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PubMed1995

[Seroepidemiology of human parvovirus B19 using recombinant VP1 + VP2 particle antigen].

Antibody prevalence to B19 virus in Japan was previously reported with 1973 and 1984 serum collections. Since then we have had two big epidemics of erythema infectiosum in Japan: 1986-87 and 1991-92. In an attempt to estimate how much those epidemics have affected seroprevalence to B19 virus infection, we studied seroepidemiology in three separate areas using a newly developed ELISA system consisting of recombinant VP1 + VP2 particle antigen. Total of 900 sera obtained in 1993 from healthy individuals living in northern, central and southwest parts of Japan were assayed for the presence of anti B19 IgG antibody. In the first, the new assay system was compared with our conventional assay system in which native B19 virus particles were used as antigen. Of 220 serum samples tested, 212 (96.4%) gave same results in both assays. Remaining 8 samples which gave variable results were those of near cut off values. We concluded that this new ELISA system can be recommended for seroepidemiological use. Antibody prevalence rates were 10% (0-4 y), 54% (5-9 y), 59% (10-14 y), 46% (15-19 Y), 38% (20-29 y), 48% (30-39 y), 64% (40-49y) and 76% (50 y-). No gender difference was observed. Comparison of antibody prevalences in 1973, 1984 and 1993 suggested that approximately 10% (about 8 million people) of the total population under 40 years of age acquired immunity to B19 virus during one epidemic period.

Adolescent↗

PubMed2000

Acute glomerulonephritis after human parvovirus B19 infection.

We evaluated clinical and histological characteristics of four adult patients who presented with acute glomerulonephritic syndrome with serological confirmation of recent HPB19 infection. All patients had generalized edema with urinary abnormalities. Body weight gain ranged from 3 to 10 kg. Three of the patients had contact with erythema infectiosum simultaneously with or within 10 days before development of flu-like symptoms. Two patients had an erythematous rash, and one patient had lower-extremity purpura. Joint pain was present in three of the patients. All patients had proteinuria and hematuria. Renal functions were normal except in one patient who had a serum creatinine of 3.2 mg/dL. Three of the patients had hypocomplementemia. All renal biopsy specimens were characterized by glomerular leukocyte infiltration and endothelial cell swelling. Mesangiolysis was seen in three of the patients. C3 was deposited in a coarse granular pattern along the capillary walls in all cases. Electron microscopic examination showed marked expansion of the subendothelial space of glomerular capillaries in all patients. Subendothelial electron-dense deposits were present in all patients. Immunohistochemical analysis using monoclonal anti-HPB19 antibody showed that one of the four patients had positive staining in the glomeruli. DNA extracted from renal biopsy specimens contained HPB19 DNA, as shown by polymerase chain reaction (PCR) analysis in all patients. PCR amplification of the renal DNA generated a 104-bp product, which hybridized to an HPB19-specific probe. No control group subjects contained HPB19 DNA as determined by PCR. This circumstantial evidence indicates that HPB19 infection may be one of the causes of acute glomerulonephritis in normal individuals.

Acute Disease↗

PubMed2002

A pilot study on the seroprevalence of parvovirus B19 infection.

BACKGROUND & OBJECTIVES: Human parvovirus B 19 (PVB 19) causes aplastic crisis in children with congenital haemolytic anaemia, erythema infectiosum, abortion and stillbirth. Since data on PVB 19 prevalence is lacking in India, a pilot study was undertaken to estimate the prevalence of IgG antibody in children and adults. METHODS: The samples were obtained from children attending our hospital and from volunteer blood donors, majority of whom were from south India. They included 45 children aged 1-5 yr, 39 aged 6-10 yr, 42 aged 11-15 yr and 100 healthy blood donors > 15 yr of age. Sera were tested for the presence of antibody to PVB 19 using a commercial enzyme immuno assay (EIA). RESULTS: Of 226 samples tested, 113 (50%) were positive for PVB 19 IgG. The prevalence of antibody increased from 8.9 per cent at 1-5 yr to 70 per cent in those > 15 yr: the median age of infection was between 6 and 15 yr. Sex and domiciliary status did not have significant effect on the prevalence of antibody. The IgG antibody index increased significantly with age, suggesting repeated exposure to the virus. INTERPRETATION & CONCLUSION: This seroprevalence study indicates that large numbers of individuals show exposure to PVB 19 virus. The exposure as indicated by IgG positivity is seen to increase with age. The IgG negative individuals may be considered to be at risk of developing infections due to PVB 19.

