ADDENDUM 1: ZOONOSES OF NONHUMAN PRIMATES

A. Shigella/Salmonella

1. Background

a. Bacterial disease, bacillary dysentery

b. Gastrointestinal disease

c. Fecal contamination

d. Adults are at less risk than children, who are highly susceptible. Lab workers get a mild case, convert to carrier state and give to their children.

2. Clinical signs

a. Profuse diarrhea

b. Mucus and pus

c. Shigella may cause bloody stools

d. Carriers exist in NonHuman Primate and man

3. Lesions

a. Hemorrhagic enteritis

b. Ulcerated intestine

c. Microabscesses in liver

d. Microabscesses in spleen

B. Campylobacter

1. Non invasive

2. Signs in Humans and Nonhuman Primates:

a. Diarrhea, with or without blood and leukocytes

b. Abdominal pain

c. Fever

3. Precautions basically the same as for Shigella

C. Viral Hepatitis A

1. Background

a. First outbreak 1953

b. 198 human cases

c. Chimpanzee primarily involved

d. 5% of all lab-acquired hepatitis in man is traced to simian source

2. Clinical signs and diagnosis

a. No signs in chimps

b. Liver biopsy - hepatitis

c. Liver function tests

3. Transmission

a. Virus in feces

b. Virus in serum

D. Monkey Pox

1. Human cases

a. 7 cases 1970-71

b. Fever, rash, headache

c. Lasts 5-25 days

2. Monkey cases

a. Rhesus and cynos - clinically similar to human smallpox

b. Many others also

c. High morbidity and low mortality

d. Signs similar to man: circular, proliferative lesions that undergo vesicle formation and ulceration

3. Background

a. Related to smallpox - cross-protection

b. No evidence of monkey pox in feral animals - suggests lab Nonhuman primate acquire from man

E. Marburg Disease

1. History

a. African Green monkeys are the primary carrier of this virus; squirrel and rhesus monkeys also carry the virus.

b. One of the most hazardous viruses associated with simians; 33% mortality rate from virus in man.

c. No clinical signs in monkeys.

d. First seen in Frankfurt and Marburg, Germany, by workers handling animal tissues.

e. Transmission via handling animals, animal products (blood, tissues), contaminated equipment, waste material.

f. Virus shed in saliva and urine.

2. Signs

a. Generalized rash

b. Extreme weakness, headache

c. Hemorrhage and nose bleeds

d. Very high fever

F. Ebola and Ebola-like Viruses

1. Background

a. In November 1989 Ebola virus was isolated from cynomolgus monkeys imported from the Philippines. By February 1990, at least 3 shipments imported from the Philippines had Ebola virus isolated.

b. In March 1990, CDC issued an advisory statement which reported that serologic studies of different species of primates (Cynomolgus, Rhesus, and African Greens) from different countries had a 10% positive rate for Ebola virus. The CDC then immediately began unannounced site visits of primate importers. Charles River, Hazelton (Reston), and Worldwide Primates immediately had their registrations lifted and the panic was on.

c. Animal Rights groups immediately took advantage of the situation and began assaulting labor unions, airplane passenger associations, and news personnel. The results were that all airlines now refuse to handle primate imports.

d. Currently, no person may import these 3 species into the U.S. without a special permit issued by the CDC. It is estimated that there will be a shortage of these species of 6000-8000 this year.

e. At least 173 persons in the U.S. have been in contact with primates from infected lots since the virus was first identified. None has developed illness, however, one person has been found to have antibodies to Ebola virus.

f. The virus has been determined to be an Ebola-like virus and not Ebola. It has been renamed Reston Virus and appears to not effect humans.

2. Transmission: occurs in humans by direct contact with infected blood, secretions, organs, semen or by aerosol. The virus has never caused human disease outside of Africa.

3. Classification: Filovirus, an RNA virus.

4. The Disease in Man and the Nonhuman Primate: Clinical symptoms include fever, progressive sore throat, maculopapular rash, abdominal pain, and bleeding from multiple sites with progression in most patients (55-90%) to death. There are no antiviral drugs available, and no licensed vaccine exists.

5. Preventive Measures: Based on strict quarantine of newly imported wild-caught primates. Naturally infected primates incubating the disease should become ill or die within several weeks.

G. Miscellaneous Primate Zoonoses

1. Yaba and Benign Epidermal Monkey Pox (BEMP)

a. Spread by inoculation

b. Old World Nonhuman Primate

c. Tumor formation

d. Spontaneous regression

e. Pox viruses, Baboon is the host for Yaba and man has acquired the disease

2. Measles

a. Very common, Nonhuman Primate USUALLY CONTRACT THIS FROM HUMANS

b. Rubeola virus

c. Old World primates usually have moderate form of disease; in New World primates the disease is often fatal.

d. Pneumonia

e. Inhalation

f. Prevented by using immune animal handlers and vaccinations of primates.