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

Eisermann, P.; Rubbenstroth, Dennis GND; Cadar, D.; Thomé-Bolduan, C.; Eggert, P.; Schlaphof, A.; Leypoldt, F.; Stangel, M.; Fortwängler, T.; Hoffmann, F.; Osterman, A.; Zange, S.; Niller, H.-H.; Angstwurm, K.; Pörtner, K.; Frank, C.; Wilking, H.; Beer, Martin GND; Schmidt-Chanasit, J.; Tappe, D.

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.

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Eisermann, P. / Rubbenstroth, Dennis / Cadar, D. / et al: Active Case Finding of Current Bornavirus Infections in Human Encephalitis Cases of Unknown Etiology, Germany, 2018–2020. 2021.

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