RESUMO
From April 2023 to May 2024, an unusual epidemic of parvovirus B19 (B19V) infections occurred in France. The number of B19V IgM-positive serologies was four times higher than in the previous epidemic in 2019. Clinical data from emergency networks corroborated this observation. Morbidity and mortality consequences were observed in children through all data sources. In adults, the increase was only observed in laboratory-confirmed data. Physicians and decisionmakers should be informed in order to better prevent, diagnose and manage at-risk patients.
Assuntos
Surtos de Doenças , Imunoglobulina M , Infecções por Parvoviridae , Parvovirus B19 Humano , Humanos , França/epidemiologia , Parvovirus B19 Humano/isolamento & purificação , Adulto , Feminino , Masculino , Criança , Infecções por Parvoviridae/epidemiologia , Infecções por Parvoviridae/diagnóstico , Imunoglobulina M/sangue , Adolescente , Pré-Escolar , Pessoa de Meia-Idade , Anticorpos Antivirais/sangue , Eritema Infeccioso/epidemiologia , Eritema Infeccioso/diagnóstico , Adulto Jovem , Lactente , IdosoRESUMO
We report an epidemic of parvovirus B19 infections in Denmark during the first quarter of 2024, with a peak incidence 3.5 times higher than during the most recent epidemic in 2017. In total, 20.1% (130/648) of laboratory-confirmed cases were pregnant. Severe adverse outcomes were observed among 12.3% (16/130) of pregnant people and included foetal anaemia, foetal hydrops and miscarriage. Parvovirus B19 infection is not systematically monitored, but a national laboratory-based surveillance system is currently being established in Denmark.
Assuntos
Infecções por Parvoviridae , Parvovirus B19 Humano , Complicações Infecciosas na Gravidez , Humanos , Feminino , Gravidez , Dinamarca/epidemiologia , Parvovirus B19 Humano/isolamento & purificação , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/virologia , Adulto , Incidência , Infecções por Parvoviridae/epidemiologia , Infecções por Parvoviridae/diagnóstico , Epidemias , Hidropisia Fetal/epidemiologia , Hidropisia Fetal/virologia , Índice de Gravidade de Doença , Adulto Jovem , Eritema Infeccioso/epidemiologia , Eritema Infeccioso/diagnóstico , Adolescente , Aborto Espontâneo/epidemiologia , Aborto Espontâneo/virologia , Vigilância da PopulaçãoRESUMO
Importance: Although the risk of parvovirus B19 infection during pregnancy and subsequent risk of adverse fetal outcome are low, understanding management practices is essential for proper treatment of fetuses with nonimmune hydrops fetalis. In addition, continued investigation into delivery management, breastfeeding recommendations, and congenital abnormalities associated with pregnancies complicated by parvovirus B19 infection is needed. Objective: This review describes the risks associated with parvovirus B19 infection during pregnancy and the management strategies for fetuses with vertically transmitted infections. Evidence Acquisition: Original articles were obtained from literature search in PubMed, Medline, and OVID; pertinent articles were reviewed. Results: Parvovirus B19 is a viral infection associated with negative pregnancy outcomes. Up to 50% of people of reproductive age are susceptible to the virus. The incidence of B19 in pregnancy is between 0.61% and 1.24%, and, overall, there is 30% risk of vertical transmission when infection is acquired during pregnancy. Although most pregnancies progress without negative outcomes, viral infection of the fetus may result in severe anemia, congestive heart failure, and hydrops fetalis. In addition, vertical transmission carries a 5% to 10% chance of fetal loss. In pregnancies affected by fetal B19 infection, Doppler examination of the middle cerebral artery peak systolic velocity should be initiated to surveil for fetal anemia. In the case of severe fetal anemia, standard fetal therapy involves an intrauterine transfusion of red blood cells with the goal of raising hematocrit levels to approximately 40% to 50% of total blood volume. One transfusion is usually sufficient, although continued surveillance may indicate the need for subsequent transfusions. There are fewer epidemiologic data concerning neonatal risks of congenital parvovirus, although case reports have shown that fetuses with severe anemia in utero may have persistent anemia, thrombocytopenia, and edema in the neonatal period. Conclusions and Relevance: Parvovirus B19 is a common virus; seropositivity in the geriatric population reportedly reaches 85%. Within the pregnant population, up to 50% of patients have not previously been exposed to the virus and consequently lack protective immunity. Concern for parvovirus B19 infection in pregnancy largely surrounds the consequences of vertical transmission of the virus to the fetus. Should vertical transmission occur, the overall risk of fetal loss is between 5% and 10%. Thus, understanding the incidence, risks, and management strategies of pregnancies complicated by parvovirus B19 is essential to optimizing care and outcomes. Further, there is currently a gap in evidence regarding delivery management, breastfeeding recommendations, and the risks of congenital abnormalities in pregnancies complicated by parvovirus B19. Additional investigations into optimal delivery management, feeding plans, and recommended neonatal surveillance are needed in this cohort of patients.
