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published and unpublished cases, knowledge of the behavior of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
CDC. Guidelines for prevention of Herpesvirus simiae (B virus)
infection in monkey handlers. MMWR 1987;36:680-2,687-9.
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.
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.
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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