A Cluster of Fatal Tick-borne Encephalitis Virus Infection in Organ Transplant Setting

Abstract

We demonstrated transmission of TBEV by transplantation of solid organs. In such a setting, TBEV infection may be fatal, probably due to pharmacological immunosuppression. Organ donors should be screened for TBEV when coming from or visiting endemic areas.

Two Cases of Severe Tick-Borne Encephalitis in Rituximab-Treated Patients in Germany: Implications for Diagnosis and Prevention

“…In addition, the lack of intrathecal neutralizing antibodies likely allows prolonged spreading of the virus between neurons, which is supported by the detection of TBEV RNA in the CSF of our patients. A recently observed cluster of lethal TBEV infections in patients after solid organ transplantation suggests that different forms of (iatrogenic) immunosuppression may represent a risk factor for more severe disease [11]. There is currently no specific antiviral treatment for TBE.…”

High-throughput sequencing for the aetiologic identification of viral encephalitis, meningoencephalitis, and meningitis. A narrative review and clinical appraisal

“…HTS was performed on CSF and brain specimens in five patients [26,29e32]. Positive results on both samples were obtained in a Cache Valley virus chronic meningoencephalitis case [30] and positive results on brain biopsies only were reported in two human astrovirus (HAstV)-VA1 and tick-borne encephalitis (TBEV) cases [29,33]. In one patient, HTS analysis did not identify a viral cause, but Balamuthia mandrillaris was identified in both CSF and brain biopsy [32].…”

“…Three novel viral species or strains were identified in CSF samples of patients with encephalitis (Table 1): human CSF-associated densovirus 1 (HuCSFDV1) [37]; cyclovirus Viet-Nam (CyCV-VN) [28]; and lymphocytic choriomeningitis virus (LCMV)-related arenavirus [26]. HTS analysis also identified viruses known to be responsible for CNS infections (n ¼ 11) and not screened or detected by routine assays (HSV-1, HSV-2, VZV, EpsteineBarr virus (EBV), TBEV, WNV, Cache Valley, Saint Louis encephalitis, Toscana, mumps, measles, and coxsackie A9 virus) [29,30,34,35,39,40,42,48,49] (Table 1).…”

“…The rapid decision to perform HTS, short HTS turnaround times, and the efficient interpretation of results were determinant for the management of these latter patients. Among immunocompromised patients, HTS contributed to the detection of viruses for which no assay was performed during conventional work-up: viruses known to cause CNS infections (TBEV, WNV, Cache Valley virus, Saint-Louis encephalitis virus, EBV) [29,30,39,40,42], viruses not known to be responsible for CNS infections (novel HAstV-VA1, HAstV-MLB1, human coronavirus OC43, mumps virus vaccine strain) [23e25, 31,33,41,43,47], and novel viruses (LCMV-related arenavirus) [26]. Focusing on novel HAstV, HTS brought new insights in our understanding of their association with CNS infections [22e24, 31,33,43].…”

Ryzyko przeniesienia czynników zakaźnych przez transfuzje w Polsce

“…W tym roku ukazała się pierwsza publikacja szczegółowo dokumentująca przeniesienie TBEV przez przeszczepienie narządów unaczynionych. Co istotne, przypadki te miały miejsce w Polsce [55]. U trzech pacjentów, którzy otrzymali narządy od jednego dawcy (2 otrzymało nerkę i 1 wątrobę), w okresie 17-49 dni po przeszczepieniu rozwinęło się zapalenie mózgu.…”