What is Lymphocytic Choriomeningitis?
The story of three Australian women who developed complications from lymphocytic choriomeningitis, which they contracted after receiving organs from one donor and shortly died thereafter was published in a Sydney Morning Herald news report May 7.
In a nutshell (read the report for yourself), three organ recipients, Karen Wilkinson, 44; Carmelina Sirianni, 63; and Gurpal Sandhu, 64, all died in the first week of January 2007.
The women all received organs from the body of Jovo Vranjesevic, 57, who died in December 2006 after returning home to Melbourne from a three-month stay with relatives in Serbia.
Mrs Sirianni and Ms Wilkinson received kidneys and Ms Sandhu a liver after Mr Vranjesevic’s family agreed to donate his organs.
Coroner Audrey Jamieson ruled the state’s screening process for transplanted organs was adequate and could not have prevented the deaths of the three women.
According to the US Centers for Disease Control and Prevention (CDC), Lymphocytic choriomeningitis, or LCM, is a rodent-borne viral infectious disease that presents as aseptic meningitis (inflammation of the membrane, or meninges, that surrounds the brain and spinal cord), encephalitis (inflammation of the brain), or meningoencephalitis (inflammation of both the brain and meninges). Its causative agent is the lymphocytic choriomeningitis virus (LCMV).
Although the virus is known for infection of the central nervous system (CNS), infection without symptoms or mild febrile illnesses are common clinical manifestations.
The host is the common house mouse. The virus is found in the saliva, urine, and feces of infected mice. Infected mice carry LCMV and shed it for the duration of their lives without showing any sign of illness.
Individuals become infected with LCMV after exposure to fresh urine, droppings, saliva, or nesting materials. Transmission can also occur when these materials are directly introduced into broken skin, the nose, the eyes, or the mouth, or presumably, via the bite of an infected rodent.
Person-to-person transmission has not been reported, except between mother and fetus.
For infected persons who do become ill, some do not, onset of symptoms usually occurs 8-13 days after being exposed to the virus.
Initial symptoms are non-specific (fever, headache, muscle ache, etc) and may last about a week. Other symptoms that appear less frequently include sore throat, cough, joint pain, chest pain, testicular pain, and parotid (salivary gland) pain. This is the initial phase.
A few days later, the second phase sets in, which includes symptoms of meningitis, encephalitis and hydrocephalus.
Recovery from LCM is typically complete and the disease is not usually fatal (<1%).
Handling mice or having contact with their bodily fluids and feces put a person at risk.
The CDC recommends the following steps be taken to prevent LCM:
Avoid contact with house mice and taking precautions when handling pet rodents (i.e. mice, hamsters, or guinea pigs).
If you have a rodent infestation in and around your home, take the following precautions to reduce the risk of LCMV infection:
- Seal up rodent entry holes or gaps with steel wool, lath metal, or caulk.
- Trap rats and mice by using an appropriate snap trap.
- Clean up rodent food sources and nesting sites and take precautions when cleaning rodent-infected areas. See recommendations for cleaning rodent-infested areas.
If you have a pet rodent, wash your hands with soap and water (or waterless alcohol-based hand rubs when soap is not available and hands are not visibly soiled) after handling rodents or their cages and bedding.
Pet rodents should not have contact with wild rodents.
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