Rapid risk assessment: Acute encephalitis associated with infection with Borna disease virus 1, Germany

Risk assessment
Cite:

European Centre for Disease Prevention and Control. Acute encephalitis associated with infection with Borna disease virus 1 – Germany, 2018. 26 March 2018. Stockholm: ECDC; 2018.

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Borna disease virus 1 (BoDV-1) has been associated with human disease in four cases in Germany resulting in the death of three people. As three of the cases belong to a cluster of solid organ recipients from a single donor, donor-derived BoDV-1 transmission is possible. There is no evidence that the donor had any clinical manifestation of the disease.

Executive Summary

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.

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.