
==== Front
New Microbes New Infect
New Microbes New Infect
New Microbes and New Infections
2052-2975
Elsevier

S2052-2975(24)00240-3
10.1016/j.nmni.2024.101456
101456
Letter to the Editor
Hong Kong's first human case of B virus: Feeding monkeys, a risky practice!
Verma Amogh amoghverma2000@gmail.com

Rama Medical College Hospital and Research Centre, Hapur, 245304, India
Medicos In Research, Nautanwa, 273164, India
Zaheer Amna amnazaheersiddiqui7@gmail.com

Liaquat National Hospital & Medical College, Karachi, Pakistan
Bisht Kiran kiranbisht.bt.phd@geu.ac.in

Department of Biotechnology, Graphic Era (Deemed to be University), Clement Town, Dehradun, 248002, India
Department of Allied Sciences, Graphic Era Hill University, Clement Town, Dehradun, 248002, India
Gaidhane Abhay M. abhay.psm@dmiher.edu.in

Jawaharlal Nehru Medical College, and Global Health Academy, School of Epidemiology and Public Health, Datta Meghe Institute of Higher Education, Wardha, India
Khatib Mahalaqua Nazli nazlikhatib@dmiher.edu.in

Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India
Sah Sanjit sanjitsahnepal561@gmail.com

Department of Paediatrics, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, 411018, Maharashtra, India
Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, 411018, Maharashtra, India
Bushi Ganesh ganyganesh313@gmail.com

Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
Medical Laboratories Techniques Department, AL-Mustaqbal University, 51001, Hillah, Babil, Iraq
Sah Ranjana ranjanasah384@gmail.com
⁎
Kritipur Hospital, Kathmandu, 44618, Nepal
Kumar Anil rxanil411@gmail.com

Zhengzoue Medical University, Henan, China
Rama Medical College Hospital and Research Centre, Hapur, 245304, India
⁎ Corresponding author. Kritipur Hospital, Kathmandu, 44618, Nepal. ranjanasah384@gmail.com
14 8 2024
12 2024
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© 2024 The Authors
2024
https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Keywords

B virus
Hong Kong
Monkey
Infection
Public health
Handling Editor: Patricia Schlagenhauf
==== Body
pmcThe recent identification of Hong Kong's first human case of the B virus, or Herpes simiae, marks a critical juncture in public health surveillance and response [1,2]. Identified by the Centre for Health Protection (CHP) of the Department of Health (DH), this case involved a 37-year-old man who was admitted to Yan Chai Hospital on March 21, 2024, after exhibiting symptoms of fever and altered consciousness. Subsequent tests confirmed the presence of B virus in his cerebrospinal fluid, necessitating intensive care due to the severity of his condition.

The B virus, primarily carried by rhesus (Macaca mulatta) and cynomolgus (Macaca fascicularis) monkeys, members of the macaque genus that are prevalent in Hong Kong's natural habitats, poses a significant zoonotic threat [3]. Transmission occurs primarily through direct contact with the bodily fluids of infected monkeys, such as saliva and urine, or through bites and scratches (Fig. 1) [4]. The patient in question encountered wild monkeys during a visit to Kam Shan Country Park, where he sustained injuries, underscoring the potential for zoonotic spillover in human-wildlife interactions. Historically, human infections with the B virus have been rare but severe, with documented cases mainly among individuals with occupational exposure to macaques, such as laboratory workers and veterinarians, totaling approximately 50 cases globally since the identification of this virus, with a mortality rate of approximately 40 % [4]. This highlights the critical need for heightened awareness and preventive measures in at-risk populations.Fig. 1 Transmission cycle and clinical manifestations of B virus (Herpes simiae) infection, including self-care measures.

Fig. 1

Symptoms of B virus infection initially mimic flu-like illnesses, including fever, muscle aches, and fatigue [5]. As the infection progresses, it can lead to severe neurological complications, including encephalitis, highlighting its rapid onset and potentially fatal consequences if untreated. Prompt medical intervention, typically involving antiviral therapies such as acyclovir, is crucial for managing severe cases and improving outcomes [4,5]. Tourists often offer food to wild monkeys at popular sites, such as Kam Shan Country Park, unaware of the potential health risks associated with such practices. This behavior not only disrupts natural animal behavior, but also increases the risk of zoonotic disease transmission, as exemplified by this recent case. Preventive strategies recommended by the CHP emphasize avoiding contact with wild monkeys and refraining from feeding them. In cases of injury from monkey bites or scratches, immediate medical attention and thorough wound care with soap, water, and disinfectants are essential to mitigate the risk of infection. Public awareness campaigns play a pivotal role in educating communities about the dangers posed by zoonotic diseases and the necessary precautions to prevent their transmission.

In conclusion, the emergence of the B virus in Hong Kong serves as a poignant reminder of the dynamic interplay between human activity and wildlife health. As urbanization encroaches on natural habitats, interactions between humans and wildlife increase, increasing the risk of zoonotic disease transmission. Through concerted efforts in surveillance, prevention, and public education, health authorities can mitigate risks, protect community well-being, and advance global health security in an increasingly interconnected world.

Financial support and sponsorship

All the authors declare to have received no financial support or sponsorship for this study.

Ethical consideration

Ethical approval is not required for this letter to the editor.

CRediT authorship contribution statement

Amogh Verma: Writing – review & editing, Writing – original draft, Visualization, Validation, Supervision, Project administration, Conceptualization. Amna Zaheer: Writing – review & editing, Writing – original draft, Validation, Supervision, Project administration, Conceptualization. Kiran Bisht: Writing – review & editing, Writing – original draft. Abhay M. Gaidhane: Writing – review & editing, Writing – original draft. Mahalaqua Nazli Khatib: Writing – review & editing, Writing – original draft, Validation. Sanjit Sah: Writing – review & editing, Writing – original draft. Ganesh Bushi: Writing – review & editing, Writing – original draft, Validation. Ranjana Sah: Writing – review & editing, Writing – original draft. Anil Kumar: Writing – review & editing, Writing – original draft, Validation.

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Acknowledgements

Amogh Verma and Amna Zaheer contributed equally and should be considered as co-first authors.
==== Refs
References

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