In the laboratory setting, non-human primates pose a real potential for exposure of personnel to zoonotic diseases. Although transmission of zoonotic diseases from non-human primates to humans is rare, laboratory personnel and animal care staff are at risk due to animal exposure. Serious injury from bites and scratches can occur. These types of injuries/ exposures can be avoided if personnel are properly trained prior to beginning any type of work with non-human primates. Staff working with non-human primate tissue should also receive first-aid training in the event of a needle stick or injury from a surgical/procedural instrument.

Non-human primates are highly susceptible to human diseases, such as influenza, measles and tuberculosis. Personnel working with primates must be TB tested prior to working with non-human primates and re-tested annually. Any individual who is experiencing cold/flu symptoms or has active herpes simplex lesions (e.g. cold sore ) should avoid going into non-human primate areas until their symptoms have resolved.

Note:

• Due to the serious zoonotic potential of Herpes B-virus, all macaque users (Macaca fasicularis/cynomolgus monkeys, Macaca mulatta/rhesus monkeys) must attend a first aid workshop prior to working with these animals.
• All personnel working with non-human primates MUST have proof of annual TB testing. Personnel that do not have a documented negative TB test within the last 12 months are required to wear both a surgical mask and a face shield.

Recommended Preventative Measures

• Require a TB test annually for all staff working with non-human primates
• Only trained personnel should handle monkeys. Handling and restraint training can be scheduled through Center for Comparative Medicine.
• Wash hands after handling animals or related equipment
• Never wear protective clothing outside the animal areas
• When seeking medical advice for any illness, inform your physician that you work with nonhuman primates
• All personnel observing husbandry procedures or surgical experiments must wear full protective clothing.  Limit observers to necessary personnel.

Protective clothing appropriate before entering animal holding rooms.	Protective clothing appropriate for laboratory procedures (including euthanasia and perfusion procedures) and acute and survival surgeries. (For all laboratory personnel, including observers.)
Disposable head bonnet Disposable or UConn-laundered moisture resistant gown or lab coat Disposable moisture resistant shoe covers Disposable gloves (equipment handlers may also be required to wear leather or fabric protective over gloves) Face mask with goggles containing peripheral protection or face shield with chin guard	Surgical scrub suit Disposable head bonnet Disposable or UConn-laundered moisture resistant gown or lab coat Disposable moisture resistant shoe covers Disposable gloves. Double gloving is required for personnel performing any procedural or surgical manipulations Surgical mask and goggles containing peripheral vision protection or face shield with chin guard

Monkeys in Transport

Monkeys should be transported outside of the animal housing either in dedicated transport cages and covered with a moisture resistant cloth. Protective clothing should remain on while working with or around the animal at all time except during transport.

Waste Management

• Disposables: All disposables, feces and left over food is treated as medical waste.
• Non-disposable soiled cloth materials including lab coats and surgical towels are sent out to a professional laundry service and are treated by commercial laundering service as BSL 2 contaminated articles.
• Cages are pre-cleaned in the animal room before sent to the washroom

Response to Injury

Any potential exposure to macaque blood/saliva/urine/feces/tissue is considered an injury and must be treated as follows. this includes cuts or scratches from a cage inside a macaque room, needle sticks, bites, splashes, etc. if in doubt ,treat it as an exposure.

Bite/Scratch Emergency Kits

Bite/ scratch emergency kids are located outside all rooms housing macaques. staff must be familiar with the location of the kits. all are square white medical cabinets with bright orange signs that say “Monkey bite/scratch emergency kit.” Dimensions are approximately 20″ x 20.”

