Active Case Finding of Current Bornavirus Infections in Human Encephalitis Cases of Unknown Etiology, Germany, 2018-2020

• Published in: Emerging infectious diseases Vol. 27; no. 5; pp. 1371 - 1379
• Main Authors: Eisermann, Philip, Rubbenstroth, Dennis, Cadar, Daniel, Thomé-Bolduan, Corinna, Eggert, Petra, Schlaphof, Alexander, Leypoldt, Frank, Stangel, Martin, Fortwängler, Thorsten, Hoffmann, Florian, Osterman, Andreas, Zange, Sabine, Niller, Hans-Helmut, Angstwurm, Klemens, Pörtner, Kirsten, Frank, Christina, Wilking, Hendrik, Beer, Martin, Schmidt-Chanasit, Jonas, Tappe, Dennis
• Format: Journal Article
• Language: English
• Published: United States U.S. National Center for Infectious Diseases 01.05.2021; Centers for Disease Control and Prevention
• Subjects: Active Case Finding of Current Bornavirus Infections in Human Encephalitis Cases of Unknown Etiology, Germany, 2018–2020; Animals; Antibodies; Autoimmune diseases; BoDV-1; Bornaviridae - genetics; bornavirus; bornavirus disease virus 1; Case reports; Case studies; Causes of; Diagnosis; Encephalitis; Epidemiology; Etiology; Germany; Humans; Infections; Laboratories; Mammals; Medical research; Patients; Prospective Studies; RNA virus infections; RNA, Viral; variegated squirrel bornavirus 1; viruses; VSBV-1; Zoonoses; Germany; Bavaria Germany; Europe; viruses; VSBV-1; zoonoses; variegated squirrel bornavirus 1; etiology; epidemiology; bornavirus disease virus 1; bornavirus; case definition; infections; serologic analysis; meningitis/encephalitis; Germany; active case finding; BoDV-1; human encephalitis
• ISSN: 1080-6040; 1080-6059
• DOI: 10.3201/eid2705.204490

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.