Assuntos
Hidropisia Fetal , Transmissão Vertical de Doenças Infecciosas , Infecções por Parvoviridae , Parvovirus B19 Humano , Complicações Infecciosas na Gravidez , Humanos , Gravidez , Feminino , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/virologia , Complicações Infecciosas na Gravidez/terapia , Hidropisia Fetal/epidemiologia , Hidropisia Fetal/etiologia , Hidropisia Fetal/virologia , Hidropisia Fetal/terapia , Infecções por Parvoviridae/epidemiologia , Infecções por Parvoviridae/diagnóstico , Eritema Infeccioso/epidemiologia , Eritema Infeccioso/diagnóstico , Eritema Infeccioso/terapia , Resultado da Gravidez/epidemiologiaRESUMO
Parvovirus B19V (B19V) infection during pregnancy can be complicated by potentially life-threatening fetal hydrops, which can be managed by intrauterine transfusion (IUT). This study investigates the long-term temporal patterns in the epidemiology of B19V and evaluates the impact on fetal hydrops, by combining data on B19V infections from the Dutch Sentinel Surveillance system in the period 1990 to 2023, Dutch blood banking data and hospital data on fetal hydrops. Using wavelet analysis, we identified annual epidemic cycles in the Netherlands in the period 1990-2019 and we identified superimposed multiannual cycles in the period 1990-2009. After 2009, no multiannual cycle could be identified, although the incidence fluctuated and correlates with number of IUT performed. As of 2020, weekly reports of B19V infection demonstrated a historically low incidence and B19V-DNA positive blood donors were nearly absent. From May 2020 to May 2023, no IUT for B19V-related hydrops was performed. In the spring of 2023, B19V infections re-emerged, reaching pre-pandemic epidemic levels. Due to the changes in B19V epidemiology over the last 30 years and the near-absence of B19V during the COVID-19 pandemic, the resulting low immunity levels may lead to rebound outbreaks. Alertness to severe complications such as fetal hydrops is warranted.
Assuntos
COVID-19 , Hidropisia Fetal , Parvovirus B19 Humano , Humanos , Países Baixos/epidemiologia , COVID-19/epidemiologia , COVID-19/virologia , Feminino , Gravidez , Hidropisia Fetal/epidemiologia , Hidropisia Fetal/virologia , Incidência , Infecções por Parvoviridae/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/virologia , SARS-CoV-2/isolamento & purificação , Pandemias , Eritema Infeccioso/epidemiologia , Transfusão de Sangue Intrauterina , AdultoRESUMO
This study aimed to estimate the serological status and dynamic changes in the prevalence of Parvovirus B19 (PVB19) antibodies within the general population residing in the northern part of the Republic of Serbia (Province of Vojvodina) during a 16-year period. Serum samples were analyzed for Human PVB19-specific IgM and IgG antibodies using enzyme-linked immunosorbent assay (ELISA). Throughout the study period, the overall seroprevalence was 49.51%. Approximately 10% of patients exhibited a serologic profile positive for PVB19 IgM antibodies. Notably, seroprevalence varied significantly, ranging from 9.12% in the pediatric cohort (ages 1-4 years) to 65.50% in the adult demographic (40-59 years old). Seroprevalence was higher (51.88%) among women compared to men (42.50%). Immunologically naive pregnant women in the age groups 26-36 and 36-45 years had 45% (OR = 0.55, 95% CI: 0.31-1.00) and 52% (OR = 0.48; 95% CI: 0.24-0.94) lower odds of having negative IgM and IgG compared to those in age group 16-25 years old. Improved knowledge of the epidemiology of PVB19 may assist clinicians in the differential diagnosis of PVB19 clinical manifestations. The PVB19 detection is particularly important for monitoring individuals in risk groups such as women of reproductive age, medical staff, patients with hematological disorders, and those with immunodeficiency.
