Borna Virus: In the same village, two children die of a rare disease

This is the second time such a tragedy has occurred in Maitenbeth, Bavaria. About two weeks ago, a seven-year-old boy died of Borna virus, Bild reports. An 11-year-old died of the disease in 2019.

Why did both children die in the same village?

The virus is extremely rare – and extremely deadly.
Until now it was not clear why it appeared in this village of 2,000 inhabitants in the Mühldorf am Inn district.
However, several scientific teams are already working on studies aimed at accurately clarifying this question.

Even before the start of the summer holidays, the Mühldorf am Inn county office announced that the Bavarian State Office of Health and Food Safety (LGL) and the University Hospital Regensburg are planning a study in the municipality of Meitenbeth.

Citizens are required to voluntarily submit a blood sample and nasopharyngeal swab and fill out a questionnaire. In this way, researchers want to know if there are other forms of infection that are milder or have no symptoms at all, as well as the sometimes fatal encephalitis. Among other things, the blood is checked for antibodies.

Two more studies will start at the end of July. The Friedrich Loeffler Institute as a Federal Research Facility for Animal Health is working on an investigation into the shrew population in Maitenbeth. A team from the University Hospital Regensburg wants to take environmental samples at 30 sites. These viruses are screened for viruses that enter the environment via field shrew secretions and thus could represent a potential route of transmission. The first results of the studies should be available in the fall.

What is Borna virus?

Borna virus is also known as Borna Disease Virus 1 (BoDV-1), “classic Borna” and “Pferdeborna” and has been an animal disease for more than 250 years. In 2018, BoDV-1 was first identified as the cause of acute encephalitis in humans.

To date, the pathogen has not been adequately investigated. In order to learn more about Borna disease in humans, two research groups on the pathogen, Bornavirus Focal Point Bayern and ZooBoCo, have been established over the past five years. Among other things, they investigate transmission routes, risk factors, virus vectors, and other possible forms of infection.

BoDV-1 is clearly distinguishable from the so-called spotted squirrel bornovirus. The virus can also be transmitted to humans and can cause severe meningitis.

How is the pathogen transmitted?

The shrew is the only known reservoir of the virus to date. The pathogen of infected animals is usually excreted in saliva, urine or feces. Scientists currently hypothesize that horses and sheep come into contact with shrews and their excrement when eating, for example.

The mouse does not have to be touched. Bornaviruses can, for example, be ingested through food or water contaminated with feces and transmitted to humans. In addition, bite injuries and inhalation of contaminated dust can transmit the pathogen to humans. According to the Robert Koch Institute (RKI), it is conceivable that other animals such as domestic cats that hunt mice are a link in the transmission chain. It is currently being investigated whether other closely related shrew species such as the garden shrew can transmit the virus.

So far, scientists consider person-to-person transmission unlikely.

In what areas can it be found?

Field shrews are found as hosts of the pathogen mainly in central and southeastern Europe. In Germany also, it increasingly occurs in the eastern half of Germany, especially in Bavaria, Thuringia and Saxony-Anhalt. In addition, the virus has been detected in animals in Switzerland, Liechtenstein and Austria.

What are the typical symptoms?

According to the RKI, the following symptoms are known so far:

  • Initial stage: headache, fever, general malaise
  • Other course: Neurological symptoms, eg behavioral problems, speech and gait disturbances
  • Advanced stage: coma

So far, all but one of the known cases have been fatal. There is currently no specific treatment against infection with pathogens.

How likely is infection?

Currently, only a few cases of the disease in humans are known. According to the Bavarian State Office of Health and Food Safety, the number of infections has been in a double-digit average range since 1996. In 2021, seven infections spread across Germany, five of which were in Bavaria. Individual cases have also been reported in Brandenburg, Saxony-Anhalt, Thuringia and North Rhine-Westphalia.

March 1, 2020
There is a requirement to report a Borna virus infection. Accordingly, direct detection of Bornaviruses in humans should be reported to the Department of Health for Laboratories.

How can you protect yourself?

At the moment, Borna virus infections are very rare. Conversely, the risk of infection is low. To date, for example, there is no available vaccination against the pathogen.

In order to protect yourself however, RKI summarized the following precautionary measures:

  • Avoid contact with the shrew.
  • Therefore shrews are not suitable as pets.
  • Live or dead shrews should not be touched with bare hands.

What should you do if you find a tiger in your home or work environment?

  • If shrews are identified in the home or work environment, it is important to identify their food source and remove it from them. Outside, this can be dog and cat food, piles of manure or other droppings.
  • If the animal is already dead, you should remove the carcass and carefully clean the contaminated surfaces with household cleaning supplies. Spray dead shrews and droppings well with a commercial cleaning agent first to prevent virus-laden dust from flying in. Wear rubber gloves when removing the carcass and wear a tight-fitting mouth mask when dust forms.
  • To remove the carcass, place it in a plastic bag placed over your hand, seal it and dispose of it in household waste.
  • In dusty areas, take a shower immediately and wash used work clothes.

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