Abstract
Human bornavirus encephalitis is a severe and often fatal infection caused by variegated squirrel bornavirus 1 (VSBV-1) and Borna disease virus 1 (BoDV-1). We conducted a prospective study of bornavirus etiology of encephalitis cases in Germany during 2018–2020 by using a serologic testing scheme applied along proposed graded case definitions for VSBV-1, BoDV-1, and unspecified bornavirus encephalitis. Of 103 encephalitis cases of unknown etiology, 4 bornavirus infections were detected serologically. One chronic case was caused by VSBV-1 after occupational-related contact of a person with exotic squirrels, and 3 acute cases were caused by BoDV-1 in virus-endemic areas. All 4 case-patients died. Bornavirus etiology could be confirmed by molecular methods. Serologic testing for these cases was virus specific, discriminatory, and a practical diagnostic option for living patients if no brain tissue samples are available. This testing should be guided by clinical and epidemiologic suspicions, such as residence in virus-endemic areas and animal exposure.
Highlights
Human bornavirus encephalitis is a severe and often fatal infection caused by variegated squirrel bornavirus 1 (VSBV-1) and Borna disease virus 1 (BoDV-1)
Human bornavirus encephalitis is a severe and often fatal disease caused by 2 related zoonotic members of the family Bornaviridae, variegated squirrel bornavirus 1 (VSBV-1, species Mammalian 2 orthobornavirus) and Borna disease virus 1 (BoDV-1, species Mammalian 1 orthobornavirus)
For group 1, a total of 4 (3.9%) confirmed bornavirus encephalitis case-patients were detected: 1 VSBV-1 case-patient in northern Germany (Schleswig-Holstein)
Summary
Human bornavirus encephalitis is a severe and often fatal infection caused by variegated squirrel bornavirus 1 (VSBV-1) and Borna disease virus 1 (BoDV-1). We report the results of a prospective screening study for bornavirus infections in human cases of encephalitis of unknown etiology in Germany during 2018–2020. Serum and cerebrospinal fluid (CSF) samples of patients with encephalitis of unknown etiology were sent to the Bernhard Nocht Institute for Tropical Medicine (Hamburg, Germany) during January 2018–August 2020 for analysis of possible bornavirus infections.
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