Herpes B virus

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  • Cercopithecine herpesvirus 1 (commonly referred to as B virus)
  • Zoonotic Endemic in Macaque Monkeys-mild symptoms like blisters
  • Fatal Encephalomyelitis in Humans: 80% fatal without treatment
  • Most common transmission by bite, but very few cases
  • Consider in Patients with Exposure, especial penetrating bites, to Macaque Monkeys in the wild or research

Herpes Virus Types

Clinical Features[1]

  • Vesicular Herpetic Lesions
  • Nonspecific Flu-like Illness
  • Lymphadenitis
  • Site of inoculation - pain, numbness, itching
  • CNS - poor coordination, respiratory depression
  • Encephalitis - late stage of the disease

Differential Diagnosis


  • Clinical
  • PCR specificity and sensitivity at nearly 100% for serologic
  • PCR wound samples less reliable
  • All symptomatic should be tested


  • Consider rabies prophylaxis for all

Asymptomatic Prophylaxis (Acute Exposure)

  1. <20 minutes clean and irrigate
  2. Antiviral prophylaxis
    • 14 day course of PO valacyclovir 1gm three times daily OR
    • 14 day course of PO acyclovir 800mg five times daily[2]
    • Indications
      • Penetrating (especially head, neck, torso)
      • Fluid on mucosa
      • Blistering Monkey

All non-CNS symptomatic

All CNS Symptomatic


  • Asymptomatic Discharge
  • Symptomatic Admit

See Also

External Links

CDC: B Virus