Biomedical Engineering Reference
In-Depth Information
wound indicates that the potential is there. Animal
Biosafety Level 2 with universal precautions, including
protective clothing, face masks, and disposable gloves for
handling all monkeys, and hand washing after working
with them is recommended.
A major lesson to be learned from experience with
herpesviruses is the importance of strict separation of
species.
sample for storage of serum for future reference or
testing, as determined by the physician. The employee
should again be reminded of the early signs of herpes
B infection and the importance of immediately
reporting swelling, pruritus, or formation of vesicles at
the wound site.
12.
Medical consultation and assistance may be obtained
from the Centers for Disease Control, Division of Viral
and Rickettsial Diseases, Atlanta, Georgia (404 639-
3532) or
http://www.cdc.gov/herpesbvirus
. Additional
information can be obtained at the National B virus
Resource Center at
http://www.gsu.edu/bvirus
.
13.
Preventing and treating herpes B infections in exposed
people are problematical. Symptomatic human herpes
B infection is so rare that few physicians are likely to
know how to diagnose and treat it. Unfortunately,
a delay of only a few days in diagnosis and initiation of
treatment may make the difference between full
recovery and death. Therefore, copies of the most
recent recommendations should be readily available
for exposed individuals to take to attending physicians,
who may not be fully informed. Valacyclovir is the
drug of choice; its efficacy in preventing the rapidly
progressive neurological disease long-associated with
human cases has now been documented in several
patients. This justifies more aggressive efforts toward
early recognition of infected people. There is no
evidence that pooled immune serum globulin is
effective in preventing or ameliorating herpes B
infection. No hyperimmune herpes B human globulin
or vaccine against herpes B is currently available.
Epstein
e
Barr Virus and Cytomegaloviruses
Old World primates are naturally infected with agents
closely related to the Epstein
e
Barr virus (EBV) (
Ohno
et al., 1978
), the etiological agent of human infectious
mononucleosis, which is also related to Burkitt's
lymphoma and nasopharyngeal carcinoma (
Henle et al.,
1979
). The human disease is characterized by a sore throat,
malaise, fatigue, and abnormal lymphocytes; chimpanzees
may have tonsillitis and elevated serum enzyme levels
(
Finkel et al., 1964
). Serological tests may distinguish
current, recent, and past infection (
Kieff et al., 1982
) but,
like other herpesviruses, EBV is carried for life and may be
shed in the saliva at any time (
Sixbey et al., 1984
). Since the
chimpanzee variant cross-reacts with human test antigens,
it could be a potential source of infection for handlers (
Levy
et al., 1971
).
Practically every known animal species has its own
cytomegalovirus (CMV) infection (
Hsiung et al., 1971
). In
humans, CMV infection is a major cause of fetal morbidity
and mortality (
Altshuler and McAdams, 1971; Muller et al.,
2010
). It causes renal disease in newborns and a mono-
nucleosis-like illness that may include hepatitis in cases
acquired later in life (
Weller, 1971
). This virus is spread
primarily via saliva and urine, and there is strong evidence
for an increased infection rate among day-care workers
who handle young children (
Adler, 1989
). Although there
are no proven human cases of CMV infection related to
chimpanzees, it has been suspected (
Muchmore, 1971
) and
the possibility should be considered.
Herpesvirus Saimiri
and Other Herpesvirus
Infections
Although there are no data to indicate that H. saimiri can
cause fatal human infection, this virus, which does cause
fatal sarcoma in other monkeys and nonprimate species
(e.g. rabbits), will replicate in human tissue cell cultures
and is classified as an oncogenic virus by the National
Cancer Institute.
Squirrel monkeys are also asymptomatic antibody-
positive reservoir hosts of Herpesvirus tamarinus, which
causes disease in Saquinus spp. and Aotus spp., ranging
from ulcerative and hemorrhagic lesions to focal liver
necrosis (
Griesemer and Manning, 1973; Whitney, 1976
).
Human infection with this virus which produced skin
pustules, fever, and nonfatal encephalitis has been reported
(
T-W-Fiennes, 1967
).
Prevention
Both EBV and CMV are spread primarily by
saliva; CMV is also spread by urine. Therefore, universal
precautions employed in a Biosafety Level 2 environment
should protect workers.
Viral Hepatitis Infections
Five different human hepatitis viruses have now been
identified, all of which can be transmitted to one or more
species of nonhuman primates. In addition, a virulent
marmoset hepatitis virus has been described. Two previ-
ously mentioned herpesviruses, EBV (
Corey et al., 1975
)
and CMV, may also cause hepatitis.
Prevention
Only one of these, H. tamarinus, has produced
human infection (
T-W-Fiennes, 1967; Daniel et al., 1972
).
However, one case from an accidental bite or scratch
