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What are the signs of herpes b in primates, southern alternative medicine - Try Out

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Persons at greatest risk for B virus infection are veterinarians, laboratory workers, and others who have close contact with Old World macaques or monkey cell cultures. This section on Primate Medicine will give you a good review of the major husbandry challenges, diseases, and clinical approaches to primate health issues. Gain an appreciation for the significant zoonotic diseases, especially viral diseases such as Herpes B and bacterial diseases such as tuberculosis. Be familiar with the preventative health measures recommended for non-human primates in a variety of settings. Primates are a diverse group of mammals representing over 600 distinct species and subspecies with worldwide distribution. Understanding primate taxonomic categories also helps in determining specific husbandry needs and disease susceptibilities. In general, the order primates share many behavioral and anatomical features that make them somewhat unique in the animal kingdom. All of these physical and mental adaptations make the husbandry of non-human primates complex and demanding. Since October 10, 1975, US Public Health regulation 42 CFR 71.53 has prohibited the importation of nonhuman primates (NHP) into the United States as pets, and neither nonhuman primates imported since that date nor their offspring may be legally bred or distributed for any uses other than bona fide science, university level education programs, or full time zoological exhibition.
Despite all of the federal regulations and state regulations, there are still plenty of NHP in the pet sector. Nutritional deficiencies, usually because of owner ignorance, are common problems in pet monkeys.
Commercially available dietary products for both New World and Old World primates offer the most balanced nutrition. Hepatic iron storage disease has been reported in lemurs and marmosets and may impact other neotropical primates.
Because of the evolutionary closeness between non-human primates and human primates, they share a lot of the same disease concerns.
This viral family is one of the more common groups of viruses found in NHPs, as well as one of the best publicized.
Probably the most famous of the herpes viruses is Herpes B (Macacine herpesvirus 1 or herpesvirus simiae), which is a disease of all macaque species, including rhesus, cynomolgus, bonnet, Japanese, Taiwan, stump tail, and pigtail macaques.
Only a small percentage of infected macaques will present with clinical signs of ulcers and white plagues on lips, nares, tongue, genitalia, and palate and they may have conjunctivitis.
Although symptomatic human infections from exposure to herpes B virus are rare, when symptomatic infection does occur, the infection is severe and often fatal (79%). Diagnostic testing for the detection of Herpes B can be done by serology to detect antibodies. It is safest to assume that all macaques are carrying and capable of transmitting Herpes B infection. Immediately scrub the wound with running water and detergent for 15 minutes; or flush mucous membrane for 15 minutes with running water or saline. Human herpesvirus 1 (Herpesvirus simplex): Both HSV1 and HSV2 have been known to be transmissible from man to monkeys (experimentally). Herpesvirus tamarinus: viral herpes in tamarins and marmosets that may cause severe clinical disease, including hepatitis, in those species. Simian Varicella viruses (SVV): This is a group of seven simian herpesviruses that closely resemble varicella-zoster in man. Simian Cytomegaloviruses (CMV): Cytomegaloviruses are relatively host specific and in its natural hosts tend to cause latent infections with relatively no clinical signs. Due to the risk of cross species transmission NEVER mix primate species in the same exhibit! There are three genera of poxviruses that infect NHP: orthopoxviruses, yatapoxviruses and molluscipoxviruses. The viral infectious hepatitis virus (Hepatitis A) has been identified in chimpanzees, patas, wooley monkey, gorilla, cebus, aotus, macaques and some tamarins. Filoviruses belong to the family Filoviridae, one of several groups of viruses that can cause hemorrhagic fever in animals and humans. SIVs are lentiviruses, morphologically similar and biologically related to HIV-1 and HIV-2.
These viruses cause widespread infection of many African species of NHP but not Asian species or new world primates. Evidence of SIV infection has been reported for over 30 different species of African nonhuman primates (see table 3).
SFVs are common in captive NHPs; greater than 95% of captive macaques over 3 years of age are seropositive.
Spumaviruses differ from other retroviruses in several respects including the viral polymerase gene is expressed from a spliced sub-genomic RNA and the extracellular particle contains large amounts of reverse-transcribed DNA. To date, there have been no ill effects to health in either the humans that are positive for SFV or the positive NHP. Type D retroviruses have been documented to cause a form of chronic immunodeficiency disease in several macaque species, including the natural hosts.
