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Encephalitides induced by lyssa-, borna- and astroviruses: molecular detection and characterization
(2017)
Encephalitis is a severe inflammatory disease of the brain which often has a fatal outcome or can lead to subsequent damages. In around two-thirds of all human encephalitis cases, the causative agent is, despite improved diagnostics, unknown today. Aim of this work was the development, improvement and validation of diagnostic methods, improvement of sampling strategies and the development of optimized systems for characterization of three viruses causing viral encephalitis. The main burden of RABV lies in developing countries, were standard diagnostic tools are often not realizable. Therefore, simple and rapid diagnostic tests for the use under resource limited settings, so called point-of-care tests (POCT), are favorable. Commercially available lateral flow device (LFD) based immunodiagnostic tests were analyzed and failed in terms of sensitivity compared to the standard FAT and RT-qPCR (Paper I). Therefore, molecular RABV alternative targeting genome tests were developed and combined with rapid nucleic acid extraction methods. The new HighSpeed RT-qPCR and RPA assays together with magnetic bead based automated or manual extraction methods delivered a specificity between 100% and 97.2% and a limit of detection of 10 or 1,000 genome copies per reaction, respectively and seem suitable as novel POCT (Paper II). Recently, a novel zoonotic VSBV-1, responsible for fatal encephalitis of three squirrel breeders, was detected. For further investigations of this new virus, methods for an in-vivo sampling approach of squirrels were established. They were useful to identify animals harboring this dangerous virus, and new sequence data could be obtained from the VSBV-1 positive animals. Until now, 3.5% of all investigated squirrels were VSBV-1 RNA positive and two subfamilies (Sciurinae and Callosciurinae) are affected. The pathogen occurs not only in Germany, but also squirrel holdings and zoological gardens in the Netherlands and Croatia were tested positive, indicating a serious human health threat of this virus (Paper III and IV). With the help of a metagenomic approach, astroviruses were detected to be associated to encephalitis in cattle and sheep. These viruses were detected in a cow in Germany (Paper V), and in brain samples from two sheep in the United Kingdom (Paper VI). In both cases, the sequences generated by high-throughput-sequencing (HTS) were confirmed by specific RT-qPCRs, which could be used for subsequent screening approaches. Together, methods for the detection of three different encephalitis viruses were developed, validated and applied for different sample material.