{Reference Type}: Case Reports
{Title}: Investigation of fatal human Borna disease virus 1 encephalitis outside the previously known area for human cases, Brandenburg, Germany - a case report.
{Author}: Tappe D;Pörtner K;Frank C;Wilking H;Ebinger A;Herden C;Schulze C;Muntau B;Eggert P;Allartz P;Schuldt G;Schmidt-Chanasit J;Beer M;Rubbenstroth D;
{Journal}: BMC Infect Dis
{Volume}: 21
{Issue}: 1
{Year}: Aug 2021 10
{Factor}: 3.667
{DOI}: 10.1186/s12879-021-06439-3
{Abstract}: <B>BACKGROUND: </B>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.<BR><B>METHODS: </B>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.<BR><B>CONCLUSIONS: </B>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.