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)