Assuntos
Eritema Infeccioso , Infecções por Parvoviridae , Parvovirus B19 Humano , Masculino , Adulto , Humanos , Feminino , Criança , Gravidez , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Eritema Infeccioso/epidemiologia , Estudos Soroepidemiológicos , Iugoslávia , Sérvia/epidemiologia , Infecções por Parvoviridae/epidemiologia , Infecções por Parvoviridae/diagnóstico , Anticorpos Antivirais , Imunoglobulina G , Imunoglobulina MRESUMO
BACKGROUND: Parvovirus B19 (B19V) infection following pediatric hematopoietic cell transplantation (HCT) is a rare complication and available data is scarce. Therefore, we present the experience with B19V Infection in allogeneic pediatric HCT recipients at our transplant center together with a systematic review of the literature. METHODS: Pediatric HCT patients with Parvovirus B19 infection treated at the University Children's Hospital Münster between 1999 and 2021 were retrospectively identified and clinical data were analyzed. Additionally, a systematic MEDLINE search to identify relevant articles was performed. RESULTS: We identified three out of 445 patients (0.6%) with B19V infection post-transplantation. B19V infection occurred in combination with other complications like Graft-versus-Host disease, additional infections, or autoimmune-mediated hemolysis potentially triggered by B19V. In one patient these complications lead to a fatal outcome. The review of the literature showed considerable morbidity of B19V infection with the potential for life-threatening complications. Most patients were treated by red blood cell transfusion and intravenous immunoglobulins (IVIG) with a high succession rate. CONCLUSION: Symptomatic B19V infection following HCT remains a rare but potentially challenging complication. A causal antiviral therapy does not exist as well as general recommendations on dosage and duration of IVIG therapy. Despite this, most patients are treated successfully with these measures. Additionally, transmission via blood or stem cell products is also rare and no general recommendations on B19V screenings exist.
Assuntos
Eritema Infeccioso , Transplante de Células-Tronco Hematopoéticas , Infecções por Parvoviridae , Parvovirus B19 Humano , Humanos , Criança , Eritema Infeccioso/epidemiologia , Eritema Infeccioso/complicações , Estudos Retrospectivos , Imunoglobulinas Intravenosas/uso terapêutico , Infecções por Parvoviridae/epidemiologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , DNA ViralRESUMO
Acute Parvovirus B19 (PVB19) infection is responsible for erythema infectiosum in children and non-specific polyarthralgias in immunocompetent adults associated with skin lesions and rarer manifestations (hepatic, neurological, cardiac or nephrological). In immunocompromised patients, cytopenias are more frequent and in some cases, viremia persists and is responsible for PVB19 chronic infection. PVB19 is responsible for pure red cell aplasia during chronic hemolytic diseases. Acute PVB19 infection is a differential diagnosis of some autoimmune diseases and has been suspected to be a trigger for some autoimmune diseases because of its ability to promote the emergence of autoimmune markers. Mechanisms of molecular mimicry, induction of apoptosis and activation of enzymes have been demonstrated, explaining in part the production of autoantibodies during infection. However, the demonstration of a causal relationship in the triggering of autoimmune disease remains to be done. This review provides a synthesis of the PVB19 infection clinical data in adults with a particular focus on these links with autoimmunity.
Assuntos
Doenças Autoimunes , Eritema Infeccioso , Parvovirus B19 Humano , Adulto , Criança , Humanos , Eritema Infeccioso/complicações , Eritema Infeccioso/diagnóstico , Eritema Infeccioso/epidemiologia , Autoimunidade , Doenças Autoimunes/complicações , Autoanticorpos , Doença CrônicaRESUMO
The use of oral fluid (OF) samples for serological diagnosis of parvovirus B19 infection during outbreaks of erythema infectiosum had already been demonstrated, but the feasibility of using OF for the characterization of B19 genotypes circulating during outbreaks has not been described. The aim of this study was to assess the use of "in-house" PCR-based assays as a powerful tool for a rapid diagnosis and molecular characterization of B19 strains in OF samples during outbreaks. Paired serum and OF samples collected from anti-B19 IgM-positive patients, during two outbreaks of ertythema infectiosum (1999-2000 and 2004-2005), were tested by conventional (cPCR) and quantitative PCR (qPCR). qPCR was more sensitive than cPCR for detecting B19-DNA in both OF and serum. Overall, OF presented lower viral load (9.97 × 106 UI/mL) than serum (2.42 × 1010 UI/mL) and this difference was statistically significant. All OF samples obtained from patients in the age group < 14 years presented low viral load (< 104 IU/mL). No correlation was found between viral load and the number of days of onset of rash. Sequence analysis from PCR positive OF samples confirmed the circulation of subgenotype 1a (G1a) during these outbreaks. Our findings indicate that PCR-based assays may fail to detect B19-DNA in approximately 50% of OF compared to serum samples. Nevertheless, our study has shown for the first time that the genome sequence of the amplicon from non-invasive clinical sample is useful for molecular genotyping and may be a tool to clarify the genetic diversity of B19 strains circulating in distinct outbreaks.
