Biomedical Engineering Reference
In-Depth Information
following is a composite listing of biosafety concerns and
practices regarding macaques throughout the biomedical
community:
prevent bites, scratches, and other exposure to
macaque body fluids, especially saliva, as well as the
importance of cleaning wounds immediately and
promptly reporting all macaque-related wounds, no
matter how slight. Personnel should be informed of the
early symptoms of herpes B infection and be reminded
that early treatment can prevent progression of the
disease and that any lesions or illness suggestive of
infection should be reported immediately for essential
medical evaluation and follow-up. Animal handlers
should also be advised that people who are immuno-
suppressed by medications or underlying medical
conditions may be at higher risk for herpes B infection.
The training program should also require a working
knowledge of standard operating procedures relevant
to protective clothing, devices to help prevent bites and
scratches, and proper methods of animal restraint.
Furthermore, initial training must be followed by
continued observation for lapses in the proper perfor-
mance of procedures.
10.
Potential human exposures to herpes B by bites,
scratches, and other parenteral or mucosal exposures
to saliva or conjunctival secretions from macaques
necessitate immediate identification of the particular
animal by number and cage or location, if possible.
The suspected animal should be chemically restrained
and examined by the attending veterinarian for oral
lesions, conjunctivitis, or other clinical signs of herpes
B infection. At the discretion of the veterinarian,
swabs for virus isolation should be taken from the
throat, conjunctiva, and any oral lesions. Sterile cotton
swabs (some synthetic swabs inhibit virus replication)
may be moistened in Hank's phosphate-buffered saline
or similar growth medium containing gentamycin
(50 mg/ml). After swabbing with a swirling motion to
obtain not just fluid but cells from all areas tested and
maintaining a sterile technique, the worker should
place the swab tip in a culture tube containing 1 ml of
Hank's balanced salt solution. The capped vial should
be maintained at 4
C until shipped to a diagnostic
laboratory. A 2-ml serum sample from the animal
should be stored at 4
or
e
20
C until needed.
1.
Macaques should be used only when no suitable
alternative animal models are available.
2.
When feasible, required macaques should be free of
herpes B infection and should be maintained under
appropriate conditions to ensure this status.
3.
All macaques should be regarded as infected because
viral shedding is intermittent and can occur in the
absence of visible lesions. The routine screening of
macaques for evidence of herpes B infection is not
recommended. Even animals previously found to be
negative for the virus or antibody might be positive at
the time of human exposure.
4.
Macaques with oral lesions suggestive of active herpes
B infection are dealt with according to policies
developed at each institution. Options should include
euthanizing the animal immediatedly, quarantining the
animal until the lesions have healed to reduce the risk
of viral transmission to workers and other macaques,
or quarantining the animal until the results of serum
analysis and cultures have been completed.
5.
Protective clothing and devices should be worn at all
times when working with macaques. When entering an
animal room housing macaques, all personnel should
wear the following: cap; mask; work uniform, lab coat,
or coveralls; rubber gloves; and rubber boots or
disposable booties. When approaching within arm's
length of caged monkeys, including infants, the
following protective devices should also be worn: face
shield; protective smock, lab coat or coveralls with
long sleeves; and heavy rubber gloves or leather
gloves.
6.
All macaques should be anesthetized or chemically
restrained with ketamine hydrochloride and/or other
suitable agents before being removed from their cages.
The only exceptions should be comatose animals and
infants less than 6 months of age.
7.
Cages and other equipment should be free of sharp
edges and corners that may cause scratches or wounds
to workers. Cages should be designed and arranged in
animal housing areas so that the risk of workers being
accidentally grabbed or scratched is minimized.
8.
Access to areas where macaques are maintained and
used should be limited to workers who are properly
trained in procedures to avoid risk of infection. All
others who must enter the facility for support or
program needs must be accompanied by trained
workers.
9.
Training of personnel to work with macaques should
include special education that teaches the nature of
herpes B infection with emphasis on the need to
11.
Recommendations for postexposure prophylaxis were
published in 2002 (
Cohen et al., 2002
). The human
wound(s) should be immediately and thoroughly
cleansed with soap and water and then scrubbed with
a surgical brush or sponge. Germicidal cleansing
agents such as chlorhexidine or povidone-iodine are
also recommended for this cleansing scrub but
common detergents are effective as well. Exposures
should be immediately reported to supervisory
personnel, who should refer the exposed person to
a medical consultant without delay. The injured
employee should be requested to provide a blood
