Man who caught virus from a monkey in a critical condition – B virus explained

By Colin Michie, University of Central Lancashire

A 37-year-old man wounded by a wild monkey in Hong Kong is in intensive care suffering from infection with B virus.

Although this is the first reported case of a B virus infection in a human in Hong Kong, it is not the first in the world. The US Centers for Disease Control and Prevention has recorded 50 cases of human infection since 1932, when the virus was first identified. Twenty-one of those infected died.

The first person – as far as we know – to catch B virus was a young doctor called William Brebner. He was bitten by a macaque monkey while researching poliovirus. The bite wound healed, but neurological illness eventually ensued, leading to respiratory failure. Brebner died at Bellevue Hospital, New York, in November 1932.

After his death, his brain tissues were found to cause neurological damage when injected into rabbits. Brebner’s colleagues Albert Sabin and Arthur Wright labelled this agent “B”.

We now know that the virus belongs to the herpes family, hence its other moniker: “herpes virus B”. It is a biosafety category 4 virus, the highest level – the same as Ebola and unknown new pathogens.

Prompt treatment with antiviral drugs can be lifesaving, but B virus remains a deadly pathogen. If not treated promptly, it has a mortality rate of 70%. There is no vaccine against this virus.

Most cases of B virus infection have involved laboratory workers handling captive animals or monkey tissues, rather than those living alongside these excitable, toothy animals in the wild.

Old World primates

In this most recent case, the 37-year-old man was attacked by macaques at Hong Kong’s Kam Shan Country Park – known locally as Monkey Hill. There are about 1,800 wild monkeys in Hong Kong, including two different macaque species. The authorities are warning people not to approach these creatures.

Macaques are a particularly adaptable group of old world primates with a wide global distribution.

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