Herpes B B08.0

Herpes B (herpes simiae) infection is a rare, severe zoonotic infectious disease of humans. To date, about 50 cases of the disease have been registered. Infections with the herpes B virus, a simplex virus, are often fatal in humans (67 %).

Herpes B virus (formerly Cercopithecine herpesvirus 1[CHV-1]) is transmitted by Macacine herpesvirus 1, an alphaherpesvirus closely related to herpes simplex virus. The virus is commonly found in populations of macaques, including rhesus macaques. Monkeys infected with this virus usually show no symptoms or only mild symptoms similar to those of herpes simplex virus 1 or 2 (HSV type 1/2) in humans. Symptoms may include oral or genital lesions. However, the virus can also be shed without visible lesions. Transmission usually occurs through animal bites, artificial scratches, or percutaneous inoculation with infectious material.

Symptoms typically occur three days to one month after exposure. Symptoms include:

• painful vesicular skin lesions at or near the site of exposure.
• Chills and other flu-like symptoms, persistent fever, nausea, lethargy, chest pain, and difficulty breathing.
• Furthermore, encephalitic symptoms (numbness, dizziness, double vision, difficulty swallowing, and confusion). Patients rapidly become comatose.
• Respiratory arrest usually leads to death.

The prognosis can only be improved by early use of an antiviral drug (e.g. valaciclovir, aciclovir). A hyperimmunoglobulin preparation is not available.

Prevention: A vaccine is not available, so prevention is limited to avoiding transmission. Testing monkeys in animal facilities for herpesvirus simiae and following hygiene and safety guidelines when handling monkeys are essential in this regard.

1. Sabimana JM et al (2008) Human infection with simian herpes B virus in Africa. Sante 18:3-8.