Adolescent↗

PubMed1997

[Parvovirus B19 in the Czech Republic. Seroepidemiologic study].

Erythema infectiosum which is caused by parvovirus B 19 is notified in the Czech Republic similarly as some other viral exanthemas under the diagnosis "Other viral infections affecting the skin and mucosae, not listed elsewhere" (B08). Analysis of the epidemiological position in the Czech Republic in 1993-1995 was based on EPIDAT data, documentation of epidemic of 1993 in the Liberec district and serologically confirmed minor epidemics (1994, 1995). An increased number of cases (in particular in late winter and early spring) is observed in several years' (cca four-year) cycles and only in some districts. Children aged 3-10 years (88.2%) are affected predominantly. All the year round however sporadic cases affecting people of all age groups are notified. Concurrent illness of several family members (usually two) was confirmed by laboratory tests only in 9 of cca 200 investigated cases. The source of infection is usually not identified. The increase in the number of cases in a given locality rose rapidly after brief time intervals. The longest interval between two cases was 24 days. In families all affected members contracted the disease with 24 hours. According to the seroprevalence of the IgG parvovirus B 19 in different age groups the majority of cases in subadult and adult subjects is not diagnosed and notified. Seroprevalence of IgG antibodies of the parvovirus B 19 in subjects with arthropathies was 72.4%, in subjects with suspect borreliosis 69.9% an in the normal population cca 50%.

Adolescent↗

PubMed2005

Prolonged activation of virus-specific CD8+T cells after acute B19 infection.

BACKGROUND: Human parvovirus B19 (B19) is a ubiquitous and clinically significant pathogen, causing erythema infectiosum, arthropathy, transient aplastic crisis, and intrauterine fetal death. The phenotype of CD8+ T cells in acute B19 infection has not been studied previously. METHODS AND FINDINGS: The number and phenotype of B19-specific CD8+ T cell responses during and after acute adult infection was studied using HLA-peptide multimeric complexes. Surprisingly, these responses increased in magnitude over the first year post-infection despite resolution of clinical symptoms and control of viraemia, with T cell populations specific for individual epitopes comprising up to 4% of CD8+ T cells. B19-specific T cells developed and maintained an activated CD38+ phenotype, with strong expression of perforin and CD57 and downregulation of CD28 and CD27. These cells possessed strong effector function and intact proliferative capacity. Individuals tested many years after infection exhibited lower frequencies of B19-specific cytotoxic T lymphocytes, typically 0.05%-0.5% of CD8+ T cells, which were perforin, CD38, and CCR7 low. CONCLUSION: This is the first example to our knowledge of an "acute" human viral infection inducing a persistent activated CD8+ T cell response. The likely explanation--analogous to that for cytomegalovirus infection--is that this persistent response is due to low-level antigen exposure. CD8+ T cells may contribute to the long-term control of this significant pathogen and should be considered during vaccine development.

ADP-ribosyl Cyclase 1↗

PubMed2003

[The use of real-time polymerase chain reaction and enzyme immunoassay for the diagnosis of acute parvovirus B19 infections in immunosuppressed patients].

Human parvovirus B19 (PV-B19) infection may lead to very serious clinical situations such as transient aplastic crisis in patients with hemolytic anemia, thrombocytopenia, neutropenia and transient arthritis accompanied with erythema infectiosum, especially in immunosuppressed patients. Early diagnosis of PV-B19 infection is of critical importance especially in immunosuppressed patients since the necessary precautions can be undertaken accordingly. In this study, PV-B19 IgM and IgG antibodies and viral DNA have been searched by enzyme immunoassay (ELISA) and real-time polymerase chain reaction (PCR), respectively, in 50 PV-B19 suspected immunosuppressed patients. Viral IgM, IgG and DNA positivities were detected in 7 (14%), 20 (40%) and 7 (14%) of the patients, respectively. During the first week three patients were found DNA and IgM positive but IgG negative, while four patients were found positive for the viral DNA, IgM and IgGs. The DNA copy numbers were high in all of the patients during the first week, with a gradual decrease during a seven-week follow-up period. IgM antibodies have disappeared in the sixth week in three of the patients and at the end of the seventh week in four of the patients. Although the IgG antibodies were negative in three patients in the first week, they became positive in the second week and the titers gradually increased during the following weeks. According to the results of this study, it can be concluded that, in high risk groups such as immunosuppressed patients, in addition to ELISA, real-time PCR method would be helpful for the early diagnosis of PV-B19 infections.

