First cases of Borna disease virus 1 (BoDV-1) transmission through organ transplantation – ECDC risk assessment

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Germany reported four human cases of acute encephalitis or encephalopathy caused by infection with Borna disease virus 1 (BoDV-1). Three of the cases belong to a cluster of solid organ recipients. This is the first time that a possible BoDV-1 transmission through organ transplantation has been reported.

On 7 March 2018, Germany reported four human cases of acute encephalitis or encephalopathy caused by infection with Borna disease virus 1 (BoDV-1). Three of the cases belong to a cluster of solid organ recipients from a single donor from southern Germany, two of them died. One additional case of encephalitis due to BoDV-1, who also died, was also found in southern Germany.

This is the first time that a possible BoDV-1 transmission through organ transplantation has been reported. Infection with Borna disease virus 1 (BoDV-1) is very rare in humans, however it can cause severe disease (acute encephalitis).

Transplantation professionals and clinicians should be aware of possible BoDV-1 related encephalitis and the possibility of transmission through donated organs especially in areas where Borna disease is endemic, states today’s ECDC risk assessment.

Endemic areas so far have been identified in central Europe including eastern and southern Germany, the eastern part of Switzerland, Liechtenstein, the most western federal state of Austria and more recently in Upper Austria.

The bicoloured white-toothed shrew has been proposed as the animal reservoir of BoDV-1. The routes of transmission of BoDV-1 to humans from the animal reservoir, remain unknown and the zoonotic transmission pathways should be further investigated, says the risk assessment.