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Borna Virus: Symptoms, Transmission & Treatment

Borna virus is a rare neurotropic virus capable of causing severe brain inflammation in both humans and animals. It is primarily transmitted to humans through contact with infected shrews.

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Things worth knowing about "Borna Virus"

Borna virus is a rare neurotropic virus capable of causing severe brain inflammation in both humans and animals. It is primarily transmitted to humans through contact with infected shrews.

What is Borna Virus?

Borna virus (officially Borna disease orthobornavirus 1, abbreviated BoDV-1) is an RNA virus belonging to the family Bornaviridae. It targets the central nervous system (CNS) and can cause severe encephalitis (brain inflammation) in both humans and animals. The name derives from the town of Borna in Saxony, Germany, where a major outbreak among horses was documented in the early 20th century.

In humans, BoDV-1 infection is extremely rare but typically follows a very severe course. The primary animal reservoir and source of transmission to humans is the bicolored white-toothed shrew (Crocidura leucodon), which carries the virus without showing signs of disease.

Transmission and Distribution

Borna virus is not transmitted from person to person. Human infection occurs primarily through direct contact with infected shrews or their secretions (e.g., saliva, urine, feces). The virus is endemic in certain regions of Germany (Bavaria, Thuringia, Saxony) as well as parts of Austria and Switzerland.

Main reservoir: Bicolored white-toothed shrew (Crocidura leucodon)
Route of transmission: Direct contact with infected animals or their excretions
No known human-to-human transmission
Risk groups: People with close animal contact (e.g., farmers, veterinarians, rural residents)

Symptoms

The incubation period (the time between infection and the appearance of the first symptoms) ranges from several weeks to months. The illness often begins with non-specific complaints before rapidly progressing to a severe neurological syndrome:

Fever, headache, and general malaise (early phase)
Confusion and altered consciousness
Seizures
Movement disorders and paralysis
Coma

Bornavirus encephalitis caused by BoDV-1 is fatal in the majority of documented cases or leads to severe permanent neurological damage in survivors.

Diagnosis

Diagnosing a Borna virus infection is challenging due to the rarity of the disease and the initially non-specific symptoms. The following diagnostic methods are used:

Detection of BoDV-1 antibodies in blood or cerebrospinal fluid (CSF)
PCR testing (polymerase chain reaction) for direct virus detection in CSF or brain tissue
Brain MRI to visualize areas of inflammation
Exclusion of other causes of encephalitis (e.g., herpes simplex virus, tick-borne encephalitis virus)

Treatment

There is currently no specifically approved antiviral treatment for Borna virus infection. Management is symptomatic and intensive care-based. The antiviral agent ribavirin has been used in isolated cases, but its efficacy against BoDV-1 in humans has not been sufficiently demonstrated.

Intensive care monitoring and support of vital functions
Management of seizures and elevated intracranial pressure
Experimental use of ribavirin (off-label)

Given the frequently fatal course of the disease, prevention and early diagnosis are of paramount importance.

Prevention

As no licensed vaccine against Borna virus exists for humans, the primary strategy is to avoid exposure to the pathogen:

Avoid contact with shrews and their secretions
Wear gloves and protective clothing when handling animals or working in affected regions
Practice good hand hygiene after spending time outdoors in risk areas

References

Robert Koch Institute (RKI): Borna Virus Disease (BoDV-1) – Fact Sheet. www.rki.de (2023)
Schlottau K. et al. – Fatal Encephalitic Borna Disease Virus 1 in Solid-Organ-Transplant Recipients. New England Journal of Medicine, 2018; 379:1377–1379.
World Health Organization (WHO): Zoonotic diseases – Emerging and re-emerging zoonoses. www.who.int (2023)

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