Acute Disease↗

PubMed2002

Human parvovirus B19 infection in children: uncommon clinical presentations.

BACKGROUND: Human parvovirus B19 is responsible for a variety of clinical syndromes, such as erythema infectiosum, non-immune hydrops fetalis, transient aplastic anemia, and arthropathies. HPV is also suspected of playing a role in the pathogenesis of various chronic inflammatory and autoimmune diseases, such as systemic lupus erythematosus, rheumatoid arthritis, Kawasaki disease and multiple sclerosis. OBJECTIVES: To study the age distribution and clinical presentation of patients hospitalized for human parvovirus B19 infection. METHOD: We reviewed the case records of all pediatric patients with serologic evidence of HPV infection who were admitted during a 20 month period to a major community hospital. RESULTS: Of 128 children tested for HPV, 48 had evidence of acute infection based on the presence of immunoglobulin M antibodies; 8 patients who also had positive IgM for other viruses were excluded, thus 40 case records were studied. The mean age of the patients was 5.21 years, but 22 patients were under 4. The clinical presentations included 25 patients with fever, either recurrent or prolonged, accompanied in some by enlarged spleen, liver and lymph nodes, skin rash and arthropathy; the remaining patients were investigated for anemia, skin rash, joint complaints and hepatitis. In addition, HPV infection was documented in several well-defined clinical conditions, such as SLE, vasculitic skin lesions, acute lymphoblastic leukemia, pure red cell aplasia, and optic neuritis. CONCLUSIONS: In a group of 40 pediatric patients exhibiting anti-HPV IgM antibodies, a younger age and less common clinical presentations were observed, furthermore 5 patients had clinical syndromes in which the causative role of HPV infection was not clear.

Acute Disease↗

PubMed2005

Evaluation of a new LightCycler reverse transcription-polymerase chain reaction infectivity assay for detection of human parvovirus B19 in dry-heat inactivation studies.

BACKGROUND: Human parvovirus B19 (B19) is a widely distributed infectious agent, which causes a variety of illnesses including erythema infectiosum (fifth disease) especially in children, arthritis, aplastic crisis, and hydrops fetalis. B19 can be transmitted from asymptomatic blood donors to recipients of their blood components. Fifth disease has been reported in patients receiving red blood cells, platelets, solvent/detergent-treated plasma, and clotting factor concentrates. STUDY DESIGN AND METHODS: A new B19-specific Light Cycler (LC) reverse transcription-polymerase chain reaction (RT-PCR) infectivity assay was developed for quantitative analysis of the infectivity of B19 in virus validation studies. The cycling conditions and the primers of the new assay were designed to amplify spliced RNA forms but not precursor RNA or B19 genome. One 50 percent infectious dose, determined on UT7/Epo-S1 cells of low passage, equaled 3.74+/-0.1 log international units of B19 DNA. RESULTS: The efficiency of the dry-heat process (100 degrees C) on inactivation of B19 spiked and lyophilized with fibrinogen, a major component of the clotting factor concentrate and hemostatic dressing products, was investigated by use of B19-specific LC RT-PCR infectivity assay. At 1.3 to 1.7 percent residual moisture of fibrinogen, the infectivity of B19 was reduced dramatically by 3.3 to 5.1 log for 1 and 2 hours of dry-heat treatment, respectively. B19 infectivity was reduced 1.5, 2.8, and 3.8 log for 1, 2, and 3 hours of dry-heat treatment, respectively, at 0.5 to 0.7 percent residual moisture level. CONCLUSION: These findings suggest that level of residual moisture of lyophilized fibrinogen with B19 spike correlated with a different resistance of B19 to dry-heat treatment, and that low moisture may stabilize virus against heat.

