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Rhesus Macaque

Rhesus macaques are familiar brown primates with red faces and rears. They have close-cropped hair on their heads, which accentuates their very expressive faces.

Population Range

Rhesus macaques are Asian, Old World monkeys. Their natural range includes Afghanistan, Pakistan, India, Southeast Asia, and China. A few troops of introduced rhesus macaques now live wild in Florida. These intelligent animals can adapt to many habitats, and some can even become accustomed to living in human communities. This is most common in India, where Hindus regard the animals as sacred and usually leave them undisturbed.

The rhesus macaque’s typical diet includes roots, fruit, seeds, and bark, but also insects and small animals. They live in active, noisy troops that can include up to 200 animals. Though these monkeys are good climbers (and swimmers), troops spend a lot of time on the ground. Males are the dominant sex, but they do not remain with troops permanently, so female macaques lead these communities. Because troops include multiple mature males and females, their members are sexually promiscuous. Females usually produce one young each year, which will be raised by its mother within the very social environment of the troop.

Relationship With Humans

Rhesus macaques have an important history with humans and have aided a great deal of medical and scientific research. Rhesus antigens found in their blood enabled doctors to identify the different human blood groups. These primates also preceded humans into space.

Discover the creature that preceded humans in outer space. Learn how this red-faced primate species helped advance scientific and medical research.

Afghan monkey

Bites from Macaca mulatta monkeys, native to Afghanistan, can cause serious infections. To determine risk for US military members in Afghanistan, we reviewed records for September–December 2011. Among 126 animal bites and exposures, 10 were monkey bites. Command emphasis is vital for preventing monkey bites; provider training and bite reporting promote postexposure treatment.

Military members deployed to Afghanistan face many risks; among these are bites from Macaca mulatta monkeys and possible subsequent infections. In August 2011, a 24-year-old US Army soldier died of a rabies infection contracted while in eastern Afghanistan. This tragedy highlights the threat that animal bites pose to deployed military members.

Figure. . Pet monkey (Macaca mulatta), Afghanistan, 2011. Photograph courtesy of Ronald Havard.

During 2001–2010, a total of 643 animal bites among deployed US military members were reported (1). Dogs were implicated in 50% of these bites, but several other animals pose risk as well. Prominent among these is the nonhuman primate M. mulatta (rhesus macaque), native to and commonly kept as a pet in Afghanistan (2) (Figure). Risks from M. mulatta monkey bites include physical trauma and/or infection with B-virus (Macacine herpesvirus 1), oral bacteria (including Clostridium tetani), and rabies virus. Although not well characterized in Afghanistan, the risk for exposure to M. mulatta monkeys has been described (3) for researchers (4), tourism workers (5), and US pet owners (6). We examined this risk for US military members deployed to eastern Afghanistan. The work presented herein was reviewed and deemed exempt from internal review board oversight by the Joint Combat Casualty Research Team, the human subjects review board responsible for oversight of human subjects research affecting US military members in Afghanistan.

The Study

Information about all reported animal bites and exposures affecting US military and coalition personnel is collected by preventive medicine officers assigned to Combined Joint Task Force–1 in eastern Afghanistan. We evaluated these records to identify and describe monkey bites and high-risk exposures among US military members serving in eastern Afghanistan during September–December 2011. For this study, eastern Afghanistan refers to North Atlantic Treaty Organization Regional Command East, which covers ≈43,000 square miles (110,000 km 2 ). The US military population in eastern Afghanistan during the study period was ≈23,500 persons. Case information obtained included patient age, sex, rank, branch of military service, animal exposures, and treatment details.

We evaluated the cases for the 5 parameters that comprise appropriate initial treatment according to the literature. The parameters are wound care (appropriate cleansing of the wound) (7), antiviral medications for B-virus (valacyclovir) (8), antimicrobial drugs for oral bacteria (amoxicillin/clavulanic acid or clindamycin plus sulfamethoxazole/trimethoprim) (3), verification of up-to-date tetanus vaccination status or vaccine administration in accordance with Advisory Committee on Immunization Practices guidelines (9), and rabies postexposure prophylaxis (PEP). US military policy advised that rabies PEP should adhere to World Health Organization guidelines (10), which recommend giving human rabies immunoglobulin plus 5 doses of rabies vaccine. In accordance with the same policy, adherence to Advisory Committee on Immunization Practices guidelines for rabies PEP with human rabies immunoglobulin plus 4 doses of rabies vaccine was also acceptable (11).

When appropriate initial treatment was not administered, subsequent follow-up was conducted to ensure that patients received required treatment. Appropriate treatment was accomplished by contacting and coordinating with the responsible provider, the patients, and their commanders.

During the study period, we identified 126 cases of animal bites or serious exposures (involving animal neural tissue or saliva affecting the mucosal surfaces or open wounds of the patient). Among these cases, 10 were cases of monkey bites.

Among the 10 military members who had been bitten by monkeys, age range was 22–44 years (Table); most (7) were

We thank David Broussard, Ronald Havard, Jason Lennen, and James Reynolds for their review and critique of this study and report. We thank James Geracci for his review of this report and for his leadership.

Bites from Macaca mulatta monkeys, native to Afghanistan, can cause serious infections. To determine risk for US military members in Afghanistan, we reviewed records for September–December 2011. Among 126 animal bites and exposures, 10 were monkey bites. Command emphasis is vital for preventing monkey bites; provider training and bite reporting promote postexposure treatment.