Cercopithecine herpesvirus 1 (B virus)
infection is widespread among Macaca genus primates; the virus is
the biologic counterpart of herpes simplex virus in humans. B
virus infection in humans is recognized as a rapidly ascending
encephalomyelitis with a fatality rate of approximately 70%. The
need for guidelines in prevention and treatment of human B virus
infection was recognized in 1987 after a cluster of four
symptomatic infections occurred among persons in Florida. CDC and
the National Institutes of Health consulted primate veterinarians
and herpesvirus experts to develop guidelines for preventing B
virus infection in persons who work with macaques (1).
Recommendations intended to minimize the risk for infection of
laboratory workers exposed to B virus-contaminated primary rhesus
monkey cell cultures were published in 1989 (2). Guidelines for
primate handlers were expanded in 1990 in response to the
recognition of filovirus infection in quarantined primates (3).
Human infections with B virus remain an
uncommon result of macaque-related injuries, and optimal
diagnostic and therapeutic approaches are unclear. However, the
increase in the use of macaques for research on simian retrovirus
infection and hepatitis has expanded the number of potential
incidents of human exposure. In January 1990, Emory University
and CDC sponsored a B virus working group intended to formulate a
rational approach to the prevention, detection, and management of
human B virus infections. Written guidelines were developed based
on information from published and unpublished cases, knowledge of
the behavior of herpes simplex virus, and expert opinion.
These guidelines (4) are intended to assist
institutions in which macaques are handled in developing and
enforcing effective standard operating procedures and
quality-control interventions and to enable local physician
consultants identified by the institutions to evaluate and treat
persons with potential B virus exposure. Such institutions should
keep a copy of these guidelines in bite/wound kits at the work
site. Institutions also should provide copies of these guidelines
to injured employees referred for medical evaluation; to the
emergency rooms, clinics, or offices where injured employees will
seek care; and to employees to give to their personal physician.
More information on the guidelines is available from B Virus
Guidelines, Division of Viral and Rickettsial Diseases, National
Center for Infectious Diseases, CDC, Mailstop G-19, 1600 Clifton
Road, NE, Atlanta, GA 30333.
References
1. CDC. Guidelines for prevention of
Herpesvirus simiae (B virus) infection in monkey handlers. MMWR
1987;36:680-2,687-9.
2. Wells DL, Lipper SL, Hilliard JK, et al.
Herpesvirus simiae contamination of primary rhesus monkey kidney
cell cultures: CDC recommendations to minimize risks to
laboratory personnel. Diagn Microbiol Infect Dis 1989;12:333-5.
3. CDC. Update: Ebola-related filovirus
infection in nonhuman primates and interim guidelines for
handling nonhuman primates during transit and quarantine. MMWR
1990;39:22-4,29-30.
4. Holmes GP, Chapman LE, Stewart JA, et al.
Guidelines for the prevention and treatment of B-virus infections
in exposed persons. Clin Infect Dis 1995;20:421-39.