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Early outbreaks were devastating, causing the loss of hundreds of primates of many species. Species most susceptible are the macaques and apes; the New World species seemingly are more resistant. Almost all species can be experimentally infected. Historically, the three major species of myco- bacteria--avium, bovis, and tuberculosis--have been incriminated as caus- ing tuberculosis in the nonhuman primate.

Recently, many atypical myco- bacteria have also been reported in the nonhuman primate, including M. The extreme susceptibility of monkeys to tuberculosis is often discussed; the disease is usually miliary, and arrest and calcification are unusual. The danger to owners and others who come in contact with infected monkeys is obvious. Control requires an effective quarantine for newly arrived primates, isolation from infected persons, and a rigorous testing program.

It is generally agreed that the route of initial infection is usually respiratory 60 per cent or intestinal 40 per cent. Because of their fulminating nature, terminal infections often present difficulty in establishing the portal of entry because so many organs are involved in the generalized infection. The clinical signs of tuberculosis are not striking until the disease is in an advanced stage. The first sign may be a slight behavioral alteration. The animal may be slower than normal or stay along the floor of the enclosure rather than climb the enclosure or cage wall.

Soon the infected animal will exhibit a dull appearance, crouch in the corner, and refuse to eat. The latter may be all the owner notices; coughing or other respiratory signs are conspicuously absent. Less common signs that may or may not be present with tuberculosis include diarrhea, skin ulceration, suppuration of Iymph nodes, and visible enlargement of the spleen and liver.

Often there are no clinical signs, and the owner reports that the animal died suddenly without explanation. Radiographs of the lungs, etc. The usual presence of mite Pneumonysis spp. The lesions seen at necropsy are fairly typical yellowish-white to grey nodules that range from pinpoint size to several millimeters in diameter and appear just under the surface of the affected organs.

As the disease progresses, the nodules fill with caseous material and may rupture and produce cavitation. Caseous, enlarged mediastinal lymph nodes in the rhesus monkeys are almost pathognomonic for tuberculosis. In baboons and apes, the disease is much more like that seen in man, with caseation and eventual calcification. Cutaneous tuberculosis in primates usually migrates to the regional Iymph nodes, and any draining lymph node should be suspected as a tubercular lesion until proven otherwise.

Tuberculosis of the spine, or Pott's disease, also occurs in monkeys and should be considered whenever there is unexplained paralysis of the hindlimbs. Tuberculin skin testing must be part of any physical examination of a nonhuman primate. Newly imported primates should be tested biweekly and isolated until five negative tests have been certified. Approximately 15, tuberculin units 0.

The test is read at 24, 48, and 72 hours. Suspicious tests may be repeated at 7 days in the opposite eyelid or abdomen. Stabilized Old World primates should be tested quarterly, and New World monkeys semi-annually. Because of the public health danger and the potential resistance to treatment, positive animals should be euthanatized; treatment is not recommended. Atypical tuberculosis, other serologic methods, and so on, are beyond the scope of this article. The reader is referred to the bibliography for further information.

Although shigellosis and salmonellosis are caused by two separate organisms, the symptoms, signs, and treatment are similar, so they will be discussed together. Shigella and salmonella are frequently present in the alimentary tract of nonhuman primates. Isolation of the organism from the carrier animal is difficult, requiring numerous samples and enrichment techniques. A single negative culture means nothing. Fortunately, the most serious human pathogens of these two groups, Shigella dysenterriae type 1 and Salmonella typhi, have only rarely been isolated from nonhuman primates; however, several others Shigella flexneri, S.

The literature contains many reports of infection in primates and few reports of transmission to human beings. One of the earlier transmissions reported was a case of shigellosis in a child who licked an ice cream cone that had been touched by a monkey in a pet shop. This illustrates the potential danger for infants and children in contact with the species.

Fortunately, the published reports of primate-to-man infections are rare. The primate carrying the organism can have a fulminating fatal infection at any time, with excretion of large numbers of organisms during the course of the disease.

