercopitecine herpesvirus simiae

• What is C. herpesvirus simiae?
  This virus is a member of the herpes group of viruses that occurs naturally in macaque monkeys and possibly in other Old World monkeys. Infection with this C. herpesvirus simiae produces very mild disease in the monkey. Most have no obvious evidence of infection. Some monkeys may have vesicles (small blisters) which progress to ulcers in the mouth, on the face, lips, or genitals and/or eye infection. These lesions spontaneously heal after a few days, but the virus resides permanently in the monkey, and may reactivate and cause ulcerative lesions periodically. These relapses are especially likely to occur when the monkey is “stressed: (like cold sores or fever blisters in humans). During these periods, the virus is shed by the monkey to the environment. However, the virus may also be shed by monkeys without visible lesions or symptoms.

• How does transmission of this virus from monkeys to humans occur?
  Transmission to humans occurs by exposure to contaminated monkey saliva, secretions, or tissues. The most likely routes of transmission are bites and scratches. Infection may also occur by splash to eyes, open cuts, or contact with other mucous membranes. There has been a single case report of person to person transmission.

• Who is at risk for infection with this virus?
  Those at risk include animal caretakers, laboratory personnel, or anyone who is exposed to monkeys or monkey tissues. Persons who are immunosuppressed because of medication or underlying medical conditions may be at higher risk for infection. The risk of acquiring C. herpesvirus simiae infections from macaques is probably very low. Thousands of persons have handled macaques since human infection of C. herpesvirus was first reported in 1934, yet only 28 cases of human infection have been described.

• Can there be serious complications from C. herpesvirus infection?
  Of the 28 reported cases, 22 infected individuals developed encephalitis and 17 of these patients have died as a result of their infection.

• How can I protect myself from infection?
  Proper work practices markedly reduce the chances of infection. When working with non-human primates:

  1. Exercise caution at all times, remembering these are wild animals. They can and will bite and      are capable of transmitting to humans several diseases.

  2. Wear appropriate protective clothing and equipment.

  3. Work together with at least one other person when handling primates. Minimize direct handling.

  4. Report any observed facial, lip, or oral lesions in primates to a staff veterinarian. Report bite, scratch injuries, or splashes involving a macaque monkey or scratches with cages or equipment that might be contaminated with their secretions. Following first aid go immediately to Emory Hospital Employee Health office at HB 53, telephone: 2-7746 and indicate a monkey exposure. Http://grants.nih.gov/grants/olaw/PrimateVideo.cfm

• What should I do if I am injured or splashed by a primate?
  First Aid Instructions
  Follow these instructions step-by-step.
  A.) Monkey bite, scratch, or needle stick (first aid kit in primate rooms)
  • Massage and apply gentle pressure to the wound to make it bleed.
  • Obtain a culture by inserting a Dacron swab into the wound (if it is large) or swab blood exiting the wound site.
  • Put the culture swab into the transport medium and cap.
  • Continue to massage the wound and rinse under warm running water for 12 minutes.
  • Wash the wound with povidone iodine swabsticks for 3 to 5 minutes and rinse periodically.
  • Dry the wound with sterile gauze pads.
  • Cover the wound with a telfa pad and wrap it with gauze.
  • Fill out an incident report. Leave it and the transport medium in the primate room.
  • Report the incident to the DAR office (7-7423).
  • Proceed to the hospital emergency room (floor 2, corridor B south) immediately for further care.
  B.) Eye splash with urine, feces, blood or secretion
  • Rinse eye(s) immediately with eye irrigating solution.
  • Wash eyes for 5 minutes at an eye wash station.
  • Fill out an incident report. Leave it in the room.
  • Call the DAR office (7-7423) and report the incident.
  • Proceed immediately to the emergency room (floor 2, corridor B south) for further care.

• What are the signs and symptoms of C. herpesvirus simiae infection in
  humans?
  Herpesvirus simiae related disease is characterized by a variety of signs and symptoms which generally occur within one month of exposure. These include:
  • Vesicular (small blister) skin lesions at or near the site of injury
  • Localized neurological symptoms such as pain, numbness, or itching near the wound site
  • Flu-like aches and pains
  • Fever and chills
  • Headaches lasting more than 24 hours
  • Muscular incoordination
  • Shortness of breath
  If such symptoms occur following an injury involving a macaque or equipment contaminated with their secretions or tissues, immediately report to the Emory University Hospital Employee Health office at HB 53, telephone: 2-7746

Prepared by: Noel Lehner, D.V.M.

Date: 12/16/97
Revised: 3/21/01 begin