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Revista da Sociedade Brasileira de Medicina Tropical

Print version ISSN 0037-8682On-line version ISSN 1678-9849

Rev. Soc. Bras. Med. Trop. vol.52  Uberaba  2019  Epub Feb 14, 2019 

Images in Infectious Diseases

Herpes simplex virus transmission following brown howler monkey (Alouatta guariba) bite

Marcelo Rosandiski Lyra1

Lara Braga Oliveira2 

Edson Elias da Silva3 

1Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil.

2Programa de Pós-Graduação Lato Sensu em Dermatologia, Hospital Central do Exército, Rio de Janeiro, RJ, Brasil.

3Laboratório de Enterovírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil.

The subfamily Alphaherpesvirinae includes herpes simplex virus types 1 and 2 (HSV-1 and HSV-2, respectively) and herpes virus B (HVB)1. In their primary hosts, they cause low-virulence infections, but can confer devastating effects when other animal species are infected1,2. A 24-year-old woman was bitten by a healthy young brown howler monkey (Alouatta guariba). She presented with a vesicle where she had been bitten, along with local pain. It regressed spontaneously but recurred many times (Figure 1). She tested immunoglobulin (Ig)G-positive and IgM-negative for HSV-1 and HSV-2. Vesicle fluids were aspirated for virus culture and polymerase chain reaction assays, which identified HSV-2. The patient was successfully treated (Figure 2).

FIGURE 1: Vesicles and pustule over an erythematous basis on the back of the patient's left hand, where she had experienced the bite, associated with significant neural pain that spread to the arm. 

FIGURE 2: Treatment containing valacyclovir (1 g) every 8 hours for 7 days resulted in fast remission of the skin lesions and reduction in pain. 

Humans are natural hosts to HSV-1 and HSV-2 Meanwhile, nonhuman primates can present with severe repercussions1,2. Old World primates are natural HVB reservoirs2,3. HVB is often lethal in humans and can be transmitted after a bite from an infected monkey3. On the inoculation site, skin lesions similar to those of herpes simplex may occur2,3. Myeloencephalitis with an 80% lethality rate is reported1-3. The possibility of it being a case of HBV transmitted by a New World primate was considered. The case described herein is rare: transmission of a human virus by a wild animal that was surprisingly asymptomatic. The monkey was possibly infected with HSV-2 after contact with its previous human owner. Animals harboring human viruses can lead to serious outcomes, as humans exposed to animal viruses can exhibit unpredictable results, emphasizing the importance of biosafety practices in handling wild animals.


The authors would like to express their gratitude to the patient and to the staff of the institution that helped develop this study.


1. Gilardi KVK, Oxford KL, Gardner-Roberts D, Kinani JF, Spelman L, Barry PA, et al. Human Herpes Simplex Virus Type 1 in Confiscated Gorilla. Emerg Infect Dis. 2014;20(11):1883-6. [ Links ]

2. Sharp PM, Rayner JC, Hahn BH. Great Apes and Zoonoses. Science. 2013;340(6130):284-6. [ Links ]

3. Black D, Ritchey J, Payton M, Eberle R. Role of the virion host shutoff protein in neurovirulence of monkey B virus (Macacine herpesvirus 1). Virol Sin. 2014;29(5):274-83. [ Links ]

Received: May 24, 2018; Accepted: July 13, 2018

Corresponding author: Dr. Marcelo Rosandiski Lyra. e-mail:marcelolyradermato@hotmail.comOrcid: 0000-0001-6969-2234

Conflict of Interest: The authors declare that there is no conflict of interest.

Creative Commons License This is an open-access article distributed under the terms of the Creative Commons Attribution License