This case report documents fatal coxsackievirus B4 myocarditis in an orangutan, highlighting the potential for cross-species transmission from human visitors.
Suggests possible human-to-primate CVB4 transmission causing fatal myocarditis; leaves open broader zoonotic risks and requires epidemiological confirmation.
A 37-year-old female orangutan died at the zoological garden. Autopsy examination demonstrated severe coxsackievirus B4 myocarditis immunohistochemically as a cause of the death. Apoptosis of the cardiac muscle cells was observed using the TdT-mediated dUTP-biotin nick endo labeling method and was considered to play a role in the myocarditis. Congestion of the liver and both lungs due to cardiac failure was also observed. Coxsackievirus infection is found frequently in the Okinawan human population. The present orangutan's infection might have come from visitors who were allowed to go near the orangutan. Malignant tumors, severe suppurative infections, and intestinal parasite infections were not observed. Epstein-Barr virus DNA was detected in lymph nodes, but there was no Burkitt's lymphoma.
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Miyagi et al. (1999) studied this question.
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