The virus has wide tropism for epithelial cells, macrophages, B cells and T cells causing a pancytopenia in peripheral blood. STLV1 and STLV2 share an extensive genomic sequence with human T-lymphotropic virus type 1 and 2 (HTLV1, 2) and are associated with T-cell lymphomas in non-human primates. Mycobacteria are responsible for tuberculosis, an increasingly rare disease in captive primates.
This syndrome seen in great apes has many etiologic agents and may be zoonotic depending on the agent involved. Giardia lamblia, Cryptosporidium, Enterocytozoon bieneusi, Balantidium coli, and Entamoeba histolytica are all intestinal protozoa that can infect monkeys and humans. Blood borne parasites are rare in captively bred monkeys but may be seen in wild caught monkeys. Infections in humans are extremely rare, but can result in severe neurologic disease or fatal swelling of the brain and spinal cord. B virus is also commonly referred to as herpes B, monkey B virus, herpesvirus simiae, and herpesvirus B.The virus is found among macaque monkeys, including rhesus macaques, pig-tailed macaques, and cynomolgus monkeys (also called crab-eating or long-tailed macaques).
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It is also important to understand these categories when discussing zoonotic disease risks. Among these features are their well-developed manual dexterity, their well-developed sense of sight and good hand-eye coordination.
The regulation also states that the maintenance of nonhuman primates as pets, hobby, or an avocation with occasional display to others is not a permissible use.
Unfortunately, many of these regulations do not extend to privately owned non-human primates.

The nutritional requirements of non-human primates are quite complex and vary greatly between the different species. Although most commercial feeds have adequate levels of vitamin C at the time of packaging, after 90 days of storage, these levels decrease dramatically. This is likely due to increased availability of dietary iron and the lack of tannins in the diet which are found in their natural environment (similar to the etiology suspected for toucans). Zoonotic risks are higher to humans when dealing with non-human primates, and diseases that are transferred from natural host reservoirs to non-natural hosts can often become devastating clinical syndromes.
They can be both diagnostically challenging, as well as devastating, when passed from the NHP to humans. Herpes infections are responsible for a wide range of symptoms ranging from inapparent infections to fatal disease. Between 1933 and 1994, fewer than 40 cases of herpes B in humans had been documented by the CDC and of the 24 known symptomatic cases reviewed by 1992, 79% were fatal.
They include Liverpool vervet monkey virus, Patas monkey herpesvirus, Delta herpesvirus, Medical Lake macaque virus, Herpesvirus cyclopis, Chimpanzee herpesvirus, and Gorilla herpesvirus.
Nearly all NHPs are infected with species specific lymphocrytpoviruses related to human EBV.
Although measles is not considered a naturally occurring disease in NHPs, it is one of the most frequently reported viral diseases. Benign epidermal Monkeypox (BEMP) is a nonfebrile disease seen in macaques and is serologically related to the Yaba pox and Yaba-like pox viruses.
In areas where polio vaccination of humans is routine, this usually does not present a problem to these animals due to the lack of disease in the human population. Marburg virus was the first filovirus to be discovered in 1967 in a shipment of African green monkeys imported into Marburg, Germany. Non-human primates are the natural hosts for a variety of retroviruses including viruses in the betaretrovirus, gammaretrovirus, deltavirus, lentivrus and spumavirus genera. In 1993, the CDC and the National Institutes of Health implemented a voluntary testing and counseling surveillance program for SIV following detection of SIV in a worker at a primate facility. Two of these viruses, SIVcpz from chimpanzees and SIVsm from sooty mangabeys, have been shown to be the source of HIV1 and HIV2 and acquired immunodeficiency syndrome (AIDS) in humans. Blood donation and organ donation research is also concerned with possible transmission of these viruses. This virus has been referred to as the virus in search of a disease, because it does have the capacity to incorporate itself into DNA and is routinely transmitted between NHP without signs of disease. The infection can affect a wide range of host species but in particular has caused numerous deaths in tamarins, marmosets and Goeldi's monkeys in captivity. The syndrome can present as either acute or chronic meningitis and prompt, effective diagnosis and treatment is required to avoid fatalities or chronic, persistent clinical impairments.
The most common species cultured in old world monkeys is Shigella flexneri, while the most common isolate from humans is S. Some of the most frequently seen are Oesophagostomum, Strongyloides, and Dipetalonema species. These infections are usually asymptomatic in the natural host but may cause disease when animals are stressed or treated with immune modulatory drugs.
