From Associated Press, in Seattle newspaper today:
Tuesday, May 24, 2005 · Last updated 8:00 p.m. PT
Rodent virus now linked to six deaths
By MARILYNN MARCHIONE
AP MEDICAL WRITER
MILWAUKEE -- At least six deaths of organ transplant patients have now been linked to a rodent virus, raising questions about whether others may have gone undetected and whether the germ also could spread through blood transfusions.
Health officials believe the deaths are rare cases, but say the situation merits closer study in light of recent discoveries that rabies and West Nile virus occasionally spread through donated organs with deadly consequences.
"We're learning as we go here. This is a new phenomenon," Dr. Matthew Kuehnert, assistant director of blood safety for the federal Centers for Disease Control and Prevention, said of the rodent virus. "We haven't seen any evidence of transfusion-transmitted infection, but that doesn't mean it couldn't happen."
Rhode Island and Massachusetts officials said Monday they are investigating the deaths of three people who got organs from a female donor whose pet hamster tested positive for lymphocytic choriomeningitis virus, or LCMV. A fourth organ recipient is believed to be recovering.
On Tuesday, health officials in Wisconsin revealed that four transplant recipients died in the only previously known cases involving the virus in December 2003.
The cases weren't clear-cut - the organ donor and a woman who received a lung from him in an operation in Minnesota both tested negative for LCMV. But three other transplant patients tested positive for the virus, strongly suggesting the donor was the source.
That was the only thing in common the recipients had, said James Kazmierczak, an epidemiologist for the Wisconsin Department of Health and Family Services.
About 5 percent of mice, hamsters and other rodents carry LCMV and about 2 percent of the general public has antibodies to it, meaning they've been exposed to it at some point, Kazmierczak said.
The virus usually causes little or no illness in healthy people, but can be deadly for those with weak immune systems like cancer patients and transplant recipients, who take immune-suppressing drugs to keep them from rejecting their new organs.
Organs are routinely tested for many viruses but there is no commercial test for LCMV. The CDC, state health officials, the Food and Drug Administration and others are investigating. Some sought to reassure people who need transplants.
"We would encourage people who are on the waiting list not to be concerned with this," said Rhode Island health director David Gifford. "This is an extremely rare and unusual event."
However, Kuehnert said it's important for doctors to watch for unusual illnesses in patients who recently had blood transfusions or transplants.
Wisconsin officials said they made no public statements in 2003 because of the tenuous evidence and because the virus doesn't spread person-to-person and wasn't considered a public health risk.
A doctor who treated one of the New England organ recipients said she didn't find out about the Wisconsin cases until too late to save her patient's life.
Dr. Staci Fischer, infectious disease physician for the transplant group at Rhode Island Hospital, discovered the infection in April, when two of her kidney transplant patients developed flu-like symptoms. One survived, but the other did not.
Fischer said she searched medical literature and asked colleagues around the country if they had heard of anything similar. But it wasn't until she called the CDC that the connection to LCMV and the donor's hamster was made.
"It clearly rang a bell in their minds," she said. "My heart sank. In the long run, it would have made a difference for our other patient."
Two patients in Massachusetts - one a double lung recipient, the other a liver recipient - also died within weeks of the transplants, which were performed on April 10 and April 11, according to the Rhode Island Department of Health.
Two people who received corneas from the same Rhode Island woman in operations outside the United States are being monitored for signs of illness, said Kuehnert, who declined to say where the corneas were sent.
The donor's hamster, bought at a Petsmart store in Warwick, tested positive for LCMV.
Gail Mastrati, a spokeswoman for the state Department of Environmental Management said the agency removed 102 hamsters, mice and guinea pigs from the store in the past week. The animals were euthanized and shipped to the CDC in Atlanta, where all will be tested. Preliminary results indicate two of the hamsters sent Friday to the CDC tested positive for LCMV, she said. The CDC would not confirm the results.
Petsmart said it has asked suppliers of rodents to the Warwick store to test their animals. Bruce Richardson, a spokesman for the Phoenix-based chain, said not all of its vendors are affected.
Richardson would not say how many animals will have to be tested. He said it's not clear whether the hamster, which has died, was infected with LCMV when it arrived at the organ donor's household.
"To our knowledge," he said, "we didn't sell any sick hamsters."
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Associated Press Writers Michelle R. Smith and Eric Tucker contributed to this report from Providence, R.I
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