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This acute infection is usually precipitated by some stress, such as environmental change of corticosteroids. As a rule, a bloody dysentery eventually occurs in shigellosis. Prolapse of the rectum is commonly seen, with death in a few days to 2 weeks after the onset of signs. At necropsy, the large intestine is distended and the serosol surface has a red tinge.

A catarrhal and diphtheritic colitis occurs with a varying degree of exudation and necrosis of the mucous membrane and ulceration that may penetrate the serosal surface. Diagnosis is based on signs, necropsy, and culture results. Culture must be fresh, but, even so, the isolation rate is low. Treatment for both entities is as follows: The family medical practitioner should be made aware of any pet monkey with symptoms of these diseases, particularly if children are or will be in contact with the primate.

Campylobacters were originally classified as a member of the family Vibriacae but recently have been reclassified as a separate group. Campylobacter jejuni, the etiologic agent seen most fre- quently in the nonhuman primate, is a small, gram-negative, non-spore- forming, curved rod causing a moderate to severe enterocolitis in a variety of mammals and birds, including man. The review article by Shane and Montrose is highly recommended for a full description of the disease and its pathogenesis.

Because Campylobacter has been one of the leading causes of diarrhea in human beings, it is keenly important as a zoonotic biohazard. The original report by King on the isolation of C. Since that time, the organism has been recognized as a significant problem in a variety of domestic and exotic animals. The signs and lesions of campylobacteriosis have been extensively reviewed by Butzler and Skerrow. A usual incubation period of 3 to 5 days is followed by a febrile period accompanied by malaise, dizziness, myalgia, and abdominal pain.

The stool is watery, bile-stained, and malodorous, and may contain blood. The diarrhea phase usually lasts for 3 days but may recur up to 2 weeks. It is most severe in infants, children, and prepubertal primates Morton et al. Poor self-hygiene in the pet owner can be directly related to infection. In the adult primate, the disease is usually a mild, self-limiting enteritis, but it is a significant hazard to the handler or owner from fecal spray and droplet contamination. The carrier reservoir condition, as with shigella and salmonella, is frequently a sequel to an active clinical infection.

Surveys in companion domestic animals have shown direct correlation between positive animals and positive household members. The organism is quite resistant, being found to remain viable in streamwater at 4x C far up to 4 weeks. Contamination of the environment by the pet primate poses a significant threat to human beings.

Diagnosis is through culture, which must be specific for the organism's growth requirement of 43x C and reduced oxygen tension. Treatment is similar for shigella and salmonella: Vaccines provide partial protection for 3 to 6 months to nonimmune individuals in highly endemic areas. However, the routine use of vaccines is not recommended. Klebsiella and other water-borne, gram-negative bacteria Pseudomonas are primarily opportunists affecting primates that have a lowered resistance.

Primates with inadequate nutrition the fruit-fed squirrel or owl monkey, for example are prime candidates for this disease. The infected primate is a real threat to the infant or child with a mild respiratory infection whose reduced level of health increases the potential for infection.

Klebsiella is present in stagnant water, dirty drinking receptacles, and soil, and as flora of the alimentary tract. The clinical signs are coughing, sneezing, facial edema air sacculitis in owl monkeys , nasal discharge, dyspnea, and anorexia. The lesions consist of pleural congestion and red to gray hepatization of the lungs. The airsacs of the owl monkey may be filled with a clear fluid, eventually leading to a severe bronchopneumonia. Diagnosis is by isolation of the organism, a nonmotile, gram-negative short bacillus with rounded ends and a thick capsule.

Treatment is with an organism-sensitive antibiotic such as streptomy- cin, kanamycin, colimycin, or gentacin. The organism may develop multiple resistance to antibiotics, however. Aerosol installation of kanamycin in an incubator has been reported to be effective. Fortunately, these are isolated cases; however, there is a potential danger to human beings. The primary pathogens are Dermato- philus congolensis, Candida albicans, and Trichophyton mentagrophytes. The systemic fungi, nocardia, coccidiomyces, and crYptococcus have been reported and are included in the bibliography.

