October 13, 2008

A New Virus Found as the Cause of Death in 3 patients, including health care workers, in southern Africa.

On Monday, October 13, the World Health Organization (WHO) posted on their website a brief update regarding the three deaths of persons from Zambia and South Africa due to an undiagnosed infection. WHO reported that preliminary evidence from the renowned viral diagnostic laboratories in Johannesburg, and from the US CDC (Atlanta), shows that the cause is a “virus from the Arenaviridae family”.

WHO also reported today that a 4^th patient has been diagnosed with this new arenavirus, based on PCR testing, symptoms, and contact exposure to one of the earlier known cases. This 4^th patient is a health care worker (nurse), as were two of the earlier patients who had cared for the index patient.

Further characterization of this apparently novel virus is ongoing in labs in Johannesburg and Atlanta.

This family of viruses contains over 20 known members. They are single stranded RNA viruses. A variety of rodents are usually the viral reservoir. The viruses can be found in rodent (e.g., mouse) excreta, especially urine. With some areanviruses, aerosolization from the urine has been demonstrated.

Some of the best known examples of arenaviruses and their year/location of discovery are: Junin (1958/Argentina), Machupo (1963/Bolivia), Lassa (1969/Nigeria), Guanarito (1989/Venezuela) and Sabia (1990/Brazil). (Reference: CJ Peters, Principle and Practice of Infectious Diseases textbook 2005. Mandell, Bennett, and Dolin (eds). pages 2090-2098).

If confirmed, then this would be at least the second novel arenavirus reported this year, albeit on a different continent.

On February 6, 2008 the New England Journal of Medicine published a paper by Palacios and colleagues describing a novel arenavirus, similar to lymphocytic choriomeningitis virus (LCMV), that had infected a person from Australia while traveling in the Balkans (see also the accompanying editorial by Richard Whitley in the Feb 6, 2008 NEJM, and the Feb 12, 2008 “Newsletter” here at www.BePast.org).

Further information on this virus, how it is transmitted, its environmental reservoir, and what antiviral drug(s) it is susceptible to, if any (e.g., ribavirin), should be anticipated.

Daniel R. Lucey, MD, MPH

EROne Institutes, Washington Hospital Center

Adjunct Professor of Microbiology and Immunology

Georgetown University Medical Center

Washington D.C.

Website for this posting: www.BePast.org

e-mail:DRL23@Georgetown.edu