While all non-human primates carry zoonotic diseases, the phylogenetic closeness of the Old World primates makes their zoonoses of particular concern. They have highly developed cerebral cortices, long infant dependency periods and tend to have very complex social organizations.
All states require that citizens comply with applicable federal regulations but many state officials may be unaware of regulatory restrictions and may be confused by the distinctions among federal agencies regarding restrictions on captively bred animals. Most owners lack the knowledge, devotion, and constant vigilance needed to properly maintain a non-human primate. They do serve as excellent standards for minimum quality of care for commercial and research organizations and should be followed by private owners as well. Diets are complex and consist of fruits, vegetables, commercially available monkey chow, and food enrichment items. This is critical for New World Primates who rely heavily on exogenous sources of vitamins C and D3.
Vitamin C deficiency typically presents as scurvy, with clinical signs including swelling of the epiphyses of long bones, hemorrhaging of the gums and periosteum and cephalohematoma. It is beyond the scope of this report to cover, in depth, all of the zoonotic diseases transmissible from nonhuman primate (NHP) to humans. Like herpes simplex virus infections in humans, B-virus infections in monkeys can be characterized by life long infections with periodic activation and viral shedding in saliva and genital secretions. The incubation period in man is anywhere from 2 weeks to 6 months and clinical signs starting out as pain, numbness, vesicles, and neuresthesia or paresthesia at site of exposure.
If B-virus is cultured from any of these sites, that is confirmation that an animal is actively shedding virus.
Infection with any of the seven viruses, in general, causes high morbidity and mortality and varies greatly depending on the virus and species involved.
Herpes virus saimiri is found in nearly all squirrel monkeys that is carried asymptomatically and without clinical effect. Infection in NHPs occurs as a result of human contact, and then the infected primate can shed the virus, and re-infect man.
It produces a typical proliferative epithelial lesion on the skin surface of the face and extremities. Because of their heightened sensitivity to polio, all monkeys, especially the great apes, should be vaccinated for the disease as juveniles. All of the simian immunodeficiency viral isolates have characteristics in common with HIV, including genomic organization and some serological cross reactivity Immunodeficiency results from progressive loss of CD4 T cells and results in reactivation of latent infections or acquisition of environmental and other opportunistic pathogens.
Historically, the three major species of Mycobacteria - avium, bovis, and tuberculosis, have been incriminated as causing disease in NHPs. In both humans and NHPs the skin test detects only mycobacterial infection, not active disease.
Clinical signs of infection can range from asymptomatic animals that shed the bacteria, to nonspecific signs of systemic or enteric diseases or sudden death that may be difficult to diagnose.
The most prevalent pathogens implicated are Streptococcus pneumoniae, Neisseria meningitides, and Hemophilus influenza type B.The N. These organisms may or may not be associated with clinical disease in NHPs and one negative culture does not indicate a disease free animal.
There have been a few documented cases of fatalities in neonatal and juvenile monkeys due to these protozoa.
Other GI parasites sometimes seen are Hymenolepis nana, Echinococcus granulosus and Prosthenorchus elegans. The most important point in any discussion of NHP zoonotic disease is the idea of disease prevention.

The virus can also spread through the saliva, feces, urine, or nervous tissue of an infected monkey. Physically they are set apart by their prehensile, opposable thumbs, tactile pads and nails on fingers and toes, a precise grip and extremely mobile, strong arms. Captive bred offspring of animals purported to have been imported before October 10, 1975, are frequently offered for sale. Primates may be primarily omnivorous, frugivorous, vegetarian, and foragers and their social standing may affect how much and what they eat. It would be negligent not to state that the keeping of NHP as pets should be strongly discouraged, both from an animal health and welfare point of view, as well as a human health concern. The primary mode of transmission between monkeys is by sexual activity and bites, while transmission to humans may be through bites, scratches, or contact with infected blood or urinary secretions to mucus membranes.
In the exposed extremity there may be a regional lymphadenopathy, fever, muscle weakness or paralysis and conjunctivitis, often accompanied by generalized malaise and flu-like symptoms. A negative antibody test or viral culture result, however, does not exclude the possibility of B-virus infection or viral shedding. Clinical signs in NHP can range from fever, conjunctivitis, coryza, bronchitis and Koplik spots on oral mucosa.
Monkeys are thought to get this infection from mice in the exhibit, or from being fed pinkie mice as treats in their diet. There are significant implications for laboratory workers and zoo personnel that work with NHPs.
