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Bertoldi A, Colazo Salbetti MB, Rodríguez G, Tenaglia M, Hernández G, Alfaro J, Riberi MI, Olivera NL, Pedranti M, Isa MB, Adamo MP. Human parvovirus B19 infection in a pregnant patient resulting in severe hydrops, foetal death and persistent infection. Access Microbiol 2022; 4:acmi000428. [DOI: 10.1099/acmi.0.000428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 09/01/2022] [Indexed: 11/06/2022] Open
Abstract
Human parvovirus B19 (B19V) is the aetiological agent of erythema infectiosum. Primary infection during pregnancy can be transmitted to the foetus and cause foetal abnormalities related to depletion of erythrocyte progenitor cells, including congenital anaemia, hydrops, and foetal death. In this paper we report the detection of B19V infection in a pregnant patient, which onset occurred without appreciable signs and symptoms until she developed inappropriate contractions for gestational age and fluid loss. B19V infection resulted in severe hydrops fetalis with a fatal course for the foetus, while persisted in the mother at least 12 months after foetal death. The objective of this report is to highlight the importance of optimizing B19V diagnosis through early suspicion and testing during pregnancy. Knowing the mother’s immune status before or at the beginning of gestation can contribute, together with early diagnosis, to improve the management of patients at risk.
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Affiliation(s)
| | - María Belén Colazo Salbetti
- Instituto de Virología “Dr. J. M. Vanella”, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Gonzalo Rodríguez
- Laboratorio de Hemoderivados, Universidad Nacional de Córdoba, Córdoba, Argentina
| | | | | | - Jimena Alfaro
- Clínica Universitaria Reina Fabiola, Córdoba, Argentina
| | | | | | - Mauro Pedranti
- Instituto de Virología “Dr. J. M. Vanella”, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - María Beatriz Isa
- Instituto de Virología “Dr. J. M. Vanella”, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Clínica Universitaria Reina Fabiola, Córdoba, Argentina
| | - Maria Pilar Adamo
- Instituto de Virología “Dr. J. M. Vanella”, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
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Sungkate S, Phongsamart W, Rungmaitree S, Lapphra K, Wittawatmongkol O, Pumsuwan V, Wiruchkul N, Assanasen S, Rongrungruang Y, Onlamoon N, Horthongkham N, Lermankul W, Kongstan N, Chokephaibulkit K. Human parvovirus B19 nosocomial outbreak in healthcare personnel in a paediatric ward at a national tertiary referral centre in Thailand. J Hosp Infect 2017; 96:163-167. [PMID: 28412176 DOI: 10.1016/j.jhin.2017.03.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 03/13/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Nosocomial outbreaks of parvovirus B19 (pB19) have been reported, but they rarely occur among healthcare personnel (HCP). Susceptibility among pregnant HCP was the major concern. METHODS An outbreak of pB19 among HCP is described in a paediatric ward with a cross-sectional serologic study in all HCP and patients exposed to the outbreak. Acute infection was diagnosed by polymerase chain reaction or positive anti-parvovirus B19 IgM. FINDINGS Among 48 HCP (three pregnant) and 22 patients included in the outbreak serologic study, 11 (23%) HCP and two (9%) patients had acute infection. Of these, six HCP and no patients were symptomatic. Clinical manifestations included itchy rash (100%) and joint pain following resolution of rash (67%), with median rash duration of four days. Forty percent of HCP and 50% of patients had positive anti-parvovirus IgG, indicating previously immune status. HCP with acute infection and HCP who were susceptible without infection were younger than HCP with previous immunity (mean age 32.2 vs 40.5 years, respectively; P = 0.003). The attack rate was 38% among HCP and 18% among patients who were susceptible, respectively. The outbreak ended within two weeks following strict droplet precaution and segregation of symptomatic HCP. CONCLUSION Parvovirus B19 infection may cause nosocomial outbreak with high attack rate among HCP. Outbreak control with droplet precaution was highly effective.
