Mysterious deaths of monkeys in the Hong Kong Zoological and Botanical Gardens and anxious parents: paediatricians’ perspectives and health education opportunities

Unlike the deaths of wild marine mammals-such as that of a Bryde's whale in waters around Hong Kong in July 2023, which generated numerous public health concerns 1 -only temporary publicity was aroused by the recent deaths of 12 De Brazza's monkeys in the Hong Kong Zoological and Botanical Gardens, as reported in October 2024. 2 Additional deaths were not prevented despite quarantine measures and investigations by zoo veterinarians.During this period, parents visiting the Gardens with their children became anxious about potential zoonotic threats.Consequently, paediatricians were alerted to this public health issue and needed to be prepared to provide counselling to anxious parents, schoolteachers, and members of the public working with children.The 12th monkey died on 23 October 2024, after the government confirmed that 11 others had died of melioidosis. 2The Leisure and Cultural Services Department subsequently confirmed that the cause of death was sepsis induced by the facultative intracellular gram-negative bacterium Burkholderia pseudomallei. 2n endemic areas (notably Asia and northern Australia), B pseudomallei is widely distributed in soil and fresh surface water. 3It causes melioidosis, an infectious disease affecting both animals and humans, primarily transmitted through contact with contaminated soil, air, or water 3 via percutaneous inoculation, inhalation, ingestion or aspiration.Melioidosis is endemic in Hong Kong. 4,5Fatal infections in animals are reported across Southeast Asia, particularly among captive primates. 3Experts suspected that the outbreak in the zoo was related to digging work performed in early October 2024. 2 Staff might have inadvertently transferred contaminated soil to enclosures, and transmission among monkeys might also have occurred. 2Further deaths were not prevented despite quarantine, protective measures