This information was collected and organized in January, 1997. At the time, I was helping the scientists in a research facility start a prevention program prior to the arrival of the monkeys in their lab. My goal was to present the CDC Guidelines and the recommendations of virologists at the NIH B Virus Resource Laboratory. There are still many gaps in our understanding of this virus that infects man only under very unusual circumstances. Please send me (Jay A. Brown, MD, MPH) your comments and suggestions so that I can keep this information up to date.
Introduction
Old World macaque monkeys (for example, rhesus and cynomolgus monkeys) are the natural hosts for B virus infection. In monkeys, the disease caused by B virus infection is generally undetectable or minimal, e.g., oral ulcerations.
B virus infection is an occupational hazard for workers who handle macaque monkeys. Approximately 40 human B virus infections have been reported in the world's medical literature, and a case-fatality rate of about 70% has been observed. Therefore, a systematic prevention program to remove the source, to reduce exposure and to treat the early stages of infection is required.
In recent years, macaque monkeys have been increasingly used for HIV, hepatitis and pharmaceutical research, and it appears that such prevention programs can be effective. Only eight confirmed cases of human infection were detected between 1987 and 1994. Several cases of complete recovery have been reported after the disease was detected early in the course and treatment with anti-viral drugs was begun.