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Affiliation(s)
- S Sungkate
- Division of Infectious Diseases, Department of Paediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - W Phongsamart
- Division of Infectious Diseases, Department of Paediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - S Rungmaitree
- Division of Infectious Diseases, Department of Paediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - K Lapphra
- Division of Infectious Diseases, Department of Paediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - O Wittawatmongkol
- Division of Infectious Diseases, Department of Paediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - V Pumsuwan
- Centre for Nosocomial Infection Control, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - N Wiruchkul
- Centre for Nosocomial Infection Control, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - S Assanasen
- Centre for Nosocomial Infection Control, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Y Rongrungruang
- Centre for Nosocomial Infection Control, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - N Onlamoon
- Division of Instruments for Research, Office for Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - N Horthongkham
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - W Lermankul
- Division of Infectious Diseases, Department of Paediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - N Kongstan
- Division of Infectious Diseases, Department of Paediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - K Chokephaibulkit
- Division of Infectious Diseases, Department of Paediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
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Bandera AR, Arenal MM, Vorlicka K, Bravo-Burguilllos ER, Vega DM, Díaz-Arcaya CV. Acute Parvovirus B19 Infection in Adults: A Retrospective Study of 49 Cases. ACTAS DERMO-SIFILIOGRAFICAS 2015. [DOI: 10.1016/j.adengl.2014.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Rodríguez Bandera AI, Mayor Arenal M, Vorlicka K, Ruiz Bravo-Burguilllos E, Montero Vega D, Vidaurrázaga Díaz-Arcaya C. Acute parvovirus B19 infection in adults: a retrospective study of 49 cases. ACTAS DERMO-SIFILIOGRAFICAS 2014; 106:44-50. [PMID: 25109767 DOI: 10.1016/j.ad.2014.06.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 05/31/2014] [Accepted: 06/13/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Our aim was to describe the epidemiologic, clinical, and laboratory characteristics of acute parvovirus B19 infection in adults. MATERIAL AND METHODS This study describes all cases of acute parvovirus B19 infection in patients older than 18 years of age who were treated at Hospital Universitario La Paz in Madrid, Spain, in 2012. RESULTS Forty-nine adults were treated for acute parvovirus B19 infection. Most were young women who were infected in the spring or early summer. In over half the cases skin lesions were key diagnostic signs.We saw the full range of types of rash of purplish exanthems that were fairly generalized; vasculitis was relatively common (in >18%). Mild or moderate abnormalities in blood counts and indicators of liver dysfunction resolved spontaneously in all but 2 immunocompromised patients, who developed chronic anemia. CONCLUSIONS This is the largest case series of acute parvovirus B19 infection published to date. This infection should be suspected on observing signs of purplish skin rashes, no matter the location or pattern of distribution, or vasculitis, especially if accompanied by fever and joint pain in young women in the spring. Measures to avoid infection should be recommended to individuals at risk.
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Affiliation(s)
| | - M Mayor Arenal
- Servicio de Dermatología, Hospital Universitario La Paz, Madrid, España
| | - K Vorlicka
- Servicio de Dermatología, Hospital Universitario La Paz, Madrid, España
| | | | - D Montero Vega
- Servicio Microbiología, Hospital Universitario La Paz, Madrid, España
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Arbeitsbedingte Infektionen bei Mitarbeitern des Gesundheitswesens: Kinderkrankheiten. ZENTRALBLATT FUR ARBEITSMEDIZIN ARBEITSSCHUTZ UND ERGONOMIE 2014. [DOI: 10.1007/bf03344250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Iwalokun BA, Iwalokun SO, Hodonu SO. Seroprevalence of parvovirus B19 antibodies and evidence of viremia among Nigerian patients with sickle cell anemia. J Biomed Res 2013; 27:272-82. [PMID: 23885266 PMCID: PMC3721035 DOI: 10.7555/jbr.27.20120067] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 08/14/2012] [Accepted: 03/14/2013] [Indexed: 11/03/2022] Open
Abstract
Clinical, biochemical and molecular evidence for the sickle cell anemia (SCA) crisis in Nigerian patients arising from parvovirus b19 infection remains inadequate. This study determined the prevalence and correlates of anti-parvovirus b19 antibodies in a population of SCA patients and non-SCA healthy controls in Lagos, Nigeria. In this prospective cross-sectional study, we enrolled 73 confirmed SCA patients from 5 district hospitals in Lagos and 81 sex and age-matched non-SCA healthy controls. Serum sample from each study participant was screened for anti-parvovirus b19 by ELISA and PCR techniques. Standard biomedical assays were also done. Anti-parvovirus b19 IgM and IgG antibodies were detected in 22 (14.3%) and 97 (62.9%) of the 154 sera screened, 13 (17.8%) and 45 (61.6%) in SCA patients; 9 (11.1%) and 52 (64.2%) in non-SCA controls. The overall seronegativity rate was 19.5%. Parvovirus B19 DNA was found in 2 (11.1%) of the 18 IgM seropositive SCA serum samples screened. On the whole, parvovirus b19 infection was more commonly asymptomatic in non-SCA controls but caused significant elevation in liver enzymes in infected SCA patients (P < 0.05). The risk of acute parvovirus b19 infection increased 65 times during unsteady state among the SCA patients. Although no deaths of infected patients were recorded during the study, age below 12 years, hospitalization and overcrowded environment were risk factors for infection. We conclude that parvovirus b19 is common in SCA patients, incurring greater susceptibility to infections.
