The Role of Parvovirus B19 in Aplastic Crisis and Erythema Infectiosum (Fifth Disease)

Abstract

In 1984, simultaneous outbreaks of aplastic crisis and erythema infectiosum occurred in northeastern Ohio. Sera were analyzed from 26 patients with aplastic crisis: 24 had IgM specific for parvovirus B19, five had B19-like particles by electron microscopy, and 13 had DNA from B19; no sera from 33 controls had evidence of recent infection with B19 (P less than .0001). DNA from B19 was also detected in specimens of throat gargle and urine from two patients with aplastic crisis. Sera from 36 of 51 children with erythema infectiosum had B19-specific IgM, compared with serum from one of 42 susceptible controls (P less than .0001). DNA from B19 was detected in sera from only two of 51 patients who had erythema infectiosum. The secondary attack rates among susceptible contacts decreased with age (overall total, 49.6%). Differential rates of asymptomatic infection were observed among black (68.8%) and white (20.0%) household members (P = .003). These were the first identified simultaneous outbreaks of aplastic crisis and erythema infectiosum. Their occurrence provided an opportunity to study the epidemiology and spectrum of B19 infection with geographically and temporally matched comparison groups; our results support the hypothesis that infection with parvovirus causes these two clinical entities.

Structure and Mapping of the DNA of Human Parvovirus B19

“…The group II genome type, for instance, was associated with not only a rash, but also purpura, aplasia and arthralgia. This conclusion is supported by the observation that various clinical manifestations of B 19 infection can occur in the same patient (Nunoue et al, 1987), in closely related family groups (Lefrere et al, 1985a), and in community-wide outbreaks of infection (Chorba et al, 1986). The different outcomes of B19 infection are more easily explained by the multiplication of the virus in genetically different hosts.…”

Parvovirus B19 outbreak on an adult ward

“…In most healthy individuals it gives rise to a mild and self limiting illness [6,7]. In some groups such as people with certain malignancies, chronic haematological disease or immunodeficiency, severe disease can occur [8][9][10][11][12][13][14]. Infection with B19 during pregnancy has been associated with hydrops fetalis and fetal desth [15,16].…”

Discordant Fetal Infection for Parvovirus B19 in a Dichorionic Twin Pregnancy

“…It has been estimated that 50% to 65% of reproductive age women have been exposed to parvovirus B19, as assessed by the presence of IgG antibodies (Cohen & Buckley, 1988;Valeur-Jensen et al, 1999). Maternal seroconversion during pregnancy is reported in 1 to 3% of nonimmune woman (Chorba et al, 1986). In this particular case, the pregnant woman contracted parvovirus B19 after exposure to her infected daughter.…”