Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors with or without signs/symptoms
  • fever (≥37.5°C) and/or chills
  • non-specific flu-like symptoms
  • numbness and/or tingling (paraesthesia) at the site of infection
  • numbness and/or tingling (paraesthesia) in the lower limbs
  • hyperaesthesias
  • severe persistent headache
  • dizziness
  • ocular pain
  • gait disturbances
  • ataxia
  • diplopia
  • agitation
  • meningismus
  • muscle weakness (paresis)
  • persistent hiccups
  • shortness of breath
  • ascending or acute flaccid paralysis
  • vesicular lesions

Other diagnostic factors

  • nausea/vomiting
  • conjunctivitis
  • rash, may be pruritic
  • lymphadenitis
  • lymphangitis
  • abdominal pain

Risk factors

  • occupational exposure
  • travel to countries with free-roaming macaques (e.g., Asia)
  • keeping macaques as pets
  • exposure to non-macaque species that have been housed with macaques

Diagnostic investigations

Investigations to consider

  • viral culture
  • brain MRI (if neurological symptoms develop)
  • brain CT (if neurological symptoms develop)
  • CSF cell count, culture, PCR, serology, and routine chemistries (if neurological symptoms develop)
  • EEG (guided by neurology consultant)
  • brainstem auditory evoked responses (guided by neurology consultant)
  • somatosensory evoked potentials (guided by neurology consultant)
  • laboratory testing (serology, PCR, culture) of animal specimen (guided by veterinary consultant)
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Leader

Herpesvirus Team

MMRHLB/DVD/NCIRD

Centers for Disease Control and Prevention

Atlanta

GA

Disclosures

DSS declares that he has no competing interests. The views included in this topic are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention or the National Institutes of Health.

Medical Officer, Captain, Public Health Service

Division of Public Health Information Dissemination

Center for Surveillance, Epidemiology, and Laboratory Services

Centers for Disease Control and Prevention

Atlanta

GA

Disclosures

LEC is the author of a reference cited in this monograph. The views included in this topic are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention or the National Institutes of Health.

Chief, Laboratory of Infectious Diseases

Chief, Medical Virology Section

National Institutes of Health

Bethesda

MD

Disclosures

JIC is the author of a reference cited in this monograph. The views included in this topic are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention or the National Institutes of Health.

Dr D. Scott Schmid, Dr Louisa E. Chapman, and Dr Jeffrey I. Cohen would like to gratefully acknowledge Dr Julia K. Hilliard for her contributions to this monograph.

Peer reviewers VIEW ALL

Professor of Virology and Infectious Diseases

University of Liverpool

Liverpool

UK

Disclosures

AMG declares that she has no competing interests.

Assistant Professor of Neurology

Johns Hopkins University School of Medicine

Baltimore

MD

Disclosures

DS has received research funding from the National Institutes of Health, the World Federation of Neurology, and the Johns Hopkins Center for AIDS Research.

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