B virus (Herpesvirus simiae) infection in humans: epidemiologic investigation of a cluster

Area of Science:

• Virology
• Public Health
• Epidemiology

Background:

• B virus (Cercopithecine herpesvirus 1) is a simian herpesvirus that can cause severe or fatal neurological disease in humans.
• Human B virus infections are rare but have a high mortality rate, necessitating prompt recognition and management.

Observation:

• A cluster of four symptomatic B virus infections occurred in Pensacola, Florida, in March 1987.
• Three cases were linked to occupational exposure to monkeys at a research facility, and one case resulted from autoinoculation via a topical skin cream.
• Contact tracing identified 159 potentially exposed individuals, but no additional cases were detected.

Findings:

• Restriction endonuclease pattern analysis linked two monkey handler cases to one ill monkey and another case to a healthy monkey, suggesting zoonotic transmission.
• Identified risk factors for human B virus infection included inadequate monkey restraint, non-use of personal protective equipment, and direct inoculation through topical medications.
• The investigation underscored the potential for B virus transmission from both symptomatic and asymptomatic monkeys.

Implications:

• The findings emphasize the critical need for stringent safety protocols when handling nonhuman primates, particularly macaques.
• Implementing universal precautions, including appropriate personal protective equipment and monkey restraint, is crucial for preventing occupational B virus exposure.
• Public awareness regarding the risks associated with simian herpesvirus and the importance of avoiding self-treatment with potentially contaminated products is essential.