Assuntos
Eritema Infeccioso , Parvovirus B19 Humano , Humanos , Adolescente , Eritema Infeccioso/epidemiologia , Eritema Infeccioso/diagnóstico , Parvovirus B19 Humano/genética , DNA Viral/genética , DNA Viral/análise , Surtos de Doenças , Reação em Cadeia da Polimerase em Tempo Real , Anticorpos AntiviraisRESUMO
BACKGROUND: There is a lack of epidemiological studies on the course and clinical characteristics of Parvovirus B19 (B19V) infections in kidney transplant (KT) recipients. This study was undertaken to provide recommendations for clinical B19V infection diagnosis and treatment. METHODS: Serum samples of KT recipients were regularly collected and tested for B19V-DNA copies, B19V-IgG/IgM levels, as well as hematological parameters and functions of kidney and liver. The course of B19V infection was described according to the results of serology and DNA testing, and the clinical and epidemiological data were combined for analysis. RESULTS: 75% B19V infections occurred within 2 weeks after KT(n = 9). The infection rate of B19V in KT recipients was high, namely 10.17% (n = 12). The number of 10 patients IgM antibodies against B19V (IgM+) and theDNA B19V (DNA+), whereas 2 patients were IgM negative (IgM-) but DNA+. The B19V infected KT patients showed several symptoms, including anemia (100%), reduction of platelets (8.33%), and damage to liver (75%) and kidney function (16.67%) Patients with progressive anemia in the first two weeks after KT, which combined with the decrease of reticulocytes, are more likely to have B19V infection. Associations of four main therapeutic risk factors for B19V infections in KT patients have been analyzed. B19V infection was associated with use of basiliximab (OR = 1.19; 95%- CI: 1.08-1.32; P = 0.003) and use of thymoglobulins (OR = 0.84; 95%-CI: 0.76-0.93; P = 0.003). CONCLUSIONS: Doctors should be alert to B19V infection, especially in the immunodeficient patients within the first two weeks after transplantation.
Assuntos
Anemia , Eritema Infeccioso , Transplante de Rim , Infecções por Parvoviridae , Parvovirus B19 Humano , Anticorpos Antivirais , China/epidemiologia , DNA Viral , Eritema Infeccioso/complicações , Eritema Infeccioso/diagnóstico , Eritema Infeccioso/epidemiologia , Hospitais de Ensino , Humanos , Imunoglobulina M , Infecções por Parvoviridae/complicações , Infecções por Parvoviridae/diagnóstico , Infecções por Parvoviridae/epidemiologia , Parvovirus B19 Humano/genética , Estudos ProspectivosRESUMO
Human parvovirus (B19V) is the causative agent of erythema infectiosum in children and is linked to a wide range of clinical manifestations. Studies related to B19V prevalence in the Middle East and North Africa (MENA) region and other parts of Asia are very scarce. The objectives of this study were to estimate the seroprevalence (anti-B19V IgM and IgG), the viremia rate (B19V DNA), and the circulating genotypes of B19V among blood donors in Qatar. METHODS: Donors' blood samples (n = 5026) from different nationalities, mainly from the MENA region and South East Asia, were collected from 2014-2016. Samples were tested for the B19V DNA using RT-PCR. Furthermore, 1000 selected samples were tested to determine the seroprevalence of B19V antibodies using enzyme-linked immunosorbent assay (ELISA). Genotyping was performed on 65 DNA positive samples by sequencing of nested PCR fragments (NS1-VP1u region, 927 nt). RESULTS: Only 1.4% (70/5026) of the samples had detectible B19V DNA in their blood. B19V DNA prevalence statistically decreased with age (p = 0.03). Anti-B19V IgG was detected in 60.3% (561/930) of the tested samples, while only 2.1% (20/930) were IgM-positive and 1.2% (11/930) were both IgM- and IgG-positive. B19V genotyping showed a predominance of Genotype 1 (100%). Sequence analysis of the NS1-VP1u region revealed 139 mutation sites, some of which were amino acid substitutions. CONCLUSION: Our results indicated a relatively high seroprevalence of B19V in Qatar. Most importantly, B19 DNA was detected among Qatari and non-Qatari blood donors. Therefore, blood banks in Qatar might need to consider screening for B19V, especially when transfusion is intended for high-risk populations, including immunocompromised patients.
