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Herpes B virus
From WikEM
Contents
Background
- Cercopithecine herpesvirus 1 (commonly referred to as B virus)
- Zoonotic Endemic in Macaque Monkeys-mild symptoms like blisters
- Fatal Encephalomyelitis in Humans: 80% fatal without treatment
- Most common transmission by bite, but very few cases
- Consider in Patients with Exposure, especial penetrating bites, to Macaque Monkeys in the wild or research
Clinical Features[1]
- Vesicular Herpetic Lesions
- Nonspecific Flu-like Illness
- Lymphadenitis
- Site of inoculation - pain, numbness, itching
- CNS - poor coordination, respiratory depression
- Encephalitis - late stage of the disease
Differential Diagnosis
Evaluation
- Clinical
- PCR specificity and sensitivity at nearly 100% for serologic
- PCR wound samples less reliable
- All symptomatic should be tested
Management
- Consider rabies prophylaxis for all
Asymptomatic Prophylaxis (Acute Exposure)
- <20 minutes clean and irrigate
- Antiviral prophylaxis
- 14 day course of PO valacyclovir 1gm three times daily OR
- 14 day course of PO acyclovir 800mg five times daily[2]
- Indications
- Penetrating (especially head, neck, torso)
- Fluid on mucosa
- Blistering Monkey
All non-CNS symptomatic
- Admit and treat
- Antiviral
- Acyclovir IV 12.5-15mg/kg every eight hours OR
- Ganciclovir IV 5mg/kg every 12 hours[2]
All CNS Symptomatic
- Admit and treat
- Ganciclovir IV 5mg/kg every 12 hours[2]
Disposition
- Asymptomatic Discharge
- Symptomatic Admit
See Also
External Links
References
- ↑ Cohen JI, Davenport DS, Stewart JA, Deitchman S, Hilliard JK, Chapman LE; B Virus Working Group. Recommendations for prevention of and therapy for exposure to B virus (cercopithecine herpesvirus 1). Clin Infect Dis. 2002 Nov 15;35(10):1191-203. Epub 2002 Oct 17.
- ↑ 2.0 2.1 2.2 B Virus (herpes B, monkey B virus, herpesvirus simiae, and herpesvirus B). Centers for Disease Control and Prevention Web site. http://www.cdc.gov/herpesbvirus/ Page last reviewed: July 18, 2014. Accessed April 3, 2015.
