Report any release of WMD to the National Response Center 1-800- Lymphocytic Choriomeningitis Virus (LCMV) 424-8802. For References, Please See: Key References Cited/Used*
in National Response Team (NRT) Quick Reference Guides (QRGs) for Biological Warfare Agents.
Agent Classification: Biological Type: Virus (Arenaviridae) CDC Class: A Bio-Safety Level: 4
Warning: This virus is highly infectious and causes severe human disease. Responders should only risk exposure if deemed absolutely necessary by Subject Matter Experts (SMEs) and the use of Personal Protective Equipment (PPE) and infection control practices deemed adequate by SMEs are rigorously observed.
Description: The lymphocytic choriomeningitis virus (LCMV) is an enveloped RNA virus that is transmitted by rodents. This virus is spread through contact with urine, saliva, blood, or feces of infected hosts (e.g., rodents). Airborne transmission and contact with contaminated surfaces is also possible. If weaponized, this virus may be highly aerosol- izable.
Infectivity/Lethality: High/High.
Persistence/Stability: Persistence of these organisms in the environment is not well documented. Extreme caution should be exercised.
Incubation Period: 8-13 days.
Person-to-Person Transmission: Possible by coming in contact with infected persons and bodily fluids.
Treatments: Quarantine of infected individuals is needed to protect caregivers and other patients. Corticosteroids; otherwise treatment is supportive.
Air/Aerosolization: Devices designed to detect aerosolized LCMV are not available. Thus, airborne releases of LCMV are likely to be identified only after exposed persons become ill. Environmental sampling will be needed to test for aerosolization and effectiveness of decon.
Soil/Surfaces: LCMV will most likely pose a non-porous surface hazard.
Water: The viral particles could potentially survive for long periods of time in untreated water.
Other: Depending upon the threat, rodent control might be necessary.
Symptoms may occur within 8-13 days.
Initial signs and symptoms include fever, eye redness, fatigue, dizziness, muscle aches, loss of strength, and exhaustion. Severe cases show signs of bleed- ing under the skin, internal organs, or from body orifices like the mouth, eyes, or ears. Severely ill patients show shock, nervous system malfunction, coma, delirium, and seizures.
Inhalation: Inhalation is the primary route of exposure in the event of a bioterror attack. With LCMV, inhalation of tiny viral particles from rodent feces, blood, urine, saliva, etc. can serve as a route of exposure.
Skin: Direct contact with rodent feces, blood, urine, saliva, bites, etc. can serve as a route of exposure. Transmission can occur through contact with infected persons and their bodily fluids. Infection through cracks in skin and through conjunctiva can occur.
Ingestion: Exposure can occur from eating contaminated food or drinking contaminated water. Eyes: Can be exposed through contact with bodily fluids of infected patients.
Specific Effect Levels Are Unknown. Lethality reflects the relative ease with which an agent causes death in a susceptible population and can be represented quantitatively by the exposed population mortality rates. Arenaviridae are highly lethal. Infectivity refers to how easily an agent can cause disease in a host. An agent is highly infective when few organisms can cause disease. An infective dose is the number of organisms required to cause disease in an exposed person. Given the uncertainties regarding published infective doses for bioagents, it is important to examine what the infectivity numbers represent, including the routes of exposure and the animal species used for the lab studies. Responders should not assume that an infective dose estimate represents a safe level. For instance, for inhalation anthrax and other severe or lethal diseases, the infective dose is the LD50 (a.k.a. “Lethal Dose 50%). The LD50 stands for the dose administered which kills half the exposed population, if untreated. Please contact the Centers for Disease Control and Prevention (CDC) for more information: (404) 639-3311.
Check with your appointed Health and Safety Officer regarding PPE, Medical Surveillance, and Health and Safety Plan (HASP). Level of PPE may vary depend- ing upon the circumstances of the site and the incident. The PPE Levels listed are general suggestions only and are appropriate only for LCMV; they may not provide protection for the other chemicals that workers may be exposed to during response/recovery operation.
Baseline: Annual physical and respiratory function exams.
Treatments Available: Quarantine of infected individuals is needed to protect caregivers and other patients. Corticosteroids; otherwise treatment is support- ive.
During Incident: Conduct medical monitoring; use PPE as designated by the HASP; document PPE levels used; observe for fever and other signs and symp- toms as listed under Health Effects, and ensure medical attention is provided as soon as possible if necessary.
Post Incident: Monitor for signs/symptoms and ensure medical attention is provided as soon as possible if necessary.
Contaminated PPE, equipment, or surfaces can be decontaminated with a dilute household bleach solution. Household bleach is 5% sodium hypochlorite. To create a dilute bleach solution, add household bleach to water (add 1 part bleach to 9 parts water) yielding a 0.5% sodium hypochlorite solution. Use warm soapy water for personal/skin decon, taking care to avoid abrading the skin.
Emergency Response to a Suspected Biological Incident: The following recommendations are based on CDC Interim Recommendations for the Selection and Use of Protective Clothing and Respirators Against Biological Agents:
http://www.bt.cdc.gov/documentsapp/Anthrax/Protective/10242001Protect.aspt.asp

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ONSET
SIGNS/ SYMPTOMS
EXPOSURE ROUTES

CONCERNS
MEDICAL SURVEILLANCE
FIRST AID/ DECON
PPE
PPE
Pressure-demand SCBA with Level A protective suit.
Pressure-demand SCBA with Level B protective suit.
Full-facepiece respirator with P100 filter or PAPR with HEPA filters. Disposable hooded coveralls, gloves, and foot coverings.
CIRCUMSTANCES
• Event is uncontrolled.
• The type(s) of airborne agent(s) is unknown.
• The dissemination method is unknown.
• Dissemination via an aerosol-generating device is still occurring.
• Dissemination via an aerosol-generating device has stopped, but there is no informa-
tion on the duration of dissemination, or what the exposure concentration may be.
• The suspected biological aerosol is no longer being generated. • Other conditions may present a splash hazard.
• An aerosol-generating device was not used to create high airborne concentration. • Dissemination was by a letter, package, or other material that can be bagged, con-
tained, etc.
Other Workers: PPE recommendations for workers other than emergency responders must be developed in the HASP for the specific scenario, as noted previously. PPE recommendations will vary by job type (cleanup, decon, rodent control, medical, etc.), type of exposure (airborne or surface/liquid/soil hazard), and any additional site hazards that may need to be considered (chemical, physical, etc.).
Since there is no field detection, LCMV is only identified once patients present with symptoms
