%0 Case Reports %T Investigation of fatal human Borna disease virus 1 encephalitis outside the previously known area for human cases, Brandenburg, Germany - a case report. %A Tappe D %A Pörtner K %A Frank C %A Wilking H %A Ebinger A %A Herden C %A Schulze C %A Muntau B %A Eggert P %A Allartz P %A Schuldt G %A Schmidt-Chanasit J %A Beer M %A Rubbenstroth D %J BMC Infect Dis %V 21 %N 1 %D Aug 2021 10 %M 34376142 %F 3.667 %R 10.1186/s12879-021-06439-3 %X 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.
METHODS: 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.