Abstract
Limbic encephalitis is commonly regarded as an autoimmune-mediated disease. However, after the recent detection of zoonotic variegated squirrel bornavirus 1 in a Prevost's squirrel (Callosciurus prevostii) in a zoo in northern Germany, we retrospectively investigated a fatal case in an autoantibody-seronegative animal caretaker who had worked at that zoo. The virus had been discovered in 2015 as the cause of a cluster of cases of fatal encephalitis among breeders of variegated squirrels (Sciurus variegatoides) in eastern Germany. Molecular assays and immunohistochemistry detected a limbic distribution of the virus in brain tissue of the animal caretaker. Phylogenetic analyses demonstrated a spillover infection from the Prevost's squirrel. Antibodies against bornaviruses were detected in the patient's cerebrospinal fluid by immunofluorescence and newly developed ELISAs and immunoblot. The putative antigenic epitope was identified on the viral nucleoprotein. Other zoo workers were not infected; however, avoidance of direct contact with exotic squirrels and screening of squirrels are recommended.
Highlights
In support of improving patient care, this activity has been planned and implemented by Medscape, LLC and Emerging Infectious Diseases
After the recent detection of zoonotic variegated squirrel bornavirus 1 in a Prevost’s squirrel (Callosciurus prevostii) in a zoo in northern Germany, we retrospectively investigated a fatal case in an autoantibody-seronegative animal caretaker who had worked at that zoo
Phylogenetic analysis performed only on the VSBV-1 dataset revealed that the VSBV-1 strain from the animal caretaker (BH55/16) clustered with the virus sequence from the single infected contact C. prevostii squirrel (BH12/16) from the zoo
Summary
Upon completion of this activity, participants will be able to: 1. Identify clinical features of limbic encephalitis (LE) in a zookeeper infected with variegated squirrel bornavirus-1 (VSBV-1), based on a case report. Upon completion of this activity, participants will be able to: 1. Identify clinical features of limbic encephalitis (LE) in a zookeeper infected with variegated squirrel bornavirus-1 (VSBV-1), based on a case report. 2. Identify immunologic and pathologic features of LE in a zookeeper infected with VSBV-1. 3. Assess management of LE and of VSBV-1 infection, and preventive measures for VSBV-1 infection, based on a case report of a zookeeper infected with VSBV-1
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