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Volume 24, Number 6—June 2018
CME ACTIVITY - Research

Occupation-Associated Fatal Limbic Encephalitis Caused by Variegated Squirrel Bornavirus 1, Germany, 2013

Dennis TappeComments to Author , Kore Schlottau, Daniel Cadar, Bernd Hoffmann, Lorenz Balke, Burkhard Bewig, Donata Hoffmann, Philip Eisermann, Helmut Fickenscher, Andi Krumbholz, Helmut Laufs, Monika Huhndorf, Maria Rosenthal, Walter Schulz-Schaeffer, Gabriele Ismer, Sven-Kevin Hotop, Mark Brönstrup, Anthonina Ott, Jonas Schmidt-Chanasit1, and Martin Beer1
Author affiliations: Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (D. Tappe, D. Cadar, P. Eisermann, M. Rosenthal, J. Schmidt-Chanasit); Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Germany (K. Schlottau, B. Hoffmann, D. Hoffmann, M. Beer); University Medical Center Schleswig-Holstein, Kiel, Germany (L. Balke, B. Bewig, H. Laufs, M. Huhndorf); Christian-Albrecht University of Kiel and University Medical Center, Kiel (H. Fickenscher, A. Krumbholz); Saarland University Medical Center, Homburg, Germany (W. Schulz-Schaeffer); Zoological Garden, Schleswig-Holstein, Germany (G. Ismer); Helmholtz Centre for Infection Research and German Centre for Infection Research, Braunschweig, Germany (S.-K. Hotop, M. Brönstrup); Euroimmun AG, Lübeck, Germany (A. Ott); German Centre for Infection Research, Hamburg (J. Schmidt-Chanasit)

Main Article

Table 2

Serologic test results for zoo animal caretaker who died of encephalitis, other zoo animal caretakers, and healthy blood donors, Germany, 2013*

Patient or group, sample type
 IgG immunoblot† BoDV IgG IFAT
 VSBV-1 IgG ELISA‡ Contact with Prevost's squirrels
BoDV-P
 BoDV-N
 VSBV-P
 VSBV-N
 VSBV-P
 VSBV-N
Encephalitis patient, age, y/sex, CSF
45 y/F
 +
 –
 +
 +
 1:2,560
 Pos
 Pos
 Regularly
14 zoo animal caretakers, age, y/sex, serum
44 y/F – – – (+) Neg Neg Neg Regularly
32 y/M – – – – Neg Neg Neg Regularly
25 y/F – + – (+) Neg Neg Neg Rarely
33 y/F – – – – Neg Neg Neg Occasionally
26 y/F – – – (+) 1:160§ Neg Neg Occasionally
27 y/M – + – – Neg Neg Neg Occasionally
29 y/F – – – – Neg Neg Neg Rarely
48 y/F – (+) – + 1:40 Neg Neg Rarely
35 y/M – – – – Neg Neg Neg Occasionally
24 y/F – – – – Neg Neg Neg Regularly
18 y/F – + – – Neg Neg Neg Regularly
21 y/F – – – (+) Neg Neg Neg Occasionally
37 y/M – – – (+) Neg Neg Neg Regularly
20 y/F
 –
 –
 –
 –
 Neg
 Neg
 Neg
 Regularly
150 healthy blood donors, %, serum
Positive 1.5 0 1.5 1.5 NA Neg Neg No
Weakly positive 4.5 4.5 0 12 NA Neg Neg No

*Boldface indicates positive response. BoDV, borna disease virus; CSF, cerebrospinal fluid; ELISA; enzyme-linked immunosorbent assay; IFAT, immunofluorescence antibody test; NA, not available; neg, negative; OD, optical density; pos, positive; VSBV-1, variegated squirrel bornavirus 1;. +, strongly positive; (+), weakly positive; –, no reaction by immunoblot.
†Results were obtained densitometrically using EUROLineScan software (EUROIMMUN AG, Lübeck, Germany) and transformed into semiquantitative categories (negative, –, 0–13; weakly positive, (+), 14–20; positive, +, 21–255).
‡Final OD values for serum dilutions of 1:400 were regarded as positive if the mean OD exceeded the mean OD + 3 SD obtained with negative control samples.
§The IgG endpoint titer is defined as the reciprocal of the highest analyte dilution that gives a positive signal in IFAT.

Main Article

1These authors contributed equally to this article.

Page created: May 18, 2018
Page updated: May 18, 2018
Page reviewed: May 18, 2018
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