Among those tested, about 5% have shown serologic evidence of previous infection with LCMV.3,4 In healthy adults, LCMV is typically a nonspecific viral syndrome sometimes followed by aseptic meningitis or other neurologic signs. Patients with weakened immune systems can suffer severe, possibly fatal systemic illness.2,5 Maternal infection with LCMV during pregnancy can result in spontaneous abortion or early neonatal death, as well as in defects similar to those of other congenital infections such as toxoplasmosis and cytomegalovirus (“TORCH” infections).6-10 The proportion of developmental defects caused by LCMV is not known.
Clinicians should consider LCMV in the differential diagnosis of patients with aseptic meningitis; in cases of fetal demise or congenital defects, including congenital hydrocephalus, chorioretinitis, blindness, or mental retardation; or in recent transplant recipients who present with signs of post-transplant infection. A detailed rodent exposure history should be taken. Contact your state health department or Special Pathogens Branch, CDC (404-639-1510), for information about testing for LCMV.
Currently, there is no specific treatment for LCMV infection other than supportive care. Ribavirin inhibits LCMV multiplication in laboratory experiments but has not been tested in clinical trials.
Clinicians should counsel their patients about the risks of contracting LCMV from laboratory, pet, and wild rodents. Wild mice in the home should be controlled and removed promptly. Immunocompromised individuals and women who are pregnant or planning to become pregnant should avoid any contact with wild or pet rodents, their excretions, and their nesting materials. While a woman is pregnant, pet rodents should be housed outside the home or in a separate part of the home where other individuals can care for the pets and clean their cages. Counseling a woman already exposed to rodents during pregnancy can be challenging; for assistance, contact your state health department.
Further information about LCMV infection and its prevention, including management and prevention of rodent infestation in the home, is available from Special Pathogens Branch, CDC, at www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/lcmv.htm. For more information about diseases commonly carried by rodents, please visit www.cdc.gov/rodents. TH
References
- Centers for Disease Control and Prevention. Update: interim guidance for minimizing risk for human lymphocytic choriomeningitis virus infection associated with pet rodents. MMWR. Aug 19, 2005;54(32):799-801.
- Fischer SA, Graham MB, Kuehnert MJ, et al. Transmission of lymphocytic choriomeningitis virus by organ transplantation. N Engl J Med. 2006;354(21):2235-2249.
- Childs JE, Glass GE, Ksiazek TG, et al. Human-rodent contact and infection with lymphocytic choriomeningitis and Seoul viruses in an inner-city population. Am J Trop Med Hyg. 1991 Feb;44(2):117–121.
- Park JY, Peters CJ, Rollin PE, et al. Age distribution of lymphocytic choriomeningitis virus serum antibody in Birmingham, Alabama: evidence of a decreased risk of infection. Am J Trop Med Hyg. 1997 Jul;57(1):37–41.
- Horton J, Hotchin JE, Olson KB, et al. The effects of MP virus infection in lymphoma. Cancer Res. 1971 Aug;31(8):1066–1068.
- Barton LL, Mets MB. Congenital lymphocytic choriomeningitis virus infection: decade of rediscovery. Clin Infect Dis. 2001 Aug 1;33(3):370–374.
- Barton LL, Mets MB, Beauchamp CL. Lymphocytic choriomeningitis virus: emerging fetal teratogen. Am J Obstet Gynecol. 2002 Dec ;187(6):1715–1716.
- Wright R, Johnson D, Neumann M, et al. Congenital lymphocytic choriomeningitis virus syndrome: a disease that mimics congenital toxoplasmosis or cytomegalovirus infection. Pediatrics. 1997 Jul;100(1):E9.
- Ford-Jones EL, Ryan G . Implications for the fetus of maternal infections in pregnancy. In: Cohen J, Powderly WG, eds. Infectious Diseases, 2nd ed. New York, NY: Mosby; 2004: 709–723.
- Greenhow TL, Weintrub PS. Your diagnosis, please. Neonate with hydrocephalus. Pediatr Infect Dis J. 2003 Dec;22(12):1099, 1111–1112.