Herpesvirus B Biological Agent Reference Sheet (BARS)

Last revised 03/05/2024

This information has been prepared to align with the NIH B Virus Resource Program guidelines and recommendations. 

Summary

Synonym or Cross Reference: Herpes simiae virus, herpesvirus simiae, B virus, herpes B virus, herpes B, monkey B virus, W virus, monkey herpes infection, simian herpesvirus B infection, and B virus infection, Macacine alphaherpesvirus 1, McHV-1, Macacine herpesvirus 1

Agent Characteristics 

Description: CHV-1 belongs to the subfamily Alphaherpesvirinae, genus Simplexvirus, closely related to herpes simplex virus-1 and -2. CHV-1 is the only non-human primate herpesvirus shown to infect humans. In the natural host, the virus exhibits pathogenesis similar to human cold sores. In humans, zoonotic infection with B virus can cause severe encephalitis, leading to permanent neurological dysfunction or death. Untreated cases have an approximately 80% case fatality rate.

The genome structure, genetic makeup, and unique features of Cercopithecinae herpes virus 1 (B virus) are studied extensively. For detailed genetic information, refer to the NIH B Virus Resource Program.

Host Range: Humans, macaque monkeys (including M. artoides, M. nemestrina, M. fuscata, M. radiate, M. cyclopis), with M. mulatta and M. fascicularis as the main natural reservoirs. All macaques should be considered potentially infected. Experimental hosts include rabbits, dogs, mice, and guinea pigs.

Host Shedding: Bodily fluids of infected monkeys. CHV-1 is not present in blood or serum in healthy infected macaques.

Route of Exposure to Humans: Mucous membranes, skin breaks.

Infectious Dose: Unknown

Incubation Period: The reported range is two days to 5 weeks, though most cases become apparent in 21 days or less.

Health Hazards

Asymptomatic CHV-1 virus shedding is the primary transmission mode among monkeys and human workers. Exposure via mucous membranes or skin breaks provides access to the new host. Transmission occurs through bites, scratches, splashes, and contaminated surfaces. Cercopithecinae herpes virus 1 is a hazard in facilities where macaque monkeys are present or with cell cultures and CNS tissue. Mucosal secretions (saliva, genital, conjunctival) are primary risk for transmission. Zoonoses have been reported after exposure to monkey cell cultures and CNS tissue. Barrier precautions should be observed with confirmed cases as there are no effective vaccines or curative therapeutics for humans.

All macaques, regardless of their origin, should be considered potentially infected. Animals with no detectable antibody are not necessarily CHV-1-free.

Agent Viability 

For more guidance on disinfection, see disinfectant selection.

Laboratory Hazards 

• High energy-creating activities (centrifugation, sonication, high-pressure systems, vortexing, tube cap popping) 
• Handling of sharps (needles, scalpels, microtome blades, broken glass, etc.) 
• Splash/droplet-creating activities (shaking incubators, liquid culturing, mechanical pipetting) 
• Equipment contamination
• Exposed skin/uncovered wounds 

Laboratory Acquired Infection (LAI) History: The first human case of CHV-1 was reported in a laboratory researcher in 1932, who was bitten on the finger by an apparently healthy rhesus macaque and died of progressive encephalomyelitis 15 days later. There have been approximately 50 reported cases of Herpes B virus (CHV-1) infections in laboratory workers globally. These infections often result from exposures such as needlestick injuries, mucous membrane contact, and broken skin coming into contact with virus-containing materials. Mortality from exposure is approximately 80%.

Laboratory Handling Guidelines 

Laboratory Biosafety Level (BSL): No work with CHV-1 isolates at Cornell. Work with the agent and infected animals requires BSL-4 or ABSL-4 containment practices.

Work with diagnostic samples at BSL-3 containment.

Work with samples from animals tested regularly and found negative may occur using BSL-2 containment practices. All materials must be handled inside primary containment, such as biosafety cabinets. Centrifugation of samples must use centrifuges with safety cups or sealed rotors loaded and unloaded inside biosafety cabinets. Processes like homogenization or vortexing must occur inside biosafety cabinets.

Attenuated Strain Alternatives: None known.

Waste Management: Regulated Medical Waste (RMW)

Shipping Guidance: Refer to EHS Biological Materials Shipping Shipment of the virus has explicit permitting requirements from CDC and USDA. Shipment of animal-derived materials may require permitting from the USDA, including domestic shipments.

Animal Vivarium Guidance

Animal Housing Biosafety Level (ABSL): No experimental infection or work with CHV-1-virus-infected animals is permitted at Cornell.