Assuntos
Anticorpos Antivirais/sangue , Doadores de Sangue , Etnicidade/estatística & dados numéricos , Infecções por Parvoviridae/epidemiologia , Parvovirus B19 Humano/genética , Filogenia , Adulto , Idoso , Idoso de 80 Anos ou mais , Doadores de Sangue/estatística & dados numéricos , DNA Viral/sangue , Eritema Infeccioso/epidemiologia , Eritema Infeccioso/virologia , Feminino , Genótipo , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Masculino , Pessoa de Meia-Idade , Infecções por Parvoviridae/sangue , Infecções por Parvoviridae/virologia , Parvovirus B19 Humano/classificação , Parvovirus B19 Humano/isolamento & purificação , Prevalência , Catar , Estudos Soroepidemiológicos , Viremia/epidemiologia , Adulto JovemRESUMO
Routine monitoring of parvovirus B19 (B19V) the first 6 months posttransplantation was performed in 241 seronegative solid organ transplant (SOT) recipients. Incidence rates during the first month and the second to sixth months posttransplantation were 1.2 (95% confidence interval [CI], .33-3.2) and 0.21 (95% CI, .06-.57) per 100 recipients per month, respectively. Of the 6 SOT recipients with positive B19V polymerase chain reaction, 3 (50%) were admitted to hospital and 2 (33%) were treated with intravenous immunoglobulin. Thus, routine monitoring of B19V in seronegative SOT recipients may not be necessary. Targeted screening 1 month posttransplantation and screening upon clinical suspicion could be an alternative strategy.
Assuntos
Hospedeiro Imunocomprometido , Transplante de Órgãos , Infecções por Parvoviridae/complicações , Infecções por Parvoviridae/epidemiologia , Parvovirus B19 Humano/isolamento & purificação , Adulto , Estudos de Coortes , DNA Viral/sangue , Eritema Infeccioso/complicações , Eritema Infeccioso/diagnóstico , Eritema Infeccioso/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Transplante de Órgãos/efeitos adversos , Infecções por Parvoviridae/diagnóstico , Parvovirus B19 Humano/genética , Reação em Cadeia da Polimerase , Estudos Prospectivos , Análise de Sequência de DNA , TransplantesRESUMO
Childcare providers are overwhelmingly women of childbearing age. Occupational risks in this sector include exposure to biological (infectious) or physical (standing, carrying loads) hazards, many of which are associated with adverse pregnancy outcomes such as children with congenital infections, low birth weight or prematurity. Here, the authors examined literature on pregnancy outcomes and infectious hazards related to employment in daycare settings. Overall, 33 original studies (10 reporting pregnancy issues, 23 focusing on infectious risks) published in 1980-2018 were retained following a Medline search. Pregnancy issues in daycare workers have rarely been studied, and inconsistent risks of spontaneous abortion, congenital malformations and fetal growth retardation have been reported. Literature pertaining to infectious risks in daycare settings is extensive. The risk of a primary cytomegalovirus infection during pregnancy was increased for daycare workers caring for >6 children and younger children, changing diapers ≥3 days/week, not wearing gloves when changing diapers, and having employment in daycare for ≤2 years. Personal factors (nulliparity, ethnicity) were also independent risk factors. Parvovirus B19 (B19V) infections appear to be related to employment in daycare, but also to having one's own children and an increased number of siblings. Consequently, the risk of a primary B19V infection during an outbreak is of most concern among younger nulliparous workers caring for large numbers of young infected children. Since the main occupational hazard is viral infection, feasible prevention strategies include improving workers' awareness, serological monitoring during pregnancy, educating on appropriate preventive measures, and ensuring age-appropriate immunization of children and staff in childcare facilities. Int J Occup Med Environ Health. 2020;33(6):733-56.
Assuntos
Creches , Exposição Ocupacional/prevenção & controle , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/prevenção & controle , Pré-Escolar , Infecções por Citomegalovirus/epidemiologia , Infecções por Citomegalovirus/prevenção & controle , Eritema Infeccioso/epidemiologia , Eritema Infeccioso/prevenção & controle , Feminino , Humanos , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/estatística & dados numéricos , Gravidez , Complicações Infecciosas na Gravidez/etiologia , Resultado da Gravidez , Prevenção Primária , Fatores de RiscoRESUMO
Parvovirus B19 (B19V) occurs globally and can cause severe anaemia. The role of co-infections with Plasmodium falciparum (P. falciparum) has been controversially discussed. The study aimed to determine prevalence and severity of B19V infection, and the effect of co-infections on the risk for anaemia. Between November 2013 and April 2015 a total of 1186 hospital visits of children with fever admitted to a hospital in Ghana were recorded. Malaria, B19V and additional diagnostics for fever causes were performed. Recent B19V infection was defined as PCR and/or IgM positivity. Risk factors for a B19V infection and for anaemia were analysed. The prevalence of anaemia was compared between children with/without B19V infection, stratified for the presence of malaria. B19V IgM/PCR was positive in 6.4% (n = 76; 40 IgM + , 30 PCR + , 6 IgM + and PCR +). Among the B19V cases 60.5% had a simultaneous P. falciparum infection. B19V IgM positivity but not PCR positivity was associated with moderate-severe anaemia (OR = 2.6; 95%-CI: 1.3-5.3; P < 0.01 vs. OR = 0.9; 95%-CI: 0.4-1.8; P = 0.70). P. falciparum and IgM positive B19V infection were independent risk factors for anaemia with no evidence of effect modification. Our data show a significant association between B19V infection, defined as IgM but not PCR positivity, and moderate-severe anaemia. A multiplicative effect of B19V and P. falciparum infection was not found.
