Novel Cyclovirus in Human Cerebrospinal Fluid, Malawi, 2010–2011

Saskia L. Smits

, Ed E Zijlstra¹, Jaap J. van Hellemond, Claudia M.E. Schapendonk, Rogier Bodewes, Anita C. Schürch, Bart L. Haagmans, and Albert D.M.E. Osterhaus

Author affiliations: ViroClinics BioSciences BV, Rotterdam, the Netherlands (S.L. Smits, A.D.M.E. Osterhaus); Erasmus Medical Center, Rotterdam (S.L. Smits, J.J. van Hellemond; C.M.E. Schapendonk, R. Bodewes, A.C. Schürch, B.L. Haagmans, A.D.M. E. Osterhaus); College of Medicine, Blantyre, Malawi (E.E. Zijlstra)

Abstract

To identify unknown human viruses, we analyzed serum and cerebrospinal fluid samples from patients with unexplained paraplegia from Malawi by using viral metagenomics. A novel cyclovirus species was identified and subsequently found in 15% and 10% of serum and cerebrospinal fluid samples, respectively. These data expand our knowledge of cyclovirus diversity and tropism.

The list of diseases caused by viral pathogens is ever changing and growing (1). Breakthroughs in the field of metagenomics had far-reaching effects on the identification of emerging viral pathogens and on the recognition that an increasing number of diseases that were once attributed to unknown causes are actually caused by infectious agents (1). Paraplegia is an impairment of motor or sensory functions of the lower extremities. Although it can be caused by spinal cord injury, nontraumatic paraplegia also should be considered, particularly in a tropical environment; tuberculosis and schistosomiasis may play a role, but in many cases, no firm diagnosis can be made (2). In this study, cerebrospinal fluid (CSF) and serum samples were obtained from 58 patients from Malawi who had paraplegia of unknown etiology and were studied for the presence of known or unknown viruses by using a metagenomics approach.