Earlier this month, Hong Kong reported its first human case of the B virus. A 37-year-old man is in  critical condition in hospital after a monkey attack.

What is B virus?

• B virus (also known as herpes simiae virus) infections in people are usually caused by macaque monkeys.

• These kinds of monkeys are commonly infected with B virus, but they usually do not have symptoms, or have just mild disease.

• B virus is naturally carried in the saliva, urine and stool of macaques. 

• B virus infection is extremely rare, but it can lead to severe brain damage or death if it is not treated immediately. 

• People typically get infected with B virus if they are bitten or scratched by an infected macaque monkey, or have contact with the monkey’s eyes, nose, or mouth.

• Symptoms typically start within one month of being exposed to B virus, but could appear in as little as three to seven days.

• The first indications of B virus infection are typically flu-like symptoms: fever and chills, muscle ache, fatigue, headache.

• Then, the infected person may develop small blisters in the wound or area on the body that had contact with the monkey.

• Other symptoms may include: Shortness of breath, nausea and vomiting, abdominal pain, hiccups.

• As the disease progresses, the virus spreads to and causes inflammation (swelling) of the brain and spinal cord. 

This can lead to:

i) Neurologic and inflammatory symptoms (pain, numbness, itching) near the wound site.

ii) Problems with muscle coordination.

iii) Brain damage and severe damage to the nervous system.

• There are no vaccines that can protect against B virus infection.

• The US Centers for Disease Control and Prevention has recorded 50 cases of human infection since 1932, when the virus was first identified. As many as 21 of those infected died.

• Human infection has been reported earlier in the US, Canada, China and Japan, and were mainly caused by bites or scratches by monkeys.

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