Published Date: 2019-11-29 06:29:37
Subject: PRO/AH/EDR> Herpes B virus - Japan: (KS) 1st rep
Archive Number: 20191129.6803152
HERPES B VIRUS - JAPAN: (KAGOSHIMA) FIRST REPORT
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A ProMED-mail post
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International Society for Infectious Diseases
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[1]
Date: Wed 27 Nov 2019
Source: NHK World [edited]
https://www3.nhk.or.jp/nhkworld/en/news/20191128_40/
An employee of a Japanese pharmaceutical research and development company has been found infected with herpes B virus which is commonly found among monkeys. This is the 1st confirmed B virus infection in Japan. B virus infection in people is usually caused by contact with monkeys. It can lead to brain fever, disturbed consciousness, even death.
Officials in Kagoshima City, western Japan, say the patient was working at a local company involved in the research and development of drugs. The employee reportedly assisted in experiments involving monkeys.
The person visited a hospital complaining of a headache and fever. The National Institute of Infectious Diseases confirmed earlier this month [November 2019] that the patient contracted the B virus and is in a critical condition. There is no record of the employee being bitten by a monkey, and it remains unknown how the infection occurred.
Health ministry officials and local authorities say they have inspected the company's facilities and found no problems with its management and control measures against infectious diseases.
Human infection of the B virus is extremely rare worldwide. The US Centers for Disease Control and Prevention says 50 people, mainly in the US, have been found infected with the virus since 1932, and 21 of them have died. CDC says the risk of human infection is extremely low even if they are bitten by wild monkeys, and there has been only one reported case of human to human infection.
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communicated by:
ProMED-mail rapporteur Kunihiko Iizuka
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[2]
Date: Thu 28 Nov 2019
Source: Mainichi Newspaper [in Japanese, machine trans, edited]
https://mainichi.jp/articles/20191128/k00/00m/040/224000c
An announcement has been received that an employee of Kagoshima City and the drug development company Shin Nippon Kagaku (Shin Nippon Biomedical Laboratories (SNBL) in Tokyo) was infected with monkey-derived "B virus". The case concerns a technician, who was conducting animal experiments on monkeys at the research institute in Kagoshima City on the [28 Feb 2019]. The condition [of the infected individual] is not disclosed. This is the 1st time that infection has been confirmed in Japan, with about 50 cases overseas.
Most cases of past infections have come into contact with monkeys at animal testing facilities, and the National Institute of Infectious Diseases says that "normally there is no risk of spreading infection because it does not move from person to person."
B virus is a type of herpes virus, and most macaque monkeys such as rhesus monkeys and Japanese [cynomolgus macaque] monkeys have viruses. It does not cause airborne infection, but if one is bitten by a monkey with the virus, fever and sensory abnormalities [may] occur at the contact area. Severe infections may cause sequelae of neuropathy.
According to the city, a technician was infected at the Safety Laboratory, which uses monkeys to investigate safety during drug development. In February of this year [2019], she complained of headache and fever, and this month [November 2019], the National Institute of Infectious Diseases determined that it was a B virus. Technicians have never been bitten or scratched and are likely to have touched excrement and saliva.
[byline: Ran Kanno]
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communicated by:
ProMED-mail rapporteur Kunihiko Iizuka
[The timeline of the infection in the above patient is uncertain. The 2nd report above indicates that the patient initially became ill in February 2019 but was diagnosed as a herpes B virus infection this month (November 2019). The 1st report above indicates that the patient is currently in a critical condition, but not for how long in that condition. The incubation period for human herpes B virus infections is 3-30 days, although CDC notes that it may be months or even years after infection is initiated for symptoms to appear.
Herpes B virus is an alphaherpesvirus. Although herpes B virus is relatively common among the 3 species of macaques affected, human cases over the years have been sporadic and few -- 50 confirmed cases (now 51 with the case above) with 21 deaths. For those humans infected CDC notes that "vesicular skin lesions sometimes occur at the exposure site. The patient may also have lymphadenitis (inflamed lymph nodes), lymphangitis (infection of lymph vessels), nausea and vomiting, abdominal pain, and hiccups.
"The virus can spread to the central nervous system (CNS) and cause the following symptoms:
- hyperesthesias (increase in sensitivity to stimuli);
- ataxia (lack of voluntary control of muscle movements);
- diplopia (double vision);
- agitation;
- ascending flaccid paralysis (extreme weakness due to reduced muscle tone).
Most patients with CNS complications will die, even with antiviral therapy and supportive care, and those who survive usually suffer serious long-term neurologic problems. Respiratory failure associated with ascending paralysis is the most common cause of death. Respiratory involvement and death can occur 1 day to 3 weeks after symptom onset." The CDC website for this virus can be found at
https://www.cdc.gov/herpesbvirus/healthcare-providers.html. - Mod.TY