Natural disease has been reported in Aotus and Lagothrix, and experimental infection was successful in rhesus, cynomolgus, and squirrel monkeys. The disease was reviewed by Kaplan in Clinically, the disease is characterized by erythema that becomes scaly and progresses to an exudative papillomatous crusty lesion. When the crust is removed, a raw bleeding area is left, resembling a strawberry surface.

Diagnosis is through gram smears of the exudate; branched filaments forming packets up to eight coccoid cells wide are seen.

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The disease is treated with penicillin, ampicillin, or streptomycin applied with a topical iodine tincture on the lesions. Strict sanitation and isolation are necessary to avoid contamination of the pet owner or technician. Candidiasis is a fungal infection of the mucous membranes. It has been reported in a variety of primates, but it is usually secondary to nutritional deficiency, other disease, or extensive antibiotic treatment. Syrnptoms vary with the site of infection.

Intertriginous infec- tions appear as pruritic, exuclative patches between the skin folds the toes, for example. Oral candidiasis appears as creamy white patches of exudate that can be scraped offthe inflammed tongue or buccal mucosa. The disease in individuals with an immune deficiency may be quite severe. Man is susceptible to the infection; however, it usually requires a favorable moist environment or reduced defenses caused by another disease. The infant with a mild diaper rash would be a prime candidate for candida transmission from the pet primate.

Diagnosis is by finding yeast cells and hyphae in gram-stained prepa- ration. Because candida is often found as a commensal organism, the culture of a species from skin, vagina, urine, sputum, or stool should be interpreted cautiously. Confirmation is based on the presence of the characteristic lesion and, if necessary, a histologic biopsy of the area. Treatment is contact application of nystatin, clotrimazole, or micono- zole. A vehicle appropriate to the site of infection should be used in light of the primate's habit of licking or rubbing off applied ointments.

Recalcitrant or recurrent cases, especially of oral or mucogenital candida, have been treated with nystatin oral suspension or tablets. Trichophyton mentagrophytes is the usual cause of ring- worm in primates. Signs, diagnosis, and treatment are similar to that for the dog and cat. Treatment is oral griseofulvin microsize to mg orally with mashed feed. The owner should be warned of the hazard, and the animal should be isolated during treatment.

All primates are susceptible to the infection. In the wild, many scavenge about villages and share not only food but also the parasites of the human inhabitants. Danger to the pet owner from imported animals, therefore, is usually during the first few months after the animal's arrival in the country. If the parasites are effectively eliminated during the initial quarantine adaptation period, the danger of transmission to the pet owner can be eliminated.

Parasites that need an intermediate host are self-limiting but those having a direct cycle become a continual problem. Possible human infection from primate carriers is a constant threat. Numerous articles and monographs have been written on the primate parasites. In this article, discussion is limited to examples of protozoa, nematodes, tapeworms, and arthropods that have a direct life cycle and are infectious to man. Many protozoa require arthropod vectors; with vector con- trol, they do not cause a significant problem to man outside the environ- mental range of the arthropod.

Giardia and Entamoeba histolytica are the two primary pathogens not requiring an arthropod vector. Although plas- modia cause malaria, a disease of major importance, they are usually specific for each primate except in experimental situations and are rarely transmitted between primates and man in North America.

References for malaria can be found in the bibliography. Giardia is becoming a frequent cause of recurrent diarrhea in man and primate. Trophozoites of Giardia are found in the upper part the small intestine, where they live adhering closely to the mucosa. The gellate is capable of almost limitless proliferation; diarrheic stools may contain countless cysts or trophozoites.

Diarrhea is the most common symptom associated with Giardia infection, although some reports show that the infection mimics biliary disease or even chronic cholecystitis. The stools frequently contain mucus, but not blood. Giardia, like other agents potentially transmissible from the primate, is also considerably more common in children than adults. Diagnosis of Giardia is easy, the organism being one of the most recognizable intestinal protozoa.

