In June 1989, two men were admitted to a Kalamazoo, Michigan, hospital with B virus (Herpesvirus simiae) infection. Both men worked at an animal research facility with rhesus (Macaca mulatta) and cynomolgus (Macaca fascicularis) monkeys.
Patient 1, a 23-year-old, had worked at the facility for 2 years. Since April, he had sustained monkey bites to hands and arms, and one bite to the chest wall. On June 10, pain and numbness developed on the right side of his back and then spread locally. Over the next 2 days, dysesthesia developed in the lower limbs, along with generalized weakness, dizziness, difficulty in swallowing, and copious oral secretions.
On June 13, the patient collapsed and had a respiratory arrest. Examination at the hospital revealed bilateral conjunctivitis, depressed gag reflex, right-sided weakness, and small vesicular lesions on the right side of his chest; his cerebrospinal fluid (CSF) had a neutrophilic pleocytosis and an
B Virus Infections in Humans—Michigan. Arch Dermatol. 1989;125(9):1183. doi:10.1001/archderm.1989.01670210021003