Parvovirus infection (PVI) is an important but little-known problem in the Russian Federation. Its clinical manifestations are characterized by different clinical entities that require differential diagnosis, as with other viral infections, as well as non-communicable diseases and epidemiological significance of PVI determined the prevalence of the development of epidemic outbreaks, mainly in organized groups. Medical and social - with teratogenic virus, as well as the possibility of its transmission at gematransfuziyah. The main risk groups - pregnant women, patients hematological profile. In the absence of recording and reporting the incidence of people is impossible to establish the scale of the spread of parvovirus infection. Crucial in this respect are laboratory studies that reveal the prevalence of its laboratory markers.
РезюмеВ статье описан клинический случай атипичного тяжелого течения парвовирусной В19 инфекции, сходный по своим проявлениям с менингококковой инфекцией, при сочетанном инфицировании менингококком, гемофильной палочкой, вирусом гриппа А и другими бактериальными патогенами. У пациента, госпитализированного с острым респираторным заболеванием и токсикодермией, в течение 24 ч появились новые симптомы: головная боль, геморрагическая сыпь, снижение артериального давления до 80/50 мм рт. ст., лихорадка до 39,8°С. На основании симптомов был поставлен предварительный клинический диагноз: «Менингококковая инфекция, генерализованная форма -менингококцемия, тяжелое течение. Инфекционно-токсический шок 2 ст.». При лабораторном исследовании клинических образцов больного бактериологическими, серологическими и молекулярно-генетическими методами в ликворе, крови и мазках из зева и носа рост бактериальной микрофлоры не обнаружен. В мазке из носовой полости был выявлен генетический материал (ДНК и РНК) Neisseria meningitides, Haemophilus influenza и гриппа А/Н3N2. В то же время в ликворе и крови пациента была выделена ДНК парвовируса В19 в высокой вирусной нагрузке: Ct 21,1 и Ct 4,9 соответственно. У пациента были обнаружены не только IgG-, но и IgM-антитела к парвовирусу В19, что является подтверждением острой парвовирусной В19 инфекции. Выраженная аллергическая реакция подтверждалась высоким показателем общего IgE (1068 Ед/мл). Таким образом, мы описали нетипичный случай лабораторно подтвержденной парвовирусной B19 инфекции при наличии бактериально-вирусной смешанной инфекции и аллергической реакции у пациента.
Parvovirus B19 (PV B19) replicates predominantly in progenitor cells of human erythrocytes and is transmitted by an airborne, vertical through and through blood or infected tissues. At-risk are pregnant women, people with immunodeficiency of different nature and individuals who need blood transfusions or organ transplantation. The available data indicate a high risk of infection through transfusion of blood containing the DNA of parvovirus B19, with viral load 105 copies/ml and above (Hourfar M.K. et al., 2011). According to the requirements of national regulations, the production of therapeutic drugs from plasma assumes the use of raw materials, free from viruses or with minimal viral load (Filatova E.C. et al., 2011). In some foreign countries a study of donor blood for the presence of DNA PV B19 is required; in our country the need for such screening is discussed (Giburt E.B. et al., 2013). Due to the fact that parvovirus is resistant to the methods of blood products desinfection, it is especially important to assess the quality of donor blood. Objective: To investigate the prevalence of the two markers parvovirus infection (IgG and PV B19 DNA) in blood samples from one of the blood centers at St. Petersburg. Plasma samples from 100 blood donors from Military Medical Academy blood centre were tested by ELISA for the presence of IgG antibodies of parvovirus B19. Positive samples were tested by PCR for the DNA of parvovirus B19. ELISA test system recomWell Parvovirus B19 IgG (Microgen GmbH, Germany) and diagnostic kits of Federal State Institution of Science «Central research Institute for epidemiology» of Rospotrebnadzor (Moscow, Russia) which are approved for use in RF was used according to the manufacturers instructions. It was shown that 78 out of 100 donors aged 18 to 58 years had IgG-antibodies.76 positive blood plasma samples were investigated by PCR, with the 19 donors have found DNA of parvovirus B19 (25%). Viral load of one donor was 106 copies/ml. In this case, there is the high risk of infection for the recipient. Results obtained are consistent with literature data. Obviously, it is need to investigate donor blood for parvovirus B19 presence. Obvious that quantification of the DNA of parvovirus B19 in blood products is need.
Currently, along with the increasing need of medical organizations for blood preparations, algorithms for laboratory testing of blood donors are not available for all infections with hemo-contact mechanism of transmission. A representative example is infection caused by parvovirus В19. Purpose of the study. The article presents the results of the original study, the purpose of which was to study the prevalence of antibodies to parvovirus B19 and the activity of the circulation of this virus in socially important categories of the population. Material and methods. The materials of the study were blood samples from blood donors of Saint Petersburg, as well as parvovirus В19 sequences isolated from DNA-positive plasma samples. Results and discussion. According to the results of the laboratory examination, a high proportion of carriers of virus-specific IgG antibodies was found in studied group of donors, which confirms the previous infection of parvovirus B19 in them and illustrates the high prevalence of infection in this socially significant group. Based on the results of the blood preparations testing, the presence of parvovirus DNA В19 in a significant number of samples was determined by polymerase chain reaction method. This indicates an current parvovirus infection in the examined donors and points to a high epidemiological risk of the blood products obtained from them. Sequencing and phylogenetic analysis of a fragment of the VP1 gene demonstrated that the studied isolates belonged to А1 genotype and its subtype 1А2, which correlates with the genotypes of parvovirus В19 circulating in the European Union and Asia. In addition, two previously unknown В19 parvovirus isolates were isolated, the nucleotide sequences of which were deposited into the international GenBank database. Conclusion. Based on the results of the study, it is justified to include testing of blood samples for markers of В19 parvovirus infection in existing algorithms of laboratory examination of donors, which will ensure prevention of hemo-contact infection of blood recipients with parvovirus В19.
Background. In the Russian Federation the number of a parvovirus В19 infection cases has increased significantly with the introduction of rubella into the measles elimination program and laboratory examination of patients with maculopapular rash and fever. The aim of study was the examination of the distribution of the parvovirus В19 infection in the North-Western Federal District. Materials and methods. In 2014–2017, 1044 blood sera of patients with exanthema diseases from different territories of the North-Western Federal District have been investigated with «Anti-Parvovirus B19 ELISA IgM» kit (EUROIMMUN, Germany) to detect IgM antibody, and 733 blood sera of clinically healthy men and women 18 to 60 years old have been tested for IgG antibodies using the «Anti-Parvovirus B19 ELISA IgG» kit (EUROIMMUN, Germany). Results. Parvovirus В19 infection is contentiously detected in 10 of the 11 territories of the district. Typical is the winterspring seasonality; in terms of the age structure – prevalence of children 3–6 (25,3% of cases) and 7–14 (33,3% of cases) years old was detected. A high proportion of seropositivity was established among the examined donors from the higher educational institutions of Saint Petersburg (75,4–88,9%%). Low rate of seropositivity (56,7%) was detected among pregnant women. A high proportion of false negative results in the primary diagnosis of parvovirus infection has been revealed. Conclusion. Parvovirus В19 infection is widespread in the territories of the North-Western of the Russia, mainly among children. The results indicate the feasibility of conducting a laboratory examination of pregnant women who are contact for exanthemous diseases, for markers of parvovirus infection; on the importance of screening donor blood for PV B19 DNA with “culling” pools characterized by high viral load; on the need for differential laboratory diagnosis between rubella and parvovirus infection.
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