Working with non-human primates constitutes major health risks for people. Many diseases that can cause significant health problems in humans, even death, can be carried asymptomatically by non-human primates. Among the most deadly is Herpes B virus infection. Other significant zoonotic diseases include other viral diseases, tuberculosis, enteric bacterial infections and parasitic diseases.

Herpes B virus

The University of Missouri only purchases animals from Herpes B negative colonies and only animals specifically bred for research. Each individual animal has been tested for antibody to Herpes B virus and found to be negative before coming to MU. Regardless, due to the fatal nature of the disease in humans, each animal is to be handled as it is potentially infected.

Herpes B virus infections in macaque monkeys is similar to Herpesvirus simplex infection in people. Once infected, they can be carriers for life. Only on occasion do they show mild clinical signs consisting of small ulcerations on their lips, gums and genital surfaces. Monkeys shed the virus when these lesions are present but also shed virus in their saliva and genital secretions. Shedding is intermittent and is usually due to stress conditions in the animal.

Documented cases of human disease have occurred with bites, cuts and scratches while working with animals, their tissues, tissue culture, cages and other equipment. Recently ocular exposure of a human to body secretions of a macaque resulted in death of the person.

Clinical signs of infections in humans usually begin with a vesicular lesion at or near the site of virus entry within one month of exposure. This rapidly develops into localized neurological symptoms followed by encephalitis and death.

Tuberculosis

Tuberculosis is a disease of animals and humans caused by bacteria of the Mycobacterium genus. Generally, monkeys that we normally use at MU are more sensitive to infection by Mycobacterium spp. than humans. Coughing with sputum production and skin infections are associated with disease in monkeys and humans. Signs of generalized disease can be associated with any organ system and can include weight loss, fatigue, fever, chills and chronic wasting. The disease is spread by aerosols, ingestion and/or wound contamination. Monkeys at MU are screened quarterly using a skin test for possible infection. Any person with access to animals or monkey tissues, fluids or equipment should be screened semiannually by skin test or chest radiographs.

Enteric Bacterial and Intestinal Parasites

Intestinal bacteria such as Salmonella spp., Shigella spp. and Campylobacteria spp. can be present in the feces of non-human primates. These bacteria may or may not cause diarrhea in monkeys. Normal appearing animals can be chronic shedders of these potential human pathogens. Clinical signs of human infection caused by these bacterial organisms include watery diarrhea with or without blood, nausea, cramping, vomiting, fever and chills. Disease is spread by oral ingestion of contaminated fecal material. Never, touch your hands to your mouth while in or after leaving a monkey area.

Non-human primates can carry many internal parasites that are infectious to humans. Among the most common are Balantidium coli, Cryptosporidium spp., and Giardia spp. Common signs in humans that are associated with the parasites include abdominal pain, nausea and diarrhea.

Other Viral Infections

Measles, hepatitis A, and poxviruses can also be transmitted to humans from monkeys. Measles in humans is characterized by fever, coughing and rash development. Clinical signs of hepatitis A infection in humans include fever, weakness, abdominal pain, nausea and jaundice. Poxvirus infection from monkeys can cause headache, weakness, muscle ache and rashes or pox-like skin lesions in humans.

Safety Precautions

To prevent exposure to the diseases listed above and additional, less common non-human primate disease, all personnel working with monkeys, monkey tissues or fluids, husbandry equipment and other experimental equipment are required to follow the precautions listed below:

1. Awake monkeys are not to be hand captured.
2. All awake monkeys will be handled by the pole and collar technique and/or restrained in primate chairs.
3. Chemical restraint (e.g. ketamine) will be used in lieu of the pole and collar or primate chairs.
4. All monkey tissues and fluids are to be handled only with protective gloves. No mouth pipetting is allowed.
5. Monkey cages, equipment and devices going to the cage wash for sanitation will be handled with protective gloves and any injury associated with this equipment will be treated as a direct injury exposure to a monkey. Monkey equipment will receive priority sanitation and dirty equipment will not be allowed to accumulate on the dirty side of the cage washer.
6. All monkey housing areas will be kept locked. No visitors are allowed and only authorized personnel are allowed entry.
7. Any person authorized entry into a monkey room or who works with monkeys, their tissues or fluids must be confirmed tuberculosis-free (skin test or chest radiographs) on a semiannual basis.
8. The following personal protective equipment (PPE) must be worn any time a person enters a monkey housing area:
   1. Tyvek protective coveralls – covering arms and all personal garments
   2. Protective, disposable booties – covering entire foot ware
   3. Disposable head covering – covering all hair
   4. Particle or surgeons mask – well fitted around nose and mouth
   5. Exam gloves – over Tyvek sleeves - no exposed hand or arms

Additional protection required when handling monkeys or direct exposure to the animal include:

6. Face shield – in place when capturing and working with monkeys
7. A second pair of exam gloves – worn over the first pair

9. Upon removing the PPE upon exit of the animal room, all personnel are to immediately wash hands thoroughly – keeping in mind not to touch their face or mouth until hands are scrubbed.

sections:

• Herpes B Virus
• Tuberculosis
• Enteric Bacterial and Intestinal Parasites
• Other Viral Infections
• Safety Precautions