Human parvovirus B19 surveillance in patients with rash and fever from Belarus

Abstract

Human parvovirus B19 (B19V) infection in immunocompetent patients usually has a mild clinical course, but during pregnancy it can cause serious and even fatal complications in the fetus. The most common clinical presentation of B19V infection is erythema infectiosum and in this case laboratory confirmation is required for differentiation from other exanthematous diseases. Measles and rubella negative sera collected in Belarus between 2005 and 2008 from 906 patients with a rash and fever were screened for B19V infection by ELISA. More than 35% of the samples (322/906) were positive for B19V. The proportion ranged from 10.1% in 2008 to 53.2% in 2006 when an outbreak took place in Minsk city. All B19V outbreaks and cluster cases occurred during the winter-spring period, but sporadic cases were recorded basically throughout the year. The majority of the cases (56.5%) occurred among the 2 till 10 year old children, and 27.3% of the cases were observed in adults between 19 and 53 years. All 104 B19V strains sequenced in the NS1/VP1u region belonged to genotype 1 with a maximal genetic distance of 1.75%. The two phylogenetic clusters reflected the geographic origins of the viruses within the country. Forty-two unique nucleotide mutations as compared to sequences downloaded from GenBank were found in the VP1u and NS1 regions; most of these changes were nonsynonymous. This report highlights the importance of B19V infection in patients with a rash and fever in Belarus.

Measles Virus Infection Among Vaccinated and Unvaccinated Children in Nigeria

“…However, the number of samples collected gives a picture of measles infections happening in these communities. The high prevalence of recent measles infection (62.4%) recorded in this study corroborates the fact that the burden of the disease in the country is still very high (9,13,20). Measles vaccination in Nigeria is part of the EPI, with the measles vaccine included in the routine vaccination campaigns given to children at 9 months of age.…”

“…It is not known from this study whether primary or secondary vaccine failure was the major cause, as there were no data available on the seroconversion status of the children after vaccination. Causes of primary vaccine failure could be failure in the cold-chain system, inadequate viral dose, or host immune factors such as persistence of maternal immunity (2,9). The nutritional status of the children as well as presence of other underlying diseases such as malaria and HIV, among others, could be responsible for secondary vaccine failure.…”

The effects of co-infection with human parvovirus B19 and Plasmodium falciparum on type and degree of anaemia in Ghanaian children

“…In patients with underlying haemolysis, acute B19V infection may lead to transient aplastic crisis, an abrupt and severe anaemia due to failure of red-cell production [29,30] . In addition, to a cessation of the erythroid production, other blood cell lineages can be affected leading to clinical manifestations such as thrombocytopenia, neutropenia or pancytopenia [31][32][33][34][35][36][37] . Anaemia may persist until the immune response clears the infection, then the red cell production resumes and eventually normalizes followed by lifelong immunity in most cases [38,39] .…”

“…In addition, some case studies have also reported of B19V induced severe anaemia following malaria infection and successful treatment with antimalarials [46][47][48][49][50] . Though it is primarily known to cause erythematous rash, foetal hydrops and other involvements in various haematological disorders, B19V is also involved in other conditions [34,[51][52][53][54][55][56][57] . B19V in many occasions have been reported as a bystander or contributor to many conditions such as hepatitis, myocarditis, arthritis among others [58][59][60][61][62][63][64][65][66][67] .…”

Viral exanthems

“…Coxsackie virus-A6 is increasingly recognized to cause HFMD with atypical presentations in children [2][3][4][5][6][22][23][24]. In addition to hand, foot and buttock involvement, rash may be present periorally, truncally or with a predilection for areas of active atopic dermatitis, termed 'eczema coxsackium'.…”