Objectives To evaluate the zoonotic risk of Simplexvirus macacine alpha 1 (B virus), a macaque-associated alphaherpesvirus that can cause severe and frequently fatal encephalitis in humans, and to assess the potential for cross-border risk through international macaque trade. Methods A comprehensive literature review was conducted to identify documented human B virus infections between 1932 and 2024. International trade records for Macaca species from the CITES Trade Database (2019–2022) were analyzed for trade volume, source, and purpose. Quarantine regulations across countries were compared, using South Korea as a case study. Results Among 33 documented infections, most were occupational exposures in laboratory settings. Recent cases highlight non-occupational risks, including viral reactivation decades after exposure. From 2019 to 2022, exporter-reported CITES data documented over 170,000 live macaques in international trade, with an increasing proportional share of wild-caught animals. Regulatory frameworks varied by country, with South Korea relying on recommendation-based biosafety oversight, whereas the U.S. applies legally binding import-control measures. Conclusions Although rare, B virus poses a severe and underappreciated zoonotic threat. The increasing wild-caught macaque trade and gaps in quarantine protocols necessitate stronger international coordination and the implementation of standardized biosafety regulations within a One Health framework.
Kim et al. (Fri,) studied this question.