Biological Assay↗

PubMed2000

Infection by human parvovirus B19: "gloves and socks" papular purpuric syndrome.

Human parvovirus B19 is the cause of erythema infectiosum a benign and self-limited infection, but sometimes the virus causes an acute and self-limiting dermatosis. It consists of a edema and erythema of the hands and feet in a gloves and sock distribution and is associated with oral lesions and fever. We report a case of a "gloves and socks" infection by human parvovirus B19.

Adult↗

PubMed1998

[Parvovirus B19 as a cause of acute liver symptoms in adults].

Parvovirus B19 (B19), also known as "erythema infectiosum", is a disease that occurs in smaller outbreaks during late winter and early summer; and in Denmark an epidemic occurs every three years. The symptoms vary from fever, fatigue and the characteristic maculopapoulous erythema to asymptomatic cases in 50% of the infected patients. Two-thirds of the Danish population have been infected. The virus has a broad spectrum of clinical manifestations ranging from erythema nodosum in children, arthralgia/arthritis (especially in adults), aplastic crisis in patients with haemolytic anaemia, chronic anaemia in immunocompromised patients, to hydrops foetalis following acute infection during pregnancy. In two adult females aged 41 and 35 years with persisting fatigue, malaise, transitory swelling and arthralgia we found elevated ALT and alkaline phosphatase (pt. 1), despite no serological evidence of hepatitis, cytomegalovirus (CMV), or Epstein-Barrvirus and no story of alcohol consumption or recent travelling outside Denmark. Ongoing B19 infection was diagnosed by ELISA and confirmed by B19 DNA PCR in case 2 and IgG avidity and epitope-type specificity in case 1, who was B19 DNA negative in three different samples. The concentrations of alkaline phosphatase and ALT returned to normal as the antibody response shifted from acute B19 infection to IgG positivity. In conclusion we suggest that a serological test and/or B19 DNA for B19 infection is a relevant test to undertake when screening patients for viral hepatitis especially during B19 epidemics and in exposed individuals.

Adult↗

PubMed1984

Human parvovirus infection and aplastic crisis in hereditary spherocytosis.

This report records an episode of parvovirus-induced bone-marrow aplasia in a child with hereditary spherocytosis and arising during a local outbreak of erythema infectiosum (fifth disease or 'slapped-cheek syndrome'). Inapparent infection was found in two haematologically normal family contacts.

Anemia, Aplastic↗

PubMed1986

[Parvovirus B 19].

Since 1981, many reports have contributed to establish that a human parvovirus (parvovirus B 19), which had been isolated only in asymptomatic blood donors, is the causative agent of transient but intense erythroblastopenia in patients with different types of chronic haemolytic anaemia. In vitro cultures of erythroid inhibitors revealed an inhibition by parvovirus B 19, abolished by convalescent serum. In healthy subjects without chronic haemolysis, first contact with parvovirus B 19 results in an inconstant influenza-like syndrome with transient erythroblastopenia which does not produce symptoms since the normal erythrocyte life span covers the effect of parvovirus B 19 on bone marrow. Parvovirus B 19 is also suspected to be the causative agent of erythema infectiosum (fifth disease) which occurs in children.

Anemia, Aplastic↗

PubMed1984

Naturally occurring T lymphocytotoxic antibody in viral and related skin diseases.

The naturally occurring T lymphocytotoxic antibodies in patients with viral and related skin diseases were investigated and compared with those of systemic lupus erythematosus (SLE). The incidences of T lymphocytotoxic antibodies in exanthema suspected of viral infection, infectious mononucleosis, rubella and pityriasis rosea were 28%, 44%, 8% and 28% respectively. Sera from patients with herpes zoster and erythema infectiosum did not show positivity. Incidence in SLE sera as positive control was 82%. The T lymphocytotoxic antibodies detected in skin diseases were similar in nature to those of SLE patients, but were transient and lower in titer than those of SLE.

Antibodies, Viral↗

PubMed1987

Human parvovirus infections.