Assuntos
Eritema Infeccioso/epidemiologia , Febre/epidemiologia , Malária Falciparum/epidemiologia , Anemia , Criança , Pré-Escolar , Comorbidade , Estudos Transversais , Eritema Infeccioso/diagnóstico , Feminino , Gana , Humanos , Lactente , Masculino , Parvovirus B19 Humano , Prevalência , Fatores de Risco , Índice de Gravidade de DoençaRESUMO
BACKGROUND: Despite high overall population vaccine coverage, identified clusters of persons refraining from vaccination interfere with pursued measles elimination. Clinical diagnosis of measles is often obvious due to its typical rash. Yet, febrile rashes may occur during many viral infections. Misdiagnosis of a specific primary viral infection may have severe consequences, particularly in immunocompromised subjects or pregnant women. To our knowledge, this case presentation is the first description of a measles and parvovirus B19 coinfection outbreak. Analysis of this outbreak underlines rash diagnosis difficulties and potential serology interpretation pitfalls. This case report is helpful for the clinicians in the context of measles re-emergence and proposes several methods to improve the diagnosis approach. CASE PRESENTATION: We investigated an outbreak of rash in 6 out of 8 Traveler family members presenting to Rennes University Hospital (West of France). Anti-B19V and measles IgM/IgG antibodies were measured and detection of Parvovirus B19 and measles virus genomes were done on blood and/or respiratory samples. Virological investigations finally documented 6 cases of parvovirus B19 infections, including 4 associated with measles. Interestingly, in the four coinfection cases, the rash was typical of B19V primary infection for the two children but typical of measles for the two adults. Clinical diagnosis of rash may be misleading and thorough virological investigations may be required to avoid misdiagnosis. CONCLUSIONS: This investigation first reports an intra-familial outbreak of MeV/B19V coinfections highlighting the high transmissibility of both viruses and the diagnostic challenges of dual rash-associated infections. This report also underlines the potential deleterious consequences of failure to identify measles cases, especially in a community with low vaccination coverage.
Assuntos
Eritema Infeccioso/etiologia , Exantema/virologia , Sarampo/etiologia , Adulto , Criança , Pré-Escolar , Coinfecção/epidemiologia , Surtos de Doenças , Eritema Infeccioso/epidemiologia , Família , Feminino , Febre/virologia , França/epidemiologia , Humanos , Masculino , Sarampo/epidemiologia , Parvovirus B19 Humano/patogenicidade , Recusa de Vacinação , Adulto JovemRESUMO
OBJECTIVE: In the multicentre Haemoglobinopathy Blood Surveillance Project, to evaluate the seroprevalence of parvovirus B19 and DNA viral load in sickle cell disease (SCD). BACKGROUND: Although the epidemiology of parvovirus B19 seropositivity in SCD has been well documented, there are few studies that have assessed possible persistent parvovirus DNAemia and associated risk factors including blood transfusion. METHODS: A qualitative analysis of parvovirus B19 serology using ELISA and quantitative parvovirus B19 DNA by RT-PCR was performed in patients with SCD. RESULTS: Of 322 patients, 113 (35%) were parvovirus IgG positive and 119 (37%) were IgM positive at enrolment. The prevalence of IgG positivity increased with age. 71/322 (22%) were parvovirus DNA positive at enrolment with a mean viral load of 15 227 ± 55 227 SD. (range 72-329 238 IU/mL). Patients who were positive for parvovirus B19 DNA received a significantly higher red blood cell transfusion volume in the prior year compared to patients who were negative (mean RBC volume = 8310 mL vs 5435 mL, respectively; P = .0073). Seventy-seven patients had follow-up testing approximately 1 year after enrolment and 11/28 (39%) patients had persistently positive IgM. CONCLUSION: Further studies are needed to better understand the natural history of parvovirus B19 infection in SCD especially in relation to RBC transfusion as a risk factor, as well as disease outcome and severity.
