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)