Exposure and Spill Procedures 

Exposure to B-virus and materials derived from macaques can occur through various means. Direct contact of macaque materials or the agent with mucous membranes (such as eyes, nose, and mouth) or broken skin can lead to exposure. Accidental cuts, stabs, or punctures with objects contaminated by macaque materials also pose a significant risk. It is crucial to note that all macaques should be considered potentially infected, and caution is advised when handling samples.

Call or contact EHS Biosafety for additional guidance.

Mucous Membranes: Flush eyes, mouth, or nose for 15 minutes at an eyewash station. See: responding to exposures.

Other Exposures: Thoroughly wash and scrub the area or wound with soap, a concentrated solution of detergent, povidone-iodine, or chlorhexidine, or 0.25% sodium hypochlorite (5% household bleach) and water for 15-20 minutes. Then, irrigate the washed area with running water. Seek medical evaluation.

Medical Treatment and Surveillance:

Employees and students go to Cayuga Medical Center’s emergency department, located at 101 Dates Dr, Ithaca, NY 14850, or the nearest emergency department. Give a copy of this sheet to the physician so they understand that you may have just been exposed to Cercopithecinae herpes virus 1 (or herpes B virus), and this is a medical emergency.

Physician Information:

This is not herpes zoster – this is a potentially life-threatening disease. Herpes B virus is one of the highest-risk pathogens in humans, belonging to the risk group 4 of pathogens. Contact Cornell University Biosafety or Cornell University Occupational Medicine for additional information.

Perform the following specimen collection:

• Irrigate wounds,
• Flush mucous membranes,
• Repeat cleansing
• Debride as necessary
• Collect
  • (2) serum separator (SST) blood collection tubes.
  • Viral swab(s) of the affected area in commercially prepared viral transport media (VTM), if appropriate, based on the nature of exposure.
    • Samples must be submitted following the instructions from the National B Virus Resource Center (http://biotech.gsu.edu/virology/ ). Specific instructions are here: http://biotech.gsu.edu/virology/PDFs/2012%20Sample%20Collect%20&%20Shipmt.pd
    • Submission forms are here: http://biotech.gsu.edu/virology/PDFs/2015%20Submission%20Form.pdf
    • Samples will need an NPL (non-permitted laboratory exemption) from Wadsworth's Clinical Laboratory Evaluation Program. DO NOT DELAY - Wadsworth does not process these samples.
  • The employee should be evaluated for treatment with oral valacyclovir 1 gram 3 times per day for 14 days, or oral acyclovir 800 mg 5 times/day for 14 days, or another comparable chemoprophylaxis. Refer to the recommendations outlined in Recommendations for Prevention of and Therapy for Exposure to B Virus (Cercopithecine Herpesvirus 1)

Small Spills:

1. Notify Others: Inform colleagues working in the lab about the spill.
2. PPE: Wear appropriate personal protective equipment (lab coat, gloves, and safety glasses).
3. Containment: Cover the spill area with absorbent materials (e.g., paper towels) to absorb the spilled material.
4. Clean-Up: Carefully clean the spill area using an appropriate disinfectant solution recommended for BSL-2 or BSL-3 labs, depending on the facility's biosafety level. Dispose of contaminated materials in a biohazard waste bag.
5. Decontamination: Decontaminate surfaces and equipment that came into contact with the spill using an appropriate disinfectant.

Large Spills:

1. Notify Others: Inform colleagues, evacuate the area, and restrict access.
2. Evacuation: Evacuate the laboratory area immediately to prevent exposure to potentially aerosolized contaminants.
3. PPE: Wear appropriate personal protective equipment (lab coat, gloves, safety glasses, and a face shield).
4. Containment: Cover the spill area with absorbent materials and apply a suitable disinfectant.
5. Clean-Up: Trained professionals or EHS personnel should handle large spills. Follow established spill cleanup procedures with extreme caution.

You may request aid from EHS by calling CUPD dispatch. Call 911 from a campus phone or 607-255-1111 from a mobile phone. Ask for a biological safety hot page.

Incident Reporting: Immediately report the incident to the supervisor and complete the EHS online injury/illness report as soon as possible.

Medical Follow-Up:

• Seek a medical evaluation with an infectious disease specialist for care at 1, 2, 4 weeks. Serological testing should occur at week 4 follow-up. Cornell Health does not see employees for post-exposure care.

• Emergencies: Call 911 from a campus phone or 607-255-1111 from a mobile phone.