行动中的One Health：德国 2022 年首例致命博尔纳病病毒 1（BoDV-1）脑炎局部聚集性病例的调查。

One Health in action: Investigation of the first detected local cluster of fatal borna disease virus 1 (BoDV-1) encephalitis, Germany 2022.

机构信息

Bavarian Health and Food Safety Authority, Munich, Germany; Institute of Social Medicine and Health Systems Research, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany; Bornavirus-Focal Point Bavaria, Germany.

Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald - Insel Riems, Germany.

出版信息

J Clin Virol. 2024 Apr;171:105658. doi: 10.1016/j.jcv.2024.105658. Epub 2024 Feb 23.

DOI:10.1016/j.jcv.2024.105658

PMID:38447459

Abstract

BACKGROUND

Zoonotic Borna disease virus 1 (BoDV-1) causes fatal encephalitis in humans and animals. Subsequent to the detection of two paediatric cases in a Bavarian municipality in Germany within three years, we conducted an interdisciplinary One Health investigation. We aimed to explore seroprevalence in a local human population with a risk for BoDV-1 exposure as well as viral presence in environmental samples from local sites and BoDV-1 prevalence within the local small mammal population and its natural reservoir, the bicoloured white-toothed shrew (Crocidura leucodon).

METHODS

The municipality's adult residents participated in an anonymised sero-epidemiological study. Potential risk factors and clinical symptoms were assessed by an electronic questionnaire. Small mammals, environmental samples and ticks from the municipality were tested for BoDV-1-RNA. Shrew-derived BoDV-1-sequences together with sequences of the two human cases were phylogenetically analysed.

RESULTS

In total, 679 citizens participated (response: 41 %), of whom 38 % reported shrews in their living environment and 19 % direct shrew contact. No anti-BoDV-1 antibodies were detected in human samples. BoDV-1-RNA was also undetectable in 38 environmental samples and 336 ticks. Of 220 collected shrews, twelve of 40 C. leucodon (30%) tested BoDV-1-RNA-positive. BoDV-1-sequences from the previously diagnosed two paediatric patients belonged to two different subclades, that were also present in shrews from the municipality.

INTERPRETATION

Our data support the interpretation that human BoDV-1 infections are rare even in endemic areas and primarily manifest as severe encephalitis. Sequence analysis linked both previous paediatric human infections to the local shrew population, but indicated independent infection sources.

FUNDING

The project was partly financed by funds of the German Federal Ministry of Education and Research (grant numbers: 01KI2005A, 01KI2005C, 01KI1722A, 01KI1722C, 01KI2002 to MaBe, DR, RGU, DT, BS) as well as by the ReForM-A programme of the University Hospital Regensburg (to MaBa) and by funds of the Bavarian State Ministry of Health, Care and Prevention, project "Zoonotic Bornavirus Focal Point Bavaria - ZooBoFo" (to MaBa, MaBe, BS, MMB, DR, PS, RGU).

摘要

背景

人畜共患的博尔纳病病毒 1 型（BoDV-1）可导致人类和动物致命性脑炎。在德国巴伐利亚州的一个直辖市三年内发现两例儿科病例后，我们进行了一次跨学科的“同一健康”调查。我们旨在探索当地具有 BoDV-1 暴露风险的人群中的血清流行率，以及当地地点的环境样本中的病毒存在情况，以及当地小型哺乳动物种群及其自然宿主双色白齿鼩（Crocidura leucodon）中的博尔纳病病毒流行率。

方法

直辖市的成年居民参加了一项匿名血清流行病学研究。通过电子问卷评估潜在的危险因素和临床症状。从直辖市采集小型哺乳动物、环境样本和蜱进行 BoDV-1-RNA 检测。对鼩鼱衍生的 BoDV-1 序列以及两个人类病例的序列进行系统发育分析。

结果

共有 679 名市民参与（应答率：41%），其中 38%报告在其生活环境中有鼩鼱，19%有直接接触鼩鼱。人类样本中未检测到抗 BoDV-1 抗体。38 个环境样本和 336 个蜱中也未检测到 BoDV-1-RNA。在采集的 220 只鼩鼱中，40 只 C. leucodon 中有 12 只（30%） BoDV-1-RNA 检测呈阳性。先前诊断出的两名儿科患者的 BoDV-1 序列属于两个不同的亚群，也存在于直辖市的鼩鼱中。

解释

我们的数据支持以下解释，即在流行地区，人类 BoDV-1 感染也很少见，主要表现为严重脑炎。序列分析将以前的两名儿科人类感染与当地的鼩鼱种群联系起来，但表明存在独立的感染源。

资金

该项目部分由德国联邦教育与研究部的资金资助（资助编号：01KI2005A、01KI2005C、01KI1722A、01KI1722C、01KI2002 给 MaBe、DR、RGU、DT、BS）以及雷根斯堡大学医院的 ReForM-A 计划（给 MaBa）和巴伐利亚州卫生部、护理和预防部的资金，项目“人畜共患博尔纳病病毒重点 Bavaria-ZooBoFo”（给 MaBa、MaBe、BS、MMB、DR、PS、RGU）。