View source for Herpes B virus

==Background==
*Cercopithecine herpesvirus 1 (commonly referred to as B virus)
*Zoonotic Endemic in Macaque Monkeys-mild symptoms like blisters
*Fatal Encephalomyelitis in Humans: 80% fetal 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

==Clinical Features==
*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==
*[[Rabies]]
*[[Herpes zoster]]
*[[Cat-scratch disease]]
*[[Herpes simplex virus]]

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

==Management==
*Asymptomatic Prophylaxis Treatment
**Treat if high risk for transmission:
***Penetrating (especially head, neck, torso)
***Fluid on mucosa
***Blistering Monkey
***Discuss with patient
Treatment
<20 minutes clean and irrigate
Prophylaxis: 
14 day course of PO Valacyclovir 1gm three times daily
14 day course of PO Acyclovir 800mg five times daily

*All non-CNS symptomatic: Admit and treat
**Acyclovir IV 12.5-15 mg/kg every eight hours OR 
**Ganciclovir IV 5mg/kg every 12 hours

*All CNS Symptomatic Admit and treat
**ganciclovir IV 5mg/kg every 12 hours

*[[Rabies]] Treatment

==Disposition==
*Asymptomatic Discharge
*Symptomatic Admit

==See Also==

==External Links==

==References==
#[http://www.cdc.gov/herpesbvirus/ B Virus (herpes B, monkey B virus, herpesvirus simiae, and herpesvirus B). Centers for Disease Control and Prevention Web site. http://www.cdc.gov/herpesbvirus/ Page last reviewed: July 18, 2014. Accessed April 3, 2015.]
#[http://cid.oxfordjournals.org/content/35/10/1191.long Cohen JI, Davenport DS, Stewart JA, Deitchman S, Hilliard JK, Chapman LE; B Virus Working Group. Recommendations for prevention of and therapy for exposure to B virus (cercopithecine herpesvirus 1). Clin Infect Dis. 2002 Nov 15;35(10):1191-203. Epub 2002 Oct 17.]

<references/>

[[Category:ID]]