Investigation of fatal human Borna disease virus 1 encephalitis outside the previously known area for human cases, Brandenburg, Germany - a case report

BMC Infect Dis. 2021 Aug 10;21(1):787. doi: 10.1186/s12879-021-06439-3.

Abstract

Background: The true burden and geographical distribution of human Borna disease virus 1 (BoDV-1) encephalitis is unknown. All detected cases so far have been recorded in Bavaria, southern Germany.

Case presentation: A retrospective laboratory and epidemiological investigation of a 2017 case of fatal encephalitis in a farmer in Brandenburg, northeast Germany, demonstrated BoDV-1 as causative agent by polymerase chain reaction, immunohistochemistry and in situ hybridization. Next-generation sequencing showed that the virus belonged to a cluster not known to be endemic in Brandenburg. The investigation was triggered by a recent outbreak of animal Borna disease in the region. Multiple possible exposures were identified. The next-of-kin were seronegative.

Conclusions: The investigation highlights clinical awareness for human BoDV-1 encephalitis which should be extended to all areas endemic for animal Borna disease. All previously diagnosed human cases had occurred > 350 km further south. Further testing of shrews and livestock with Borna disease may show whether this BoDV-1 cluster is additionally endemic in the northwest of Brandenburg.

Keywords: BoDV-1; Bornavirus; Case report; Clinical awareness; Phylogeny.

Publication types

  • Case Reports

MeSH terms

  • Animals
  • Borna Disease* / epidemiology
  • Borna disease virus* / genetics
  • Encephalitis*
  • Germany / epidemiology
  • Humans
  • Retrospective Studies