The trophozoite is bilaterally symmetric and pear-shaped with an attenuated posterior end. The two nuclei and the rodlike median bodies resemble a face with eyes and mouth. Nonhuman primates can be asymptomatic carriers to man, with infec- tin via direct contact. Treatment using metronidazole is usually successful at a dose of 10 to 35 mg per kg per day, three times a day, for 7 days.

This drug, however, is currently not licensed for use with Giardia, and there is concern over its potential carcinogenicity. Quinacrine at 10 mg per kg per day, three times a day, for 5 days is 70 to 95 per cent effective but is not tolerated well by squirrel monkeys, often causing some gastrointestinal disturbances. Proper hygienic practices with routine fecal smears will minimize the pet's disease potential to the owner. Amebiasis is a severe disease of man and primate; it causes a protracted diarrhea from chronic colitis and occasionally abscesses in the brain, liver, or lungs.

The cyst must be ingested to cause disease; the trophozoite in fresh stools is rarely infective. The organisms involve the intestinal mucosa and form small colonies that extend into the submucosa and, occasionally, the muscularis, producing the typical bottle- or flask-shaped ulcers. The frequency of this tissue invasion varies within an individual; most patients are asymptomatic.

Primate Info Net: Zoonoses Acquired From Pet Primates

When symptoms do occur, they vary according to geography. In temperate climates, the disease is usually characterized by a mild, intermittent diarrhea and constipation, flatulence, and cramping abdominal pain in both primate and man. In tropical environments, the disease may be characterized by a frank dysentery with episodes of frequent semifluid stools, often containing blood and mucus. Diagnosis is confirmed by the presence of the trophozoite in fresh stools. Diagnosis may require examination of three to six stool specimens. The high incidence of symptomatic carriers complicates the problem.

Metronidazole is the treatment of choice for both intestinal and extra-intestinal amebiasis. A dose of 30 to 50 mg per kg per day given orally in three divided doses for 10 days is recommended. Severe cases may require combination with diiodohydroxyquin at a dose of 30 to 40 mg per kg per day in three individual doses. Three negative stools, obtained on three successive days, are usually indicative of cure.

Reexamination of the stools at 1, 3, and 6 months after treatment is recommended. The principal infective nematode from primate to man is Strongyloides spp. Strongyloides is common in many species of primates and, because of its direct life cycle, can be infectious for man. Three species are involved: The infective third-stage filariform larvae rhabditiform , found as a free-living stage or in fresh feces, penetrates the skin or mucosa and migrates via the blood to the lungs, alveoli, and trachea.

They are swallowed and cause a severe acute enteritis. The invasion through the skin can cause pruritus and erythema. The passage through the lungs can cause pneumonia and possibly death due to pericarditis.


The affected primate, unless treated and tested frequently, can reinfect itself and may be a continual hazard to the pet owner. Diagnosis is confirmed by finding ova or larvae in the feces, coupled with the clinical signs. Treatment is effective, with thiabendazole at mg per kg repeated in 2 weeks.

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Sanitation is essential in preventing reinfection. Veterinarians and technicians handling fecal specimens are advised to wear gloves during all diagnostic procedures to avoid potential skin penetration of the infective larvae. CESTODES The nonhuman primate is susceptible to a variety of cestodes; however, the only cestode considered a potential zoonosis from nonhuman primates is Hymenolepsis nana. Hymenolepsis has a direct life cycle but can also pass through an intermediate host such as a beetle or flea.

The life span of the adult in the intestine is only a few weeks. The tapeworm causes a catarrhal enteritis with abscesses of the mesenteric lymph nodes. The principal signs are diarrhea and abdominal pain, exhibited in the nonhuman primate by crouching and tucking of the abdomen. The diagnosis is through fecal examination with demonstration of the typical proglottid. Treatment is the use of niclosamide at 20 mg per kg per day.

