Electron microscopy of B virus(1)

Description: Cercopithecine herpesvirus 1, or B virus, is a neurotropic and neurovirulent herpesvirus of macaque monkeys.(2),(3)  However, zoonotic transmission between macaques and humans has been documented in more than two dozen instances.  Among all the identified non-human primate herpesviruses, it is the only one that is highly pathogenic.

Power: All in all, 80% of untreated human infections result in death.(4)  However, the risk of serious disease is largely determined by the method of infection.  For instance, deep needlesticks are hard to clean out thoroughly and can result in a worse outcome.  In addition, the closer the site of infection is to the brain, the shorter the time until development of CNS symptoms, limiting the window of opportunity for postexposure prophylaxis.(5)  Infection through cracked skin, on the other hand, usually just results in localized erythema.(6)

Offenses: At first, humans infected with B virus develop an influenzalike syndrome, followed by myalgia, and paresthesia or numbness near the site of inoculation.(7) As the virus spreads along the nerves of the peripheral nervous system, the patient’s condition worsens and can include dizziness, vomiting, hemiplegia, ascending paralysis, respiratory failure, encephalomyelitis, coma, and death.(8)  The clinical picture also frequently includes vesicular lesions, cerebral hemorrhagic infarcts, and multifocal necrotizing retinitis.(9)

Defenses: Defenses against B virus include primary prevention, post-exposure prophylaxis (PEP), and antiviral therapy after presentation of disease.  Primary prevention includes thorough washing of any contaminated bites, scratches, etc.  Post-exposure prophylaxis is administered as quickly after exposure as possible and consists of either famciclovir or valacyclovir.  On the other hand, treatment of sequelae of B virus is usually done with acyclovir or ganciclovir.  There are no hopes for a vaccine any time soon because studies have not been able to induce long-lasting immunological memory and there is not a large demand for vaccine because B virus is such a rare zoonosis.  Behavioral prevention includes proper precaution when dealing with macaques.(10)

Game Action: You just were bitten by an angry macaque!  Spend two turns neurotically washing your wounds.

One Liner: In four of five, macaque attack will make you not survive!