Sudden infant death syndrome and Ljungan virus
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Ljungan virus (LV) has recently been associated with perinatal death in its natural rodent reservoir and also with developmental disorders of reproduction in laboratory mice. A strong epidemiological association has been found between small rodent abundance in Sweden and the incidence of intrauterine fetal death (IUFD) in humans. LV antigen has been detected in half of the IUFD cases tested. The question was therefore raised whether sudden infant death syndrome (SIDS) might be associated with rodent abundance, and whether the virus is present in cases of SIDS. Variation in the incidence of SIDS using the Swedish cause-of-death database tracked the changes in the population fluctuations of native rodents. Formalin-fixed tissues from the brain, heart, and lung were investigated from cases of SIDS, SIDS with lymphocytic infiltration of the myocardium (myocarditis) and myocarditis cases using LV specific immunohistochemistry (IHC). Ljungan virus was detected in the brain, heart, and lung tissue from all three of the patient categories investigated using IHC. These studies suggest that LV may play a prominent role in infant death, and that IUFD and SIDS may have common etiological underpinnings.