A Tanapox Outbreak in a Primate Research Center

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The Vital Role of Gossip in Scientific Research

As in many  infections, inter-species transfer of a virus, like monkey-man-monkey-man,  is more likely when the two hosts are under stress;   and in such transfers the virus  is likely to become progressively more virulent. ( The opposite is true when a virus re-infects the same host many many times. That is, in general,  how the live virus for polio was developed.)

What follows is a factual report of an iatrogenic (man made)  outbreak of tanapox,  a  viral infection normally confined to certain monkeys. In this case it  bounced back and forth among the research animals and their handlers; it ultimately spread to the surrounding community. I was the physician responsible for treatment of infected workers, witnessing the increased virulence  and infectiousness of the virus.  Other outbreaks have occurred, but never have they  spread beyond the confines of the research workers involved. There has been monkey to man spread but never secondary spread of the same infection, monkey to human, and then human to human. 

To my knowledge the episode has never been reported;  the administrative defenses of the university and the  research institution  immediately isolated,  and  successfully walled off and  prevented spread of  information, and fear-   and have avoided formal  publication of the details- during more than 40 years.

Most significantly, however, that is not to say that the outbreak is  unknown to the  scientific community. Though unpublished and  religiously undocumented,  it  has had a significant effect, both locally  and far afield among  the world’s primate centers.  Afterward,  no one, anywhere, was willing to take a chance of it happening again. Therefore this post is not an exposé. It   merely  describes a particular outbreak in terms of  the people involved and their interaction with  one another in a great and powerful research institution.

Yaba-like disease, YLD, (or Tanapox, as described in monkey exposed children in Kenya on the Tana River), is an oncogenic (tumor forming) infection of certain old world monkeys, producing intra-dermal (skin confined) tumors. When seen in humans it causes a tender, indolent nodule, which may ulcerate before gradually clearing over several weeks without systemic effects like fever, and  without scarring. (Orf is a similar infection seen among sheep handlers.)

At the Primate Center and outbreak of YLD had been taking place over several years among approximately 340 monkeys. Because the animals required handling, when  I saw caretakers with infections of their hands or forearms,  I required  they be off work until healed,  to avoid re- infecting other animals. But the Director was  a doctor as well, and vetoed my decision.  He was also a world reknowned primate researcher, commanding many millions of dollars, while I was just a  salaried  university employee.   Likewise the  Campus Office of Environmental Health and Safety tried to enforce the off-work status of handlers, but  to no effect. We  understood that the  university, like congress, can absolve itself  of selected laws and regulations,  in the name of the greater good.   Unlike congress, research  institutions  appear  to be still subject  to the Laws of Money which  generally override all other considerations.

The  animal handlers continued to  work  in contact with active exposed lesions, setting up monkey to man to monkey to man transfers of YLD.  Inadvertently, the Director had set up a lovely, though unauthorized and illegal, experiment of inter-species transfer of the viral infection.

As the outbreak continued over the following year, lesions became larger,  and more painful, with  longer periods of indolence. Soon, multiple lesions were seen. Then handlers developed  generalized symptoms of lethargy, fever, malaise, and occasionally a generalized itching rash. I  had become professionally invested in the process and provided the Primate Center virologist with serial blood samples, as well as biopsies of lesions. Even though it is likely that some cases were not reported at first, we had blood samples on 15 cases.

The first and only case of YLD off campus occurred in the wife of an animal technician. She developed a single lesion on her cheek.  Within two days the director was gone- taking his big money grants, requiring much  animal handling , with him.  The YLD  among technicians ceased abruptly.   The technician’s wife recovered without incident.  The episode was never published, but is sometimes referred to obliquely.  While it’s out of date now, within months a seven point procedure was proposed to avoid such events. In the intervening years the world has become less dependent on Primate  Research and  less aggressive in handling   animals. That seems to me to suggest one thing:

Gossip , and the fear publicity can generate, is a vital  but undocumented aspect of clinical  research. 

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Jesek, Z et al Human Tanapox in Zaire Bull Wld Hlth Org 73 1027-35, 1985

España C. Medical Primatology, 1970. Proc 2nd Conf. exp Med Surg Primates

Downie, W.A. and España  C. A. Comparative  Study of Tanapox and Yaba Viruses. J. gen Virol. 1973, 19 27-29

Tauraso, Nocholas, Review of recent epizootics in nonhuman primate colonies and their relation to man. Lab Animal Science Vol 23, no w 201-210 1973

España Carlos, Review of Some Outbreaks of Viral Disease in Captive Nonhuman Primates Lab Animal Science, Vol 21, No. 6, 1023 -1030

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