Notes from the Field: Congenital Lymphocytic Choriomeningitis --- New York

Lymphocytic choriomeningitis virus (LCMV) is an arenavirus carried by rodents, most notably domestic house mice (Mus musculus), but also laboratory and pet rodents (1). Manifestations of infections in humans are protean, from inapparent or mild febrile illness to choriomeningitis, encephalitis, or severe multi-organ disease. Mother-to-child transmission of LCMV during pregnancy can cause abortion, chorioretinitis, hydrocephalus, or microencephaly, and can result in life-long vision deficits or neurologic impairment (2,3). Clinically, congenital LCMV infection closely resembles perinatal infections caused by the pathogens grouped under the TORCH acronym: toxoplasmosis, rubella, cytomegalovirus, and herpes simplex virus.

Reports of congenital LCMV cases are extremely rare in the United States. In January 2010, an infant in upstate New York with hydrocephalus and chorioretinitis was confirmed to have congenital LCMV infection by the Viral Special Pathogens Branch at CDC. A review of records by the Onondaga County Health Department (Syracuse, New York) and the New York State Department of Health found that 7 years earlier, two cases of congenital LCMV infection were diagnosed in infants residing within a 1.5-mile radius of the infant in the 2010 case.

LCMV infection is not a nationally notifiable disease in the United States, the extent of LCMV-associated morbidity is currently unknown, and most LCMV infections are believed to go undiagnosed. Health-care practitioners are encouraged to contact their local or state health department if they have observed cases of suspected LCMV infection. When LCMV-associated disease is suspected, the Viral Special Pathogens Branch at CDC asks that state health departments contact the branch via e-mail ([email protected]) or telephone (404-639-1510) for consultation and diagnostic assistance and to better identify and characterize LCMV-associated morbidity in the United States.

Reported by

Onondaga County Health Dept, Syracuse; New York State Dept of Health. Viral Special Pathogens Br, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

References

1. Jamieson DJ, Kourtis AP, Bell M, Rasmussen SA. Lymphocytic choriomeningitis virus: an emerging obstetric pathogen? Am J Obstet Gynecol 2006;194:1532--6.
2. Barton LL, Mets MB. Congenital lymphocytic choriomeningitis virus infection: decade of rediscovery. Clin Infect Dis 2001;33:370--4.
3. Wright R, Johnson D, Neumann M, et al. Congenital lymphocytic choriomeningitis virus syndrome: a disease that mimics congenital toxoplasmosis or cytomegalovirus infection. Pediatrics 1997;100:E9.