Assuntos
Anemia Falciforme , Anticorpos Antivirais/sangue , DNA Viral/sangue , Eritema Infeccioso , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Parvovirus B19 Humano/metabolismo , Adolescente , Adulto , Anemia Falciforme/sangue , Anemia Falciforme/epidemiologia , Anemia Falciforme/terapia , Anemia Falciforme/virologia , Centers for Disease Control and Prevention, U.S. , Criança , Pré-Escolar , Eritema Infeccioso/sangue , Eritema Infeccioso/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Fatores de Risco , Estados UnidosRESUMO
INTRODUCTION: Parvovirus B19 (PVB19) infection has a high incidence and worldwide distribution. It has a broad clinical spectrum, with skin, joint and haematological manifestations being the most common. The objective of this study was to determine the epidemiology and clinical-analytical manifestations of acute PVB19 infection. PATIENTS AND METHODS: A retrospective study of patients with a positive IgM serology for PVB19 (10 years). Forty-six patients were included and their demographic, clinical and analytical characteristics were analyzed. RESULTS: Primary infection was most prevalent in women (ratio 2.2:1) aged 41 (mean age). Joint involvement was the most common manifestation (65%). Skin abnormalities were observed in more than half of patients (24 cases): rash (28%), megalerythema (9%), "gloves and socks" involvement (6.5%), periflexural rash (4%) and oedema (4%). Anaemia was the main haematological alteration (35%). The symptoms were self-limiting and resolved in 1-2 weeks in most patients. CONCLUSIONS: Although there is a variable clinical spectrum, polyarthralgias and generalized maculopapular rash with fever and anaemia are the typical and most frequent manifestations of primary infection by PVB19 and are usually self-limiting.
Assuntos
Eritema Infeccioso , Exantema , Infecções por Parvoviridae , Parvovirus B19 Humano , Adulto , Eritema Infeccioso/diagnóstico , Eritema Infeccioso/epidemiologia , Exantema/epidemiologia , Exantema/etiologia , Feminino , Humanos , Infecções por Parvoviridae/diagnóstico , Infecções por Parvoviridae/epidemiologia , Estudos Retrospectivos , PeleRESUMO
OBJECTIVE: Blood-derived products from patient with hemophilia treated by factor VIII concentrates are potential sources of transfusion-transmitted infections, including human immunodeficiency virus, hepatitis, human pegivirus-1 (HPgV-1), B19 virus, and also human hepegivirus-1 (HHpgV-1). In the current study, we investigated the impact of blood transfusion on the prevalence of HHpgV-1, HPgV-1, and B19 virus in plasma of Iranian patient with hemophilia after direct-acting antiviral treatment of hepatitis C virus (HCV) infections for the first time. MATERIALS AND METHODS: A total of 170 patients with hemophilia who received direct-acting antivirals were enrolled in this study. Among them, 92 patients had a history of blood transfusion. The presence of HHpgV-1, HPgV-1, and B19 virus was detected by nested polymerase chain reaction analysis using the conserved primers. The plasmids harboring 5'-UTR and NS3 were used as positive controls for HPgV-1 and HHpgV-1, respectively. RESULTS: Our data identified 3 individuals with HHpgV-1 viremia (1.76%), 11 individuals with HPgV-1 viremia (6.47%), and 33 individuals with B19 viremia (19.4%). All patients were negative for hepatitis B virus, human immunodeficiency virus, and HCV infections. These findings indicated lower transmissibility or higher rates of virus clearance for HHpgV-1, HPgV-1, and B19 virus as compared with other bloodborne human flaviviruses such as HCV. However, the prevalence of B19 virus was significantly higher than the other 2 viruses. CONCLUSION: In general, these findings showed that the history of blood transfusion could increase the risk of viral transmission of bloodborne viruses among patient with hemophilia.