Discovered by chance in 1974, the human serum parvovirus B19 is at present the only recognized, autonomous, pathogenic human parvovirus. For some years following its discovery, B19 was not associated with any defined clinical syndrome; although a high titre viraemia was often noted in infected individuals they were largely asymptomatic. In 1980 the causal association between B19 infection and aplastic crisis in chronic haemolytic anaemia began to emerge with the discovery of B19 as the agent responsible for aplastic crisis in sickle cell anaemia. This fulfilled the expectation of a disease of tissue comprising a large proportion of dividing cells, namely the erythropoietic elements of the bone marrow, anticipated in autonomous parvovirus infection where viral replication is confined to dividing cells. More recently, erythema infectiosum, an illness sharing many of the clinical features of rubella, has been found to be the common result of B19 infection, although a spectrum of disease is now emerging. Much effort is currently directed toward the elucidation of the effects of maternal B19 infection on the developing fetus.

Anemia, Hemolytic↗

PubMed1986

Parvovirus infections in childhood.

Human parvovirus (HPV) infections have been associated with several clinical syndromes. The virus is the etiologic agent of erythema infectiosum (fifth disease) and the primary cause of aplastic crises in children with sickle cell disease and other hemolytic anemias. Some individuals with an acute symmetric polyarthritis were found to have a recent HPV infection. Although two stillborn infants with proved HPV infections have been identified, the exact relationship among HPV, intrauterine infection, and subsequent fetal damage requires further research.

Anemia, Aplastic↗

PubMed1986

[Parvovirus B 19 infections].

We report the human parvovirus (HPV) infection cases diagnosed in 1984 and 1985 in the virological laboratory of C.N.T.S. Detection of viral antigen and total anti-HPV antibodies was performed by electroimmunodiffusion, and specific IgM by antibody-capture-radioimmunoassay. Seven viraemias were found in 38,730 sera sent for detection of hepatitis A and B markers. Twenty-two observations of aplastic crisis are described, with underlying haemolytic anaemias in 21 cases. HPV infection was serologically proven in 4 cases out of 22 rubeolelike illness, and, in 17 cases out of 17 erythema infectiosum (fifth disease). Four cases of vascular purpura (one of which was Schonlein-Henoch purpura) were studied, and HPV antigen was isolated in 2 cases. An observation of arthropathies in a young adult is described. Finally, 2 spontaneous abortions were simultaneous to an HPV infection. Our study allows us to underline the following points: HPV is the principal (but not exclusive) agent of the aplastic crisis in chronic haemolytic anaemias; these acute erythroblastopenias can reveal an unknown haemolytic anaemia, in particular in hereditary spherocytosis; the polymorphism of the clinical expression of HPV infection is important. Some viraemias are asymptomatic, while others are accompanied by vascular purpura, or atypic erythema; HPV has never been isolated in the fifth disease. Nonetheless bringing out of specific IgM and association of HPV infection linked manifestations in a same patient or in a same family shows its responsibility in the fifth disease; HPV responsibility in spontaneous abortions and fetal malformations remains to be demonstrated.

Antibodies, Viral↗

PubMed1987

Pruritus in parvovirus infection.

An outbreak of slapped cheek syndrome (erythema infectiosum) occurred in Chepstow between March and June 1986. About 50 children with the illness were seen in one general practice. During the same period five women in the practice developed arthritis associated with human parvovirus infection and four of them suffered marked pruritus. It is suggested that if pruritus is a feature in any patient with an acute onset arthritis, parvovirus infection should be considered as a possible cause.

Adolescent↗

PubMed1987

Infection with human parvovirus (B19), aplasia of the bone marrow and a rash in hereditary spherocytosis.

Infection with human parvovirus (HPV) B19 was diagnosed in persons with hereditary spherocytosis during an outbreak of erythema infectiosum. A 10-year-old boy had an aplastic crisis of the bone marrow and a maculopapular rash. His mother also had an aplastic crisis, fever, rash and a transiently acellular marrow. Another boy had an aplastic crisis, leucopenia and fever, but did not have a rash. Aplastic crisis and a rash have rarely before been observed together and attributed to infection with HPV.

Adult↗