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Yerkes tragedy: Death by herpes B

		

		Dr. Jane Koehler, an epidemiologist with the Georgia Division of
		Public Health, and Dr. Louisa Chapman of the U.S. Centers for Disease
		Control and Prevention spoke with staff writer Patricia Guthrie about
		the herpes B virus.
		
		Q: What is herpes B virus?
		
		A: It's basically the monkey version of herpes simplex found in humans
		that can be present for years but only periodically show symptoms. It
		is transmitted only by macaque monkeys.
		
		Q: How does it differ from the commonly known herpes simplex?
		
		A: Herpes simplex usually only causes cold sores on the lips or
		genital area in humans. The B virus in monkeys does not sicken the
		monkeys but when passed to humans leads to deadly infections of the
		brain.
		
		Q: How common is it?
		
		A: It's extremely rare. The Centers for Disease Control and Prevention
		reports only 40 cases of it in the world; the majority of the cases
		involved research primate handlers. The CDC has investigated cases in
		Florida, Michigan and Texas.
		
		Q: When was the last fatal case?
		
		A: In Texas in 1990, the CDC investigated the death of a research lab
		worker. "He was a primate worker who got infected and died when his
		wife was pregnant with their first child. All of these cases are
		tragic cases," said Chapman.
		
		Q: Have there ever been previous cases in Georgia?
		
		A: No.
		
		Q: How is it transmitted?
		
		A: People may be exposed to the virus when handling bodily fluids of
		infected animals or when they are scratched or bitten by these
		monkeys. About 80 percent to 90 percent of adult rhesus macaques are
		infected with the herpes B virus.
		
		Q: What is the treatment for it?
		
		A: There is no vaccine or cure. Anti-viral medications are attempted
		but are not often successful; 70 percent of the virus B cases reported
		were fatal. The infection spreads into the spinal cord and brain after
		initially appearing as mild flu-like symptoms or eye infections. "It's
		a terrible disease," said Koehler.
		
		Q: Can it be transmitted person-to-person?
		
		A: Only one of the 40 cases known to the CDC was a person-to-person
		transmission. An exposed research handler in Florida accidentally
		infected his wife who was suffering from a skin disease and had open
		sores.
		
		Q: Where are these monkeys found?
		
		A: In Asia and Africa. Macaques are about 18 to 24 inches high, weigh
		up to 40 pounds. They are mostly used for research in the United
		States, but some are kept as pets in people's homes. The CDC has been
		consulted on numerous cases involving Americans who've been bitten by
		wild monkeys while traveling in Thailand and other places native to
		the macaques. "None of these bites that I've known of have resulted in
		infection," said Chapman.
		
		========
		
		At a glance: herpes B virus
		
		Up to 90 percent of adult rhesus macaques are infected with the herpes
		B virus, for which there is no vaccine or cure. People may be exposed
		to the virus when handling bodily fluids of infected animals or when
		they are scratched or bitten.
		
		The macaque is the only known carrier among monkeys of the B virus.
		Macaques are mostly used for research in the United States, but some
		are kept as pets in people's homes. Types of macaque monkeys known to
		carry herpes B are Tibetan macaques, lion-tailed macaques and
		crab-eating macaques.
		
		Thousands of people handle macaque monkeys in research but not many
		cases of the virus have been documented. The CDC reports fewer than 40
		cases in the world.
		
		CDC guidelines for properly handling monkeys were created in 1987
		after a herpes B outbreak in Pensacola, Fla., killed two monkey
		handlers and infected two other people.
		
		Employees at International Research and Development Corp. in Mattawan,
		Mich., sued after a co-worker died of infection with the herpes B
		virus. The employees claimed the company failed to tell its workers
		about the risks of handling monkeys. The employees lost their lawsuit
		for damages against the company when the Michigan Court of Appeals
		ruled they could only seek worker's compensation benefits.
		
		-- Patricia Guthrie
		
		=========================================

        Pet Monkeys Can Carry Deadly Virus 

        By Theresa Tamkins

        NEW YORK (Reuters) -- Owners of macaque monkeys are at risk of
        becoming infected with a potentially deadly virus, according to the
        Centers for Disease Control and Prevention (CDC). An estimated
        80% to 90% of adult macaque monkeys carry B-virus, a herpes virus
        that is harmless to the animal but deadly in humans. 

        The virus is shed in saliva or genital secretions, and pet owners are
        at high risk of being infected because monkeys tend to establish
        dominance in a social group by biting, and also often become more
        aggressive with age. Some pet owners also put themselves at risk by
        intimate contact, including kissing their pets on the lips, eating off
        the same plate, sharing chewing gum, or diapering the animals.
        Children are three times as likely as adults to become infected,
        according to a report in the CDC's journal, Emerging Infectious
        Diseases. 

        The monkeys can also be found in animal parks, and in some states --
        particularly Florida and Texas -- there are wild packs of the animals. 

        Just last week an animal research worker died after being exposed to
        contaminated fluid from a macaque monkey at Yerkes Regional
        Primate Center in Atlanta, Georgia. A drop of fluid from the cage of
        an infected animal landed in the woman's eye six weeks before she
        died. The case was unusual in that infection is relatively rare -- there
        have been only 40 cases between 1933 and 1994 -- and most
        infections result from bites or scratches. 

        B-virus can be extremely deadly, with 79% of people with symptoms
        dying of the disease, according to a study of 24 people in 1992. The
        virus gains access to the brain via the spinal cord, causing severe
        inflammation and neurological impairment. The antiviral drug
        acyclovir has saved three people since 1987, and can prevent
        permanent disability. However, rapid treatment is essential and the
        drug is not always effective. 

        Monkey owners may not seek treatment for bites and scratches, and
        they may not associate the first symptoms of B-virus infection --
        headache and flu-like symptoms -- with bite wounds that may have
        healed a month earlier. 

        Macaques and other monkey species cannot be imported into the
        U.S. as pets, and they may not be bred or sold for that purpose,
        according to a law passed in 1975. The illegal trade in the animals as
        pets is ``an emerging infectious disease threat in the United States,''
        according to the CDC. 

        ``The extremely high prevalence of B-virus along with their
        behavioral characteristics make the macaque species unsuitable as
        pets,'' according to the report. 

        SOURCE: Emerging Infectious Diseases (January-March, 1998) 

        Reut14:43 12-16-97 

        (16 Dec 1997 14:41 EST)