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Recommendations for prevention of and therapy for exposure to B virus (cercopithecine herpesvirus 1)
Jeffrey I Cohen1, David S Davenport, John A Stewart
1Medical Virology Section, Laboratory of Clinical Investigation, National Institutes of Health, Bethesda, Maryland 20892, USA. jcohen@niaid.nih.gov
Abstract:
B virus (Cercopithecine herpesvirus 1) is a zoonotic agent that can cause fatal encephalomyelitis in humans. The virus naturally infects macaque monkeys, resulting in disease that is similar to herpes simplex virus infection in humans. Although B virus infection generally is asymptomatic or mild in macaques, it can be fatal in humans. Previously reported cases of B virus disease in humans usually have been attributed to animal bites, scratches, or percutaneous inoculation with infected materials; however, the first fatal case of B virus infection due to mucosal splash exposure was reported in 1998. This case prompted the Centers for Disease Control and Prevention (Atlanta, Georgia) to convene a working group in 1999 to reconsider the prior recommendations for prevention and treatment of B virus exposure. The present report updates previous recommendations for the prevention, evaluation, and treatment of B virus infection in humans and considers the role of newer antiviral agents in postexposure prophylaxis.
Insights
B virus (Cercopithecine herpesvirus 1) is a zoonotic virus that can cause fatal human disease. Updated recommendations address prevention and treatment following potential exposure, including newer antiviral therapies.
Area of Science:
- Virology
- Public Health
- Infectious Diseases
Background:
- B virus (Cercopithecine herpesvirus 1) is a zoonotic virus naturally infecting macaques.
- While typically mild in macaques, B virus can cause fatal human encephalomyelitis.
- Previous human cases primarily resulted from bites, scratches, or direct inoculation.
Purpose of the Study:
- To update recommendations for preventing, evaluating, and treating human B virus infection.
- To consider the role of novel antiviral agents in postexposure prophylaxis.
- To address B virus exposure risks, including mucosal splash incidents.
Main Methods:
- Review of B virus epidemiology and clinical manifestations.
- Analysis of a fatal mucosal splash exposure case.
- Reconsideration of existing prevention and treatment guidelines by a CDC working group.
Main Results:
- A fatal case of B virus infection resulted from mucosal splash exposure, highlighting a less common transmission route.
- The 1998 case prompted a re-evaluation of B virus prevention and treatment strategies.
- Updated guidelines incorporate current knowledge on B virus pathogenesis and management.
Conclusions:
- Revised recommendations are crucial for managing human B virus exposure.
- Postexposure prophylaxis strategies should be reassessed, considering newer antiviral options.
- Enhanced vigilance and updated protocols are necessary to prevent fatal outcomes from B virus infection.