Common AIDS defining clinical diseases include wasting, CMV, LCV lymphoma, Pneumocystis pneumonia, Cryptosporidia and Mycobacterium avium and closely paraellel the spectrum of diseases observed in human patients.
Active disease is diagnosed either by recovery of the organisms in culture or by thoracic radiographic lesions consistent with active TB. The disease in humans may cause debilitating diarrhea and people may also shed the bacteria asymptomatically. This is the key to maintaining both healthy NHPs and minimizing the risk to pet owners and veterinary staff. Macaques housed in primate facilities usually become B virus positive by the time they reach adulthood. The disease then may progress to cause persistent hiccups, sinusitis, neck stiffness, headache, flu-like symptoms, nausea, vomiting, confusion, brain stem damage and fatal meningoencephalitis in humans.
Clinical signs can range from severe dermatitis to a severe, life threatening and often-fatal exanthematous disease.
Ebola virus has now been subtyped into these four distinct viral groups: Zaire, Sudan, Ivory Coast, and Ebola-Ralston. PCR and other amplification tests can also detect organisms but the sensitivity of PCR for the detection of latent infection is not well established. The organism can live in the soil for long periods of time and asymptomatic animals, combined with the difficulties in culturing the organism from rectal or fecal swabs, can all lead to difficulties in controlling the organism. The American Veterinary Medical Association also has a policy opposing the keeping of wild animals as pets and advising veterinarians to exert their influence to discourage this practice. Only a well-equipped practice, with staff that have been properly trained in primate handling and have been informed about and screened for zoonotic disease, should take on this challenge. The virus may induce sever immunosuppression that can lead to the acquisition of opportunistic infections. These relatively newly recognized strains of filoviruses have been given special attention due to a viral outbreak in a Virginia quarantine facility in recently imported cynomolgus monkeys (Ebola-Reston). Preventative measures such as quarantine, good sanitation, good hygiene, especially in food preparation, and pest control, together with a vaccination program in endemic areas, are all recommended in preventing infection, although vaccination is not 100% effective. When it does occur, the infection can result in severe brain damage or death if the patient is not treated soon after exposure (see Risks for Infection and Treatment sections). This treatment halts the progression of the process but the major bone deformities are irreversible. Even then, the occupational health and safety hazards, ethical and legal ramifications can be enormous.
Antiviral treatments given early in the course of the disease may prevent progression of the disease and has proven to be life saving in some patients. No filovirus-related illness was observed in any humans who had been in contact with these infected monkeys, but antibody titers were detected, indicating transmission did occur.
All staff handling both the animal and its biological products must be well educated in the risks they are taking and in the ways of disease prevention. UVB or natural sunlight may be helpful in treatment and should be considered for prevention of the problem. These antiviral medications must be taken continuously throughout life to prevent recrudescence of disease.
Because Monkeypox is serologically related to smallpox, it has the potential to be devastating in unvaccinated human populations. The three subtypes that are known to cause disease in humans are Ebola-Zaire, Ebola-Sudan and Ebola-Ivory Coast. The NHP owner must also be aware of the risks to both humans who have contact with the animal and also the risks to the animal from the contacted humans. Macaques housed in primate facilities will usually be carriers of the herpes B virus by the time they reach adulthood. Rapid diagnosis and treatment is essential in preventing permanent disability and death in patients that are symptomatic. The disease is called Ebola Virus Hemorrhagic Fever and clinical signs in both humans and NHP are: fever, chills, headaches, muscle aches, and anorexia. Eggs are passed in the feces and the ex vivo development leads to the maturation of an infective cystacanth.
As the disease progresses, vomiting, diarrhea, abdominal pain, sore throat, and chest pain may develop.
Progression of the disease may depend upon the site of infection and amount of infectious particles transmitted. A coagulopathy then develops and bleeding may occur from injection sites as well as into the gastrointestinal tract, skin, and internal organs. Because of the high mortality rate from human filovirus infections (Ebola, Marburg-Europoe, Sudan and Zaire strains), the CDC has updated regulations and inspections of imported primates.
Around 70% of untreated patients will die from the infection.You should begin first aid immediately if you have been bitten or scratched by a monkey that can carry herpes B virus.
Recent evidence has shown that wild primates, especially the great apes, may be susceptible to naturally occurring Ebola outbreaks in Africa.

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