Procedure

1. Scrub or irrigate wound immediately with a mixture of soap and irrigation solution. you must do this within 2 to 3 minutes of exposure. since the B-virus may enter the body within minutes of exposure, this is the only way to keep it from entering the wound and becoming infected. Scrub or irrigate the wound for 15 to 20 minutes. For exposures of the eyes, nose, mucous membranes: irrigate with the sterile eye solution in first aid kit immediately and then find an eye wash station to continue rinsing your eyes for 15 to 20 minutes. Never use a bleach solution in your eyes For bites, lacerations or needle sticks: soak and scrub the wound with the soap mixture. Deep wounds can be gently massaged to increase contact with the mixture. Keep scrubbing for 15 to 20 minutes. Wash all of the soap mixture out of the wound after you are done scrubbing.
2. Visit Employee Health during working hours (Dowling South Building, 3rd Floor) or the Emergency Department during Weekends, Holidays and after hours (Dempsey Hospital first floor, 860-679-2588) for a wound culture, a blood sample and other immediate care as necessary. Bring the bag labeled Employee Health/Emergency Department from the first aid kit with you. This should include sterile swabs, culture and serum tubes, a protocol for further evaluation, a signs and symptoms of infection sheet and a form for sample submission to Georgia State University Viral Immunology Center.
3. Notify Veterinary Services during working hours call 860-679-2731, during weekends, holidays and after hours call 860-679-2626 and ask the operator to page the attending veterinarian. Veterinary services will follow up on the health status of the monkeys.

Specific Occupational Hazards

There are several viruses associated with non-human primates that can cause significant disease in people. These include the Hemorrhagic Fever Viruses, Filoviruses and Monkey Pox Viruses. These are usually associated with recently imported, wild-caught animals in quarantine, but are very rare in domestically bred animals. These viruses can cause fatal diseases in people.

Note: There are numerous viruses associated with primates which have unknown or uncertain pathogenic potential. Examples include:

• SIV and STLV, This is the simian counterpart to HIV and HTLV
• Foamy agent and various other simian viruses, e.g., SV5, SV40, etc.
• Herpesviruses saimiri (squirrels), tamarinus (tamarinds), etc. These may be progenitors of human viruses and their role in human illness is unknown at this time.

Cercopithicine Herpesvirus 1 (CHV1, Herpesvirus Simiae, Monkey B Virus)

This disease is quite rare in people but is either fatal or causes permanent neurological disease. most macaques are asymptomatic carriers or display only mild oral lesions that are difficult to detect. therefore, all macaques should be presumed to be shedding B virus.

• Reservoir/source of infection to people: Macaques are the major source of infection; although other old world primates may be infected
• Transmission: Transmission occurs via bites, scratches, splashes (any body fluid or secretion, feces) needle sticks and any direct contact with macaque tissue
• Disease in people: The disease in people is associated with a rapidly ascending encephalomyelitis leading to death in 50 percent of the cases. Permanent neurological deficits are present in survivors.

Tuberculosis

This disease may be transmitted to people through contact with birds, livestock, and non-human primates. Routine TB testing is performed on all UConn non-human primates.

• Reservoir/source of infection to people: Mycobacterium spp. may be transmitted to non-human primates (old world primates are particularly susceptible) from humans which can be a source of infection to other people and monkeys
• Transmission: Tuberculosis is usually transmitted by the aerosolization of infective bacilli which can be found in the sputum as well as other body fluids. Contact with body fluids during necropsy may be a major mode of transmission to humans
• Disease in people: Pulmonary tuberculosis is the most common type but other organs may also be involved.

Shigellosis

This is a relatively common zoonotic disease that must be differentiated from salmonellosis, campylobacteriosis and other enteric diseases.

• Reservoir/source of infection to people: Humans are the main reservoir of disease but like tuberculosis, infected monkeys can be a source of infection. Any non-human primate may harbor Shigella bacteria, and clinical signs may not be apparent
• Transmission: fecal/oral
• Disease in people: Diarrhea, may be with blood or mucus.

Salmonella

• Reservoir/source to people: Non-human primates, dogs, cats, birds, reptiles (especially iguanas and turtles), and wild rodents
• Transmission: fecal/oral
• Disease in people: Gastrointestinal disease, can be febrile with septicemia.

Cryptosporidium

Protozoal organism that is common in mammals, particularly younger animals.

• Reservoir/source of infection: Many mammals
• Transmission: Fecal/oral
• Disease in People: Self-limiting diarrhea except in immune compromised people where it can be quite severe. No treatment.

Giardia

• This protozoan is found in many mammals.
• Reservoir/source: non-human primates, other mammals, standing water
• Transmission: Fecal/oral
• Disease in People: Diarrhea +/- other systemic signs such as severe cramping and nausea/vomiting.

Allergies

General animal related allergies are common. Although there are no known allergens associated with monkeys, the non-human primate environment may have common allergens present such as dust from bedding.