B virus infection
- Jeffrey I Cohen, MD
Jeffrey I Cohen, MD
- National Institutes of Health
B virus (Cercopithecine herpesvirus 1) causes a herpes simplex virus (HSV)-like infection in macaque monkeys but can also cause a fatal encephalomyelitis in humans. Fatal cases of B virus infection have been reported after exposures to monkey bites, monkey scratches, cage scratches, a mucosal splash from monkey material, and from infected cell cultures. Postexposure prophylaxis has been demonstrated to be effective in an animal model and is likely effective in humans exposed to the virus. Prompt therapy for B virus infection of humans is critical to prevent severe morbidity and mortality.
The pathogenesis, epidemiology, clinical manifestations, prognosis, prevention, postexposure prophylaxis, and treatment of B virus infection will be reviewed here. Infections caused by other zoonoses are discussed separately. (See "Zoonoses from pets other than dogs and cats" and "Zoonoses from cats" and "Zoonoses from dogs" and "Initial management of animal and human bites".)
PATHOGENESIS AND EPIDEMIOLOGY
Natural infection in macaques — B virus is a herpesvirus in the same subfamily as herpes simplex virus (HSV) that naturally infects macaque monkeys (eg, rhesus macaques, cynomolgus monkeys, pig-tailed macaques, bonnet macaques, Japanese macaques, and stump-tail macaques) and usually results in either no symptoms in these animals or oral or genital lesions similar to HSV in humans [1,2]. B virus has not been detected in other Old World monkeys or in New World monkeys.
Macaques become latently infected and virus is shed lifelong in oral and genital secretions and from the conjunctivae, including when animals are asymptomatic .
The complete sequence of the virus has been determined .
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- PATHOGENESIS AND EPIDEMIOLOGY
- Natural infection in macaques
- Infection of humans
- Risk factors
- CLINICAL MANIFESTATIONS
- POSTEXPOSURE EVALUATION
- Postexposure cultures and serology
- Cultures and serology in nonhuman primates
- Diagnostic laboratories
- POSTEXPOSURE PROPHYLAXIS
- Animal studies
- Indications for prophylaxis
- Antiviral medications
- B VIRUS DISEASE
- SUMMARY AND RECOMMENDATIONS