Most of these can be transmitted to humans through contact. Of these, the most likely problems are with Sarcoptes scabiei the itch mite , Pediculus humanas the human head or body louse , Tunga penetrans the chigoe flea , and Ornithodorus tick. Disease caused by these arthropods involve the skin and are characterized by pruritus and scaling, which, in the case of the chigoe flea, can lead to severe inflammation and ulceration. Fortu- nately, the grooming habits of healthy primates prevent severe infestation of most ectoparasites.

Sarcoptic mange is the only significant threat among most animals. The most serious danger to man and primate is the role of the arthropods as an intermediate biological host for parasitic diseases and as a mechanical vector for infectious organisms. The tick Ornithodorus is an intermediate host for relapsing fever. Yellow fever, an important disease of Central and South America, has its reservoir host in the primate and utilizes the mosquito Aedes as an important vector. Control is through environmental sanitation and direct treatment of the primate.

Treatment is difficult because of the grooming, licking nature of the primate; however, dusts and ointments suitable for cats and humans can be used with discretion on the primate. SUMMARY Laws regulating the importation of primates have drastically reduced the number of primates seen as pets and, thus, the hazard both to the potential owner and veterinarian.

Active disease and latent carrier states in primates potentially have severe consequences for the contact person. This potential for human transmission makes it imperative that medical and veterinary professionals collaborate to educate the public on the danger of the primate as a pet. Planning of national zoonosis control programs in developing countries. Pathology of simian primates.

Infectious and Parasitic Diseases. Basel, Switzerland, Karger, Prevalence of selected zoonotic diseases in vertebrates from Haiti, J Wildlife Dis Handbook of Laboratory Animal Science. Cleveland, CRC Press, Diseases of primates transmissible to man. Sciences et Techniques de l'Animal de Laboratoire 4: Import of exotic diseases in pets and other animals. Ann Soc Belse Med Trop Diseases of Laboratory Primates. Philadelphia, WB Saunders Co, A zoo s concern. J Am Vet Med Assoc St Whitelock OV ed: Care and Diseases of the Research Monkey.

Review of recent epizootics in nonhuman primate colonies: Their relation to man. Lab Anim Sci Tribe GW, Noren E: Incidence of bites from cynomolgus monkeys in attending animal staff New York, Academic Press. Newly appearing virus diseases in animals and humans. In Virology Monographs 2. New York, Springer-Verlag, , pp Recent advances in viral zoonoses.

Int J Zoonoses 6: In Bourne GH ed: Nonhuman Primates and Medical Research. New York, Academic Press, , pp New emerging viral zoonoses. Exotic viruses Marburg disease, Lassa fever, rabies. In Fiennes RN ed: Pathology of Simian Primates. New York, S Karger, , pp Herpesvirus infections of nonhuman primates: Lab Anim Care Herpesvirus simiae B virus 1. Diagnosis and handling of B virus in rhesus monkey Macaca mulatta. Herpesvirus simiae infection in Macaca radiata. Am J Phys Anthropol Naturally occuring "B" virus infection in cynomolgus.

Natural virus-B infection in rhesus monkeys. Acute ascending myelitis following a monkey bite with the isolation of a virus capable of reproducing the disease.

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J Exp Med Herpesvirus tamarinus Herpes T 1. Isolation and characterization of a new herpes virus. Spontaneous herpes-T infection in the owl monkey Aotus trivirgatus. Overt herpes-T infection in squirrel monkeys Saimiri sciureus. A new member of the herpesvirus group isolated from South Americall marmosets. Herpesvirus T as cause of encephalitis in an owl monkey Aotus trivirgatus.

Herpesvirus hominis simplex 1. Natural Herpesvirus hominis infection of a gibbon Hylobates lar. Arch Gesamte Virusforsh Spontaneous generalized Herpevirus hominis infection of a lowland gorilla Gorilla gorilla gorilla. J Med Primatol Kalter SS, et al: Experimental herpesvirus hominis type 2 infection in non-human primates.

Proc Soc Exp Biol Med Experimental Herpes simplex infection in the owl monkey.

