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Epidemiologic Notes and Reports Lymphocytic Choriomeningitis -- Georgia

On December 31, 1983, a 58-year-old woman from Winder, Georgia, was admitted to a hospital in Cincinnati, Ohio, with a 1-week history of malaise, diffuse myalgias, fever, and chills; a 1-day history of vomiting, severe headache, stiff neck, and photophobia; and a history of exposure to mice in her home. Examination revealed a lethargic but arousable patient with a temperature of 38.5 C (101.3 F), and nuchal rigidity. The cerebrospinal fluid (CSF) contained 930 white blood cells, with 69% lymphocytes. Lymphocytic choriomeningitis (LCM) virus was isolated from the CSF. The patient's recovery was uncomplicated, and she was discharged January 7, 1984.

On January 13, the Georgia Department of Human Resources and CDC visited the patient's home. Blood specimens were obtained from two other household residents, and rodent traps were set inside and outside the house. By the following morning, seven grey house mice (Mus musculus) had been caught, six within the house and one in an adjacent wooded area.

The two household residents had no detectable LCM antibodies by indirect fluorescent antibody (IFA) testing. However, all six mice trapped in the house had evidence of LCM virus infection; four mice had IFA antibodies, and two were viremic and had virus antigen in the liver, as detected by direct FA staining of liver-touch impressions. On February 23, the patient's neighborhood was investigated. Blood specimens were obtained from 13 persons in six nearby residences; traps were set in five of those residences. Five mice were trapped in two of the houses. None of the specimens from humans or mice showed evidence of LCM virus. Reported by W Bullock, MD, M Meier, MD, University of Cincinnati Medical Center, Ohio; B Willingham, Barrow County Health Dept, Winder, RK Sikes, DVM, State Epidemiologist, Georgia Dept of Human Resources; Special Pathogens Br, Viral and Rickettsial Zoonoses Br, Epidemiology Office, Div of Viral Diseases, Center for Infectious Diseases, CDC.

Editorial Note

Editorial Note: LCM virus is a mouse-borne arenavirus that can cause three different forms of human illness: aseptic meningitis, encephalitis, and an influenza-like illness. Inapparent infections may also occur (1). Diagnosis requires the isolation of LCM virus from CSF or blood using an appropriate cell-culture system, or demonstration of either a fourfold rise in antibody titer between acute- and convalescent-phase serum specimens or an IFA titer 1:128 or higher in a single specimen in which immunoglobulin M (IgM) anti-LCM antibody is present.

This investigation points out that LCM should be considered in sporadic cases of aseptic meningitis, especially in the winter. Few estimates exist of the exact incidence of LCM; however, in one investigation, LCM was responsible for 8% of 1,568 cases of clinically diagnosed aseptic meningitis in the United States (2). The present report emphasizes the previously described association of sporadic cases with infected mice (3), and the previously described observation that the virus can remain localized to a single household.

In contrast, outbreaks of LCM in the general population have generally been traced to contact with Syrian golden hamsters (Mesocricetus auratus). In the United States (4) and Germany (1), these have resulted from exposure in the home to pet hamsters obtained from breeders with infected stock. Outbreaks have also occurred among laboratory workers following the introduction of LCM virus into hamster colonies through infected cell lines (5).


  1. Ackermann WS, Blumenthal W, Helm EB, Keller K, Baldus O. Syrische Goldhamster als Ubertrager von Lymphozytarer Choriomeningitis. Deutsch Med Woch 1972;45:1725-31.

  2. Meyer HM Jr, Johnson RT, Crawford IP, Dascomb HE, Rogers NG. Central nervous system syndromes of "viral" etiology. Am J Med 1960;29:334-47.

  3. Farmer TW, Janeway CA. Infections with virus of lymphocytic choriomeningitis. Medicine 1942;21:1-63.

  4. Biggar RJ, Woodall JP, Walter PD, Haughie GE. Lymphocytic choriomeningitis outbreak associated with pet hamsters: fifty-seven cases from New York State. JAMA 1975;232:494-500.

  5. Lewis AM Jr, Rowe WP, Turner HC, Huebner RJ. Lymphocytic-choriomeningitis virus in hamster tumor: spread to hamsters and humans. Science 1965;150:363-4.

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