CMAJ • October 25, 2005; 173 (9). doi:10.1503/cmaj.051184.
© 2005 CMA Media Inc. or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
Lymphocytic choriomeningitis virus
John Hoey
CMAJ
Background and epidemiology: In May 2005, the US Centers for Disease Control and Prevention (CDC) reported cases of lymphocytic choriomeningitis virus (LCMV) infection in 4 people who had received transplants of the liver, lungs or a kidney from a single common donor. Within 3 weeks after their surgery the organ recipients had fever, localized rash, diarrhea, hyponatremia, thrombocytopenia, hypoxia and renal failure along with dysfunction of the transplanted organ; 3 of the 4 patients died. Histopathologic findings varied, but at autopsy all 3 decedents had hepatocellular necrosis. The source of the disease was an infected hamster in the donor's home.
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Figure. Guinea pigs (along with hamsters and pet mice) are sources of lymphocytic choriomeningitis virus. The primary reservoir of LCMV worldwide is wild mice. Photo by: Photos.com
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LCMV infection is either asymptomatic or causes a mild self-limited illness in healthy people who are not immunocompromised. LCMV can cause aseptic meningitis, but this is rarely fatal. In the earlier trimesters of pregnancy, however, LCMV infection can cause fetal defects.1
Serum markers for LCMV infection indicate that about 5% of the population has been infected. Normally, the disease cannot be transmitted from human to human (except vertically during pregnancy). LCMV is an arenavirus primarily affecting rodents; it is endemic worldwide among house mice. Pets can be infected after contact with wild rodents at the breeding facility, in pet stores or in the home. Although other animals could be infected by LCMV, transmission to humans has been documented only from infected hamsters, guinea pigs and mice.
Clinical management: Human infection in immunocompetent people is asymptomatic or is associated with mild, self-limited illness characterized by fever, malaise, loss of appetite, head and muscle aches, nausea and vomiting. Aseptic meningitis can occur but is rarely fatal. Infection during the first or second trimester can cause more severe illness and developmental defects in the fetus.
Prevention: Environmental modifications should be undertaken if wild rodents are found to have entered homes or workplaces. General recommendations1 from the CDC about pet rodents are provided in Box 1 and Box 2. Useful information on diseases in pets and how to prevent infection is also available through the CDC Web site (at www.cdc.gov/healthypets).
REFERENCE
- Interim guidance for minimizing risk for human lymphocytic choriomeningitis virus infection associated with rodents. MMWR Morb Mortal Wkly Rep 2005;54(30):747-9.[Medline]