London WT, et al: Genital Herpesvirus hominis type 2 infection of monkeys. Natural Herpes-irus horninis infection of tree shrews Tupaia glis. Natural Hetpes simplex infection in the owl monkey Aotus trivirgatus. The gibbon Hylobates lar: A new primate host for Herpesvirus hominis. A natural epizootic in a laboratory colony. J Infect Dis Daniel M, et al: Induction of malignant lymphoma in New Zealand white rabbits.

J Natl Cancer Inst Hull D, et al: Recovery and characterization of a new simian herpesvirus from a fatally infected spider monkey. Hunt RD, et al: Morphology of a disease with features of malignant Iymphoma in marmosets and owl monkeys inoculated with Herpesvirus saimiri. Pathologic features of Herpesvirus ateles Iymphoma in cotton-topped marmosets Saguinus oedipus. Spontaneous Herpesvirus saimiri Iymphoma in an owl monkey. An apparently new herpesvirus from primary kidney cultures of the squirrel monkey Saimiri sciureus.

Melendez LV, et al: Further characterization studies of a new virus from the squirrel monkey. Experimentally induced malignant lymphoma in primates. Herpesrirus ateles, a new Iymphoma virus of monkeys. Nature New Biol Two new herpesviruses from spider monkeys Ateles geoffroyi. Oncogenicity of Herpesvirus saimiri in marmoset monkeys. Recent studies on the isolation and characterization of delta herpesvirus. Studies of the delta herpesvirus isolated from the patas monkey Erythrocebus patas. A virus disease of captive vervet monkeys Cercopithecus aethiops caused by a new herpesvirus. Arch Gesamte Virusforsch Varicella chicken pox in three young anthropoid apes.

Mialherbe H, Strickland-Cholmley M: Simian herpesvirus SA8 from a baboon. McCarthy K, et al: Chickenpox in young anthropoid apes: Clinical and laboratory findings. Arita I, Jezek Z. A newly emerged orthopoxvirus zoonosis in the tropical rain forests of Africa. Am J Trop Med Hyg Foster SO, et al: J Hyg Epidemiol Microbiol Immunol Leone L, Leona S: Human infection with monkeypox.

Atlanta, Georgia, Centers for Disease Control, Mayr A, Danner K: Vaccination against pox diseases under immunosuppressive conditions. Dev Biol Stand McConnell SJ, et al: Protection of rhesus monkeys against monkeypox by vaccinia virus immunization. Am J Vet Res Human monkeypox transmitted by a chimpanzee in a tropical rain-forest area of Zaire.

Studies on a pox disease of monkeys. Isolation of the etiologic agent. Sauer RM, et al: A pox-like disease in cynomolgus monkeys. Acta Path Micr Scand Electron microscopy of a benign epidermal pox disease of rhesus monkeys. Am J Pathol Shldies of newly recognized poxvirus of monkeys. Downie AW, et al: A new disease caused by a poxvirus. Br Med J 1 Downie AW, Espana C: Comparisons of tanapox and Yaba-like viruses causing epidemic disease in monkeys.

A contagious pox disease in monkeys. McNulty WP Jr, et al: A pox disease in monkeys transmitted to man. Clinical and histological feahlres Arch Dermatol Caliciviruses infecting monkeys and possibly man. Yaba Virus Disease 1. An outbreak of subcutaneous tumors in rhesus monkeys. Human susceptibility to a simian tumor virus. Ann NY Acad Sci Experimental Yaba and benign epidermal monkey pox in rhesus monkeys.

Neven JSF, et al: Subcutaneous "growths" in monkeys produced by a poxvirus. J Pathol Bacteriol Experimental aerosol transmission of Yaba virus in monkeys. Douglas JE, et al: Molluscum contagiosum in chimpanzees. Molluscum contagiosum in a colony born chimpanzee. Lab Prim Newsletter Symptomatology and pathology in monkeys experimentally infected. Hall WC, et al: Pathology of measles in rhesus monkeys. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education.

Fineberg is president of the Institute of Medicine.

