Exposure to Macaque Monkey Bite
William F Johnston1, Jesson Yeh1, Richard Nierenberg1
1Emergency Trauma Department, Hackensack University Medical Center, Hackensack, New Jersey.
Background:
The herpes B virus is a zoonotic agent that is endemic among macaque monkeys only, but can cause fatal encephalomyelitis in humans.
Case Report:
A 26-year-old female presented to a U.S. emergency department after being bitten by a wild macaque monkey. The emergency medicine team administered rabies immunoglobulin and rabies vaccine. The team also prescribed acyclovir for prophylactic coverage against herpes B, a deadly zoonotic agent that is endemic among macaque monkeys. A discussion of background, exposure, transmission, symptoms, treatment for herpes B, including latest data available, literature, and Centers for Disease Control and Prevention guidelines are included. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Zoonotic exposures can cause infectious diseases, which are unfamiliar and deadly. The emergency physician's knowledge of the association between the deadly herpes B infection and wild macaque monkey may expedite treatment and be instrumental in patient morbidity and survival.
Insights
A wild macaque bite can transmit herpes B virus (HBV), a deadly zoonotic infection. Prompt medical care, including prophylactic acyclovir, is crucial for emergency physicians managing such exposures to prevent severe outcomes.
Area of Science:
- Infectious Diseases
- Virology
- Emergency Medicine
Background:
- Herpes B virus (HBV) is a zoonotic pathogen primarily affecting macaque monkeys.
- HBV infection in humans can lead to fatal encephalomyelitis.
- Wild macaque monkey bites pose a significant risk for HBV transmission.
Observation:
- A 26-year-old female presented after a wild macaque monkey bite.
- Emergency treatment included rabies prophylaxis and acyclovir for potential HBV exposure.
- The case highlights the importance of recognizing zoonotic risks in emergency settings.
Findings:
- Acyclovir was administered for prophylactic coverage against herpes B virus.
- The case underscores the potential for severe zoonotic infections from seemingly routine exposures.
- Early recognition and intervention are critical for patient survival.
Implications:
- Emergency physicians must be aware of the risks associated with zoonotic exposures, particularly from non-human primates.
- Prompt administration of appropriate antiviral prophylaxis can mitigate severe morbidity and mortality.
- Enhanced vigilance for rare but deadly infections like herpes B virus is essential in emergency medicine.
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