Herpes B virus and the neglected risk of zoonotic spillover

Objectives: (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: 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.