Detection ofHuman parvovirus B19(HPVB19) in serum samples from fever-rash ill individuals during the rubella outbreak (2005) in Bulgaria

Abstract

The present study aimed to determine the involvement of the parvovirus B19 (HPVB19) as an etiological agent in individuals with fever-rash infections but not infected with rubella during the rubella outbreak (2005) in Bulgaria. A total of 194 serum samples with negative results for measles and rubella-specific IgM antibodies were tested in the National Reference Laboratory. The individuals aged 5–52 years (mean age 17.2 ± 10.15) were divided into four age groups: 5–14; 15–24; 25–34; and 35+ years old. Serological (indirect enzyme immunoassay – EIA) and molecular (extraction and detection of HPVB19-DNA) methods were used. A genotyping assay of the NS1-PCR product was proceeded with the MfeI restriction enzyme. Out of the total number of samples, 95 samples (48.97%) tested positive for HPVB19-IgM and 109 (56.18%) for HPVB19-DNA. The results from the genotyping assay revealed that genotype 1 (prototype B19) was dominant in 106 from 109 samples (97.25%), while genotype 3 (prototype V9) was detected in only 3 (2.75%). Subjects whose sera tested positive for IgM and had a positive PCR result formed a group that was most frequently linked (in 40% of cases) to acute infection. The highest prevalence was established in the group of the school-age children (5–14 years). The combined application of serological and molecular methods confirms the etiological role of HPVB19, and including virus genotyping, confirms the involvement of HPVB19 in the etiological palette of febrile rash diseases and provides a correct differential diagnostic approach.

Detection of human parvovirus B19 in serum samples from children under 5 years of age with rash–fever illnesses in the Democratic Republic of the Congo

“…Indeed, according to data from the Ministry of Public Health, several outbreaks of measles-like rashes have occurred over the last 5 years in Katanga. As B19V IgM antibodies and DNA were found in sera from all provinces of DRC, it can be confirmed that B19V has spread countrywide, and this supports the hypothesis that B19V has a worldwide distribution ( Rezaei et al, 2016 , Zhang et al, 2016 , Toshev et al, 2014 , Tolfvenstam et al, 2000 , Schwarz et al, 1989 ).…”

Insights into epidemiology of human parvovirus B19 and detection of an unusual genotype 2 variant, Bulgaria, 2004 to 2013

“…While the lowest yearly proportions of B19V IgM positives in the present study were detected during the 2009 to 2010 measles outbreak (6% and 13%), a high proportion of more than 47% was found towards the end of the 2005 to 2006 rubella outbreak. A recently published study based on a somewhat different patient cohort and only 194 samples collected early during the 2005 to 2006 rubella outbreak, found an even higher rate of IgM positivity of 48.97% [5]. The more similar clinical presentation of rubella and B19V infections, but also the increased B19V incidence reported from elsewhere in Europe in 2005 and 2006 [3,16] may explain the apparent positivity rate difference during the measles and rubella outbreaks.…”

“…In Bulgaria, as well as in most other countries, this infection is not a notifiable disease. However, the clinical presentation of B19V infection is sometimes mistakenly diagnosed as rubella or measles [3][4][5], which are both notifiable diseases in Bulgaria. An accurate diagnosis of fever/rash illness is necessary for case management and public health control activities [6], in particular in the context of the World Health Organization's goal to eliminate measles and rubella in the European Region [7,8].…”

Identification of human parvovirus B19 among measles and rubella suspected patients from Cuba

“…B19V is frequently reported in measles and rubella negative cases and in our study more than 10% of the patients were B19V IgM antibody positive without any seasonal or geographic pattern. The percentage of B19V positives among rash and fever patients varies widely (eg, 2.40% in a study from Brazil; 48.97% among measles and rubella negative patients from Bulgaria and depends among other factors on geographical region, measles and rubella control status and age groups tested. In the present study, positive cases were found in all age groups, but especially among children between 5 and 9 years and in adults above the age of 19 years.…”