Monkey B virus (BV), initially isolated in 1932, is currently designated as Macacine alphaherpesvirus 1 by the International Committee on Taxonomy of Viruses (1). BV is an alphaherpesvirus enzootic in macaques of the genus Macaca, normally transmitted horizontally via direct contact and exchange of bodily secretions, just like herpes simplex virus (HSV) in humans. BV is not evident in its natural macaque hosts, but about 60 additional cases of pathogenic zoonotic BV infection have occurred sporadically and the fatality rate of zoonotic BV infections is 70%-80%. Although the risk for secondary transmission appears to be minimal, one case of human-to-human transmission of herpes B virus has previously been documented (2). Zoonotic BV infections have mainly involved primate veterinarians, animal care personnel, or laboratory researchers in North America. However, there were no fatal or even clinically evident BV infections in China before 2021. Here, we reported the first human infection case with BV identified in China.This case of BV occurred in a veterinary surgeon (53 years old, male) who worked in an institute specialized in nonhuman primate breeding and experimental research in Beijing. He dissected two dead monkeys on March 4 and 6, 2021 and experienced nausea and vomiting followed by fever with neurological symptoms one month later. As a result, the patient visited doctor in several hospitals but eventually died on May 27.On April 17, cerebrospinal fluid (CSF) was collected from this patient for next generation sequencing (NGS), 285 reads obtained suggesting possible alphaherpesvirus infection. To further identify the etiological agent, several specimens (including CSF, blister fluid, blood, airway aspirates, nasal swab, throat swab, and plasma) were collected from this patient and 2 close contacts (1 doctor, 47 years old, male; 1 nurse, 25 years old, female), then sent to National Institute for Viral Disease Control and Prevention (IVDC) of China CDC on April 19. Four sets of real-time