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Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Wulf are chair and vice chair, respectively, of the National Research Council. The publication in of the Institute for Laboratory Animal Research ILAR report Occupational Health and Safety in the Care and Use of Research Animals provided an excellent reference for the development of occupational health and safety programs in the animal research setting.

The diversity of species and potential hazards encountered in animal care and use programs required a broad view of many topics and by necessity, limited the depth of any particular subjects in the report. The care and use of nonhuman primates in the research setting presents a number of challenges to facility management. These challenges include specific hazards unique to some primate species and the need for guidance in risk assessment and management.

This report was generated in response to that need and to specific events that took place in the same year as the first ILAR report. On October 29, , a research assistant at Yerkes Regional Primate Research Center was splashed in the eye with an unidentified body fluid from a nonhuman primate and later died from encephalitis caused by B virus formerly called Cercopithecine herpesvirus 1.

This incident confirmed the suspicion that B virus infection can be acquired through mucosal contact, in addition to the more common exposures through bites, scratches, and needle sticks. Therefore, one specific intent of this report has been to address these recommendations and concerns. Infectious agents represent only one of the hazards present in nonhuman-primate animal care and use programs. The size, strength, and intelligence of many primate species can result in unique hazards associated with animal care and management. In addition, these same taxonomic attributes may require heavy caging and support equipment that can present ergonomic hazards to the employee.

The Committee was asked to identify the hazards associated with using nonhuman primates in research, assess the degree of risk of these hazards, and suggest options for managing the risks including engineering controls, personal protective equipment, facilities design, and worker training.

The committee was also asked to make recommendations for institutional management of workers after suspected exposure to infectious agents. The Committee approached this task by focusing on major hazards and risks to workers at all nonhuman-primate research facilities. Recognizing that the level of risk associated with a hazard is dependent on numerous factors that vary from institution to institution, the Committee on Occupational Health and Safety in the Care and Use of Nonhuman Primates put forth in this report a programmatic structure for assessing and managing risk at different kinds of institutions.

In addition to providing this structure and discussing the elements necessary for the successful implementation of an occupational health and safety program, the Committee reviewed specific recommendations on the use of personal protective equipment and the medical management of exposed workers. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge.

The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:. Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations, nor did they see the final draft of the report before its release. The review of this report was overseen by W. Appointed by the National Research Council, he was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered.

Responsibility for the final content of this report rests entirely with the authoring committee and the institution. Since this report will undoubtedly be updated in the future, the members of the Committee ask that comments, corrections, and ideas for future studies be sent to the Institute for Laboratory Animal Research, The National Academies, Fifth Street, NW, Washington, DC Occupational Health and Safety Program,.

Implementing the Occuptional Health and Safety Program,. Hazards Associated with Nonhuman-Primate Behavior,. The Process of Risk Assessment,.

Zoonoses Acquired From Pet Primates

Federal Occupational Health and Safety Requirements,. State Occupational Health and Safety Requirements,. Facility Design and Operation,. Defining Routes of Exposure,. Determining Appropriate Postexposure Medical Management,. First Aid after Exposures to Nonhuman Primates,. Medical Evaluation and Followup,. Exposure to Simian Immunodeficiency Viruses,.

The field of occupational health and safety constantly changes, especially as it pertains to biomedical research. New infectious hazards are of particular importance at nonhuman-primate facilities. For example, the discovery that B virus can be transmitted via a splash on a mucous membrane raises new concerns that must be addressed, as does the discovery of the Reston strain of Ebola virus in import quarantine facilities in the U.

The risk of such infectious hazards is best managed through a flexible and comprehensive Occupational Health and Safety Program OHSP that can identify and mitigate potential hazards. Occupational Health and Safety in the Care and Use of Nonhuman Primates is intended as a reference for vivarium managers, veterinarians, researchers, safety professionals, and others who are involved in developing or implementing an OHSP that deals with nonhuman primates. The book lists the important features of an OHSP and provides the tools necessary for informed decision-making in developing an optimal program that meets all particular institutional needs.

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