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Affiliation(s)
| | - Senapon Olusola Iwalokun
- Maternal and Child Health Unit, Iru/VI, Primary Health Centre (PHC), Lagos, Lagos 23401, Nigeria;
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Chen YC, Chen MY, Lu CY, Chang HH, Hung CC, Chen MY, Chen ML. Cluster of parvovirus infection among hospital staff working in coronary care units. J Formos Med Assoc 2011; 109:886-94. [PMID: 21195886 DOI: 10.1016/s0929-6646(10)60135-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2010] [Revised: 05/23/2010] [Accepted: 06/23/2010] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Parvovirus B19 is associated with erythema infectiosum in children or arthralgia and arthritis in adults. The virus is relatively conserved and nucleotide identity is expected in viruses that are epidemiologically related. Here, we describe the first cluster of parvovirus infection among hospital staff documented in Taiwan. METHODS Active surveillance was conducted in coronary care units (CCUs) at a 2200-bed teaching hospital for 1 month in 2007. A case defined clinically as occurring in a patient or staff in CCUs with new onset of fever or rash. Serum was tested for parvovirus B19 IgM and IgG by immunoblotting and DNA by nested polymerase chain reaction. When viremia was detected, nucleotide sequences were analyzed and compared with those of two clinical isolates. The attack rate was defined as the cumulative incidence of acute infection in CCU staff and patients during the study period. RESULTS Among 57 staff and 15 patients, five nurses met the clinical case definition. Three had acute infection as demonstrated by viral DNA and IgM. The attack rate was 5.3% for the staff and zero for patients. Seroprevalence rate was lower in staff than in patients (26.3%vs. 53.3%). The isolates collected from three cases were highly similar to a community isolate, and they varied with each other by 2-6 nucleotides. The isolate collected from a nurse was identical to that from her friend 3 weeks apart and was concordant with mutual transmission. A sequence with 45 nucleotide variations was identified from a staff member with chronic infection who was negative for IgM and had only weak IgG anti-VP1 reaction with immunoblotting. We did not find any patient as the source of infection. CONCLUSION We identified a cluster of parvovirus infection that was caused by three circulating strains which did not support the hypothesis of transmission of a single strain in CCUs.
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Affiliation(s)
- Yee-Chun Chen
- Department of Internal Medicine, National Taiwan University Hospital, Taiwan.
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Franssila R, Hedman K. Infection and musculoskeletal conditions: Viral causes of arthritis. Best Pract Res Clin Rheumatol 2007; 20:1139-57. [PMID: 17127201 DOI: 10.1016/j.berh.2006.08.007] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Several viruses cause postinfectious arthritis. The disease is a typical manifestation of arthritogenic alphaviruses, rubella virus and human parvovirus B19. In addition, arthritis is not uncommon after infection by HIV, cytomegalovirus, hepatitis B virus, hepatitis C virus, or Epstein-Barr virus (EBV). Also prolonged arthritis may result from viral infections, particularly with alphaviruses and human parvovirus B19. Viruses such as EBV and B19 may have significant roles in initiating chronic arthropathies, which in some cases may be indistinguishable from rheumatoid arthritis.
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Affiliation(s)
- Rauli Franssila
- Department of Virology, Haartman Institute, University of Helsinki and HUCH Laboratory Division, Haartmaninkatu 3, FI-00290 Helsinki, Finland.
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