Human exposure to herpesvirus B-seropositive macaques, Bali, Indonesia.

Gregory A Engel,Michael A Schillaci,Artha Putra,Lisa Jones-Engel,Richard Henkel,Komang Gde Suaryana,Agustin Fuentes

doi:10.3201/eid0808.010467

Abstract

Herpesvirus B (Cercopithecine herpesvirus 1) has been implicated as the cause of approximately 40 cases of meningoencephalitis affecting persons in direct or indirect contact with laboratory macaques. However, the threat of herpesvirus B in nonlaboratory settings worldwide remains to be addressed. We investigated the potential for exposure to herpesvirus B in workers at a “monkey forest” (a temple that has become a tourist attraction because of its monkeys) in Bali, Indonesia. In July 2000, 105 workers at the Sangeh Monkey Forest in Central Bali were surveyed about contact with macaques (Macaca fascicularis). Nearly half of those interviewed had either been bitten or scratched by a macaque. Prevalence of injury was higher in those who fed macaques. Serum from 31 of 38 Sangeh macaques contained antibodies to herpesvirus B. We conclude that workers coming into contact with macaques at the Sangeh Monkey Forest are at risk for exposure to herpesvirus B.

Highlights

Herpesvirus B (Cercopithecine herpesvirus 1) has been implicated as the cause of approximately 40 cases of meningoencephalitis affecting persons in direct or indirect contact with laboratory macaques
Since first reported in the 1930s, a total of 43 cases of CeHV-1 have been diagnosed worldwide, all reported from the United States, Great Britain, or Canada, exclusively in people who had direct or indirect contact with laboratory macaques [2,3,4,5,6]
The threat of herpesvirus B has led the Centers for Disease Control and Prevention to recommend strict precautions for persons who come into contact with monkeys in occupational settings [2,6,9,10]

Summary

Introduction

Herpesvirus B (Cercopithecine herpesvirus 1) has been implicated as the cause of approximately 40 cases of meningoencephalitis affecting persons in direct or indirect contact with laboratory macaques. In July 2000, 105 workers at the Sangeh Monkey Forest in Central Bali were surveyed about contact with macaques (Macaca fascicularis). We conclude that workers coming into contact with macaques at the Sangeh Monkey Forest are at risk for exposure to herpesvirus B. One case of human-to-human transmission has been documented, when infection developed in the wife of a man who subsequently died of a CeHV-1 infection She had a rash on her finger that came into contact with a vesicular lesion on her husband’s arm, at the site of a monkey bite. The threat of herpesvirus B has led the Centers for Disease Control and Prevention to recommend strict precautions for persons who come into contact with monkeys in occupational settings [2,6,9,10]

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