Bornavirus: In the same village, 2 children die of a rare disease

It is the second time that such a tragedy has happened in Maitenbeth, Bavaria. About two weeks ago, a seven-year-old child died there as a result of an infection with the Borna virus, reports “Bild”. 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.
So far, it is unclear why it appears in this 2000-inhabitant village in the district of Mühldorf am Inn.
But several scientific teams are already working on studies aimed at clarifying this very question.

Already before the start of the summer holidays, the Bavarian State Office for Health and Food Safety (LGL) and the University Hospital Regensburg are planning an investigation in the municipality of Maitenbeth, the Mühldorf am Inn district office announced in July.

Citizens are asked to voluntarily submit a blood sample and a nasopharynx swab and fill in the questionnaire. In this way, the researchers will find out whether, in addition to the sometimes fatal encephalitis, there are other forms of infection that are milder or have no symptoms at all. The blood is examined, among other things, for antibodies.

Two additional studies will also start at the end of July. The Friedrich Loeffler Institute as a federal research facility for animal health is working on a study of the shrew population in Maitenbeth. And a team from the University Hospital Regensburg wants to take environmental samples at 30 locations. These are examined for viruses that enter the environment via secretions from the shrew and may therefore represent a possible route of infection. The first results of the studies should be available in the autumn.

What is Borna virus?

Bornavirus is also known by the names 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 severe encephalitis in humans.

So far, the pathogen has not been adequately studied. To find out more about Borna’s 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 research routes of infection, risk factors, virus carriers and possible additional forms of infection.

BoDV-1 can be clearly distinguished from the so-called spotted squirrel Bornavirus. The virus can also be transmitted to humans and can cause severe inflammation of the meninges.

How is the pathogen transmitted?

The field shrew is the only known reservoir of the virus so far. The pathogen from infected animals is usually excreted in saliva, urine or faeces. Scientists currently assume that horses and sheep come into contact with the shrew and their excrement when they e.g. eats.

The mouse does not necessarily have to be touched. Borna virus can, for example, be ingested through food or water contaminated with excrement 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 represent a link in the transmission chain. It is currently being investigated whether other closely related shrew species such as e.g. garden shrews can transmit the virus.

So far, researchers consider person-to-person transmission to be unlikely.

In which regions can it be found?

The shrew as the host of the pathogen is mainly found in Central and South-Eastern Europe. Also in Germany, it occurs increasingly in the eastern half of Germany, especially in Bavaria, Thuringia and Saxony-Anhalt. In addition, the virus was detected in animals in Switzerland, Liechtenstein and Austria.

What symptoms are typical?

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

  • Initial phase: headache, fever, general malaise
  • Further course: neurological symptoms, e.g. behavioral problems and speech and walking difficulties
  • Advanced stage: coma

So far, all known cases have been fatal with just one exception. There is currently no specific treatment against infection with the pathogen.

How likely is an infection?

Only a few cases of the disease in humans are currently known. According to the Bavarian State Office for Health and Food Safety, the number of infections has been in the mid-double digits since 1996. By 2021, seven infections had been known across Germany, five of them in Bavaria. Individual cases were also registered in Brandenburg, Saxony-Anhalt, Thuringia and North Rhine-Westphalia.

1 March 2020
there is a reporting obligation for Bornavirus infections. Therefore, direct virus detection of Borna viruses in humans must be reported to the health department for laboratories.

How can you protect yourself?

Currently, infections with Borna virus are very rare. The risk of infection is correspondingly low. So far, for example, there is no vaccination available against the pathogen.

In order to protect yourself, RKI has nevertheless summarized the following precautions:

  • Avoid contact with shrews.
  • Shrews are therefore not suitable as pets.
  • Live or dead shrews should not be touched with bare hands.

What should you do if you spot a shrew in your home or work environment?

  • Should shrews be identified in the home or work environment, it is important to identify their food source and remove it from them. Outside, it can be dog and cat food, compost heaps or other waste.
  • If the animal is already dead, you should remove the carcass and carefully clean contaminated surfaces with household cleaners. Spray dead shrews and droppings thoroughly with a commercial cleaner first to prevent virus-laden dust from being stirred up. Wear rubber gloves when removing the carcass and use a tight-fitting mouth mask when dust is generated.
  • To remove the carcass, place it in a plastic bag over your hand, seal it, and dispose of it with household waste.
  • In dusty areas, you should immediately take a shower and wash the used work clothes.

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