To Employees Working with Macaque
Monkeys:
The following signs or symptoms
should be reported immediately, especially if they occur after sustaining a macaque monkey
bite or scratch.
Early manifestations (inconsistently present)
- Small blister-like eruptions (vesicles) or ulcerations at or
near the exposure site
- Severe pain or itching at the exposure site
- Inflamed lymph nodes, especially if they occur in the armpit
or elbow of the injured arm
Intermediate manifestations (inconsistently present)
- Fever
- Numbness or tingling at or near the exposure site, with or
without progression toward the center of the body
- Muscle weakness or paralysis in the exposed extremity
- Eye redness and inflammation (conjunctivitis)
- Persistent hiccups
Late manifestations (avoidable with early therapy)
- Sinusitis
- Neck stiffness
- Headache lasting more than 24 hours
- Nausea and vomiting
- Double vision, difficulty speaking, difficulty swallowing,
dizziness, muscle weakness or partial paralysis on either side, or other symptoms of brain
stem dysfunction (cerebellar signs with ataxia, crossed sensory loss, cranial nerve
palsies, or drop attacks)
- Altered mental activity
- Other signs compatible with an infection of the central
nervous system, including urinary retention, respiratory failure, convulsions, hemiplegia
(paralysis on one side of the body), other localized neurological signs, progressive
ascending paralysis, or coma.
(Adapted from Table 1 in Guidelines for the Prevention
and Treatment of B-Virus Infections in Exposed Persons by Gary Holmes, et al.)