Assuntos
Transfusão de Sangue , DNA Viral/sangue , Eritema Infeccioso/sangue , Hemofilia A/sangue , Hepacivirus/metabolismo , Hepatite C/sangue , Parvovirus B19 Humano/metabolismo , Adolescente , Adulto , Criança , Pré-Escolar , Estudos Transversais , Eritema Infeccioso/epidemiologia , Eritema Infeccioso/etiologia , Feminino , Hemofilia A/epidemiologia , Hemofilia A/terapia , Hemofilia A/virologia , Hepatite C/epidemiologia , Hepatite C/terapia , Hepatite C/virologia , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , PrevalênciaRESUMO
OBJECTIVE: Infection by Primate erythroparvovirus 1, generally known Parvovirus B19, is highly prevalent worldwide. Although infection by this virus will not be clinically problematic in most cases, new infections during pregnancy could result in serious repercussions in the fetus. Serologic and PCR-based methods are among the available approaches for diagnosis of Parvovirus B19 infection. In this regard, the present study is aimed to investigate the frequency of Parvovirus B19 infection by these two techniques in pregnant women of Zanjan. MATERIALS AND METHODS: In this cross sectional-descriptive study, 110 pregnant women referring to Mousavi hospital in Zanjan during one year were evaluated in terms of serologic and Real-Time PCR test results in search for Parvovirus B19 infection. The rate of positive IgG and IgM were determined in women and the Real-Time PCR results were reported. RESULTS: Overall, 18.2% of participants were above 35 years old and 4.5% of them were younger than 18 years old. 41 (44.1%) and 2 (1.8%) cases had positive anti-Parvovirus B19 IgG and IgM, respectively. Real-Time PCR results were negative in all the studied samples. CONCLUSION: Based on the findings of this study, prevalence of acute Parvovirus B19 infection was 0 and 2% based on Real-Time PCR and IgM tests, respectively. About 40% of pregnant women had experienced infection with this virus before.
Assuntos
Eritema Infeccioso , Doenças dos Genitais Femininos , Parvovirus B19 Humano , Complicações Infecciosas na Gravidez , Adulto , Anticorpos Antivirais/sangue , Eritema Infeccioso/diagnóstico , Eritema Infeccioso/epidemiologia , Feminino , Doenças dos Genitais Femininos/epidemiologia , Doenças dos Genitais Femininos/virologia , Ginecologia/estatística & dados numéricos , Humanos , Irã (Geográfico)/epidemiologia , Obstetrícia/estatística & dados numéricos , Parvovirus B19 Humano/genética , Parvovirus B19 Humano/imunologia , Parvovirus B19 Humano/isolamento & purificação , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/virologia , Prevalência , Testes Sorológicos/métodos , Testes Sorológicos/estatística & dados numéricosRESUMO
BACKGROUND: Human parvovirus B19 (PVB19) is a cosmopolitan DNA virus transmissible parenterally by blood transfusion. Therefore, the risk of transmission through asymptomatic blood donors should be considered and appropriately managed worldwide. PVB19 screening of blood and blood products for transfusion is not done routinely in the Democratic Republic of Congo (DRC). The main objective of this study was to determine the seroprevalence of PVB19 infection in healthy eligible blood donors in Kinshasa, capital of the DRC, located in the western part of the DRC, and the association of infection with the sociodemographic characteristics of blood donors. MATERIALS AND METHODS: A total of 360 whole blood donors who attended the National Center of Blood Transfusion were examined for anti-PVB19 IgG and IgM antibodies by using enzyme-linked immunosorbent assay kits. Sociodemographic information was collected on the blood donors. All statistical analyses were performed with SPSS 21. RESULTS: Among the study group, 289 men and 52 women were infected with PVB19. The mean age was 32.7 ± 9.8 years, 48.6% of donors were positive only for PVB19 IgG antibodies while 40.8% were positive for both IgG and IgM antibodies. In addition, 5.3% were positive only for PVB19 IgM antibodies and so were considered as a potential group of PVB19 transfusion-transmission. PVB19 seropositivity was significantly associated with sex, with a higher prevalence in men. In multivariate analysis, male sex and Tshangu district have emerged as major factors associated to PVB19 seropositivity. CONCLUSIONS: This research showed that recipients of blood and blood products in Kinshasa are at a high risk (5.3%) of transfusion-transmitted PVB19 infection. Therefore, the implementation of PVB19 nucleic acid testing assays capable of detecting all PVB19 genotypes and discard donations with high titer PVB19 DNA for blood products seems to be necessary.
Assuntos
Anticorpos Antivirais/sangue , Eritema Infeccioso/epidemiologia , Eritema Infeccioso/imunologia , Parvovirus B19 Humano/imunologia , Adolescente , Adulto , Doadores de Sangue , Estudos Transversais , República Democrática do Congo/epidemiologia , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Masculino , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Adulto JovemRESUMO
Diagnosis and epidemiological analysis of human parvovirus B19 (hB19V) infections are essential for disease management in severely ill patients. This study aimed to evaluate the performance of an optimized NS1-VP1u nested PCR for detection and sequencing of viruses in clinical samples using 224 clinical and five reference samples. PCR sensitivity, specificity, and positive and negative predictive values were perfect (100%). While phylogenetic analysis of a 615 bp-long fragment demonstrated that the viruses in all of the samples belonged to genotype 1, this study confirmed that this optimized PCR could detect all known hB19V with high performance.