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Notice to Readers Publication of Guidelines for the Prevention and Treatment of B Virus Infections in Exposed Persons

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 Written guidelines were developed based on information from published and unpublished cases, knowledge of the behavior of herpes simplex virus, and expert opinion.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.


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