Fever, headache, and localized skin vesicles; [CCDM] Some patients present with flu symptoms followed by encephalitis. May have paresthesias and weakness in extremity bitten by monkey; [PPID, p. 1784]
Macaque monkeys are the natural hosts for this virus, and rhesus monkeys (Macaca mulatta) have 30-80% seropositive rates. "On a given day, approximately 2% of seropositive rhesus monkeys shed B virus, but shedding increases during periods of stress (e.g., shipping and handling)." B virus ascending encephalomyelitis is an occupational hazard for workers who handle macaque monkeys (bites, scratches, or eye exposure from fomites).The case-fatality rate is about 80% in untreated patients. [CCDM, p. 281-2] Patients may have vesicles at the bite site with regional lymphadenopathy. Other symptoms are sinusitis, conjunctivitis, hiccups, abdominal pain, stiff neck, dysphagia, dysarthria, ataxia, seizure, and coma. Vesicles may appear at the wound site. About 50 cases human B virus infection have been reported with about 26 well-documented. [PPID, p. 1783-4]
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