Zoonoses Associated with Nonhuman Primates and NHP Tissue

Zoonoses Associated with Nonhuman Primates and NHP Tissue

Zoonoses Associated with Nonhuman Primates

This document provides information on various diseases that can be transmitted from nonhuman primates (NHPs) and NHP tissue to humans. Often these diseases do not make the animal appear sick but can cause serious illness in humans. Persons with specific medical conditions such as a chronic illness, immunodeficiency, and/or pregnancy may be at higher risk of developing disease or complications from a zoonotic disease and should consult with their physician before working with animals. The diseases associated with NHPs include herpesvirus simiae (Herpes B) infection, simian foamy virus infection (SFV), monkeypox, tuberculosis, shigellosis, leptospirosis, salmonellosis, cryptosporidiosis, campylobacterosis, giardiasis, internal parasite infections and ringworm.  

Diseases associated with vectors or contaminated materials:

Herpesvirus simiae (Herpes B virus Cercopithecine Herpesvirus 1, or B virus), is frequently found in macaque monkeys and can potentially cause a fatal disease in humans. Labs working with NHP tissue are required to have a BAF with a treatment plan in the event of an exposure, as laboratory-acquired infections have been documented. Macaque monkeys infected with this virus usually do not have symptoms or may have mild disease. Humans can become infected with this virus after bites or scratches from infected macaques, contact between mucous membranes and infected tissues or bodily fluids (e.g., splashes into the eyes), or contact between broken skin and contaminated materials (e.g., scratches from contaminated caging, needle stick). The disease in people initially resembles a flu, with symptoms like fever and chills, muscle ache, headache, and fatigue within 1-3 weeks of exposure and potentially local dermatitis at the site of infection. As the disease progresses, neurological symptoms appear such as muscle coordination problems and numbness that can progress to coma and death. Immediate first aid and treatment for high-risk exposures is crucial to preventing life-threatening disease.

  • Splash to eyes, nose or mouth: irrigate exposed area with running water at an eyewash station or other drench hose for at least 15 minutes.
  • Skin wound: wash and gently scrub the wound or area on your body that had contact with the monkey with soap, detergent, or iodine for at least 15 minutes.
  • Immediately seek medical attention after flushing/washing the exposed area. Tell the healthcare provider that you have been exposed to a macaque monkey that may be infected with B virus.

In case of exposure, it is recommended to provide your health care provider with the B-virus information found at the CDC website as this is not a routinely seen infection.

Simian foamy virus and monkeypox virus can be found in Old World NHPs (apes or monkeys). People can become infected after being bitten or scratched by affected primates, direct contact with infectious bodily fluids from these animals, direct contact with rash lesions, and contaminated needle stick injuries. Infected persons are typically asymptomatic with SFV but develop flu-like symptoms and a rash with monkeypox infection. Affected NHPs may not show signs of disease.

Tuberculosis (Mycobacterium spp.) is a bacterial zoonotic disease that can be transmitted between humans and NHPs by inhalation of airborne infectious particles, direct contact with infected individuals or their tissues and fluids, such as blood, and in rare occasions by ingestion of the causative agent. Infected humans may be asymptomatic or may present coughing up blood, fever, fatigue, weight loss, and potentially fatal lung disease. Infected animals also may be asymptomatic or may present a wide range of signs, including cough and/or difficulty breathing, weight loss, skin lesions, or sudden death. Animals may carry the latent form of TB for several years but the infection can become reactivated and cause outbreaks. Routine tuberculosis testing for both the animals and personnel may be advised.

Dermatophytosis is a fungal skin infection commonly known as “ringworm” and is seen in both animals and people as scaly round areas of hair loss. Transmission of ringworm is by direct skin-to-skin contact with an infected animal or from contaminated materials.

Leptospirosis is a bacterial infection of wild rodents and rabbits that occasionally infect NHPs that ingest contaminated food or water. People can be infected by contact with infectious bodily fluids and tissues, and ingestion and inhalation of contaminated water or materials. Leptospirosis can cause flu-like symptoms in people (i.e., fever, headache, chills), vomiting, and rashes but may progress to more severe ones including jaundice (yellow skin and eyes), kidney or liver failure, and meningitis.

Cryptosporidiosis, giardiasis and internal helminth infection such as roundworms are acquired by contact and accidental ingestion of fecal material from infected animals. Symptoms in people may include abdominal cramps, vomiting and diarrhea, etc. Animals infected with these parasitic and protozoal diseases typically have diarrhea, but some animals may show no symptoms of disease.

Shigella, Salmonella and Campylobacter are bacteria that can be transmitted through accidental ingestion of fecal material from infected animals or by direct contact with them. Symptoms in humans appear 1-2 days after infection, and typically last up to a week, including diarrhea, stomach cramps, fever, weakness, and lethargy. Animals may present intermittent diarrhea while some animals may become asymptomatic carriers.

Any animal with diarrhea should be suspect of having a zoonotic disease. Avoid direct contact with feces and urine and use gloves and hand washing to avoid accidental ingestion of animal waste.

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Individuals with exposure to animals and animal environments may develop allergic reactions to animal proteins (allergens). Approximately 20-30 percent of individuals working with laboratory animals will develop an allergic reaction to animal proteins and 5-10 percent of individuals will develop asthma. Personnel may be exposed to allergens through inhalation and contact with skin, eyes and mucous membranes. Animal allergens may be present in animal dander, hair, skin, urine, saliva, serum, and any contaminated feed or bedding materials. Risk factors for developing an allergic reaction include history of previous allergies to animals. The signs and symptoms of an allergic reaction are nasal discharge and congestion, conjunctivitis, tearing and eye itching, skin redness, rash, or hives and lower airway symptoms (coughing, wheezing, and shortness of breath).  Individuals with symptoms suggestive of an allergic reaction related to a workplace allergen should report their concerns to their supervisor and consult a physician.

Transmission of zoonotic diseases from animals is primarily by direct contact, ingestion, indirect contact with insect vectors and contaminated inanimate objects, or inhalation of aerosolized materials. We can protect ourselves from most diseases by using the following procedures:

  • Handle animals appropriately and safely to avoid bites and scratches. Thoroughly wash any bite or scratch wounds and report injuries.
  • Do not eat, drink, apply cosmetics or use tobacco products while handling animals or in animal housing areas.
  • Wear gloves when handling animals, animal tissues, bodily fluids and waste and wash hands after contact.
  • Wear dedicated protective clothing with long-sleeves and pants such as a lab coat, scrubs or coveralls and close-toed shoes when handling animals. Handling live NHPs requires safety glasses and face mask protection and/or face shield to protect from bodily fluid exposure. Launder the soiled clothing separate from your personal clothes and preferably at the animal facility.
  • Wear respiratory protection when appropriate.
  • Keep animal areas clean and disinfect equipment after using it on animals or in animal areas.

Most importantly, familiarize yourself about the animals that you will be working with and the potential zoonotic diseases associated with each species. If at any time, you suspect that you have acquired a zoonotic disease, inform your supervisor and seek medical care.

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**Prepared by Office of the Campus Veterinarian and the Office of Research Assurances July 2022

References

  • Centers for Disease Control and Prevention. B Virus.
  • Calattini S, Betsem EB, Froment A, et al. Simian Foamy Virus Transmission from Apes to Humans, Rural Cameroon. Emerging Infectious Diseases. 2007;13(9):1314. doi:10.3201/eid1309.061162.