Parvovirus B19 infection

Human parvovirus B19, discovered in 1974, is a single-stranded DNA virus which causes erythema infectiosum, arthralgia, aplastic crisis in patients with red cell defects, chronic anaemia in immunocompromised patients, and fetal hydrops. Seroprevalence in developed countries is 2-10% in children less than 5 years, 40-60% in adults more than 20 years, and 85% or more in those over 70 years. The virus may be transmitted by the respiratory route and by transfusion of infected blood and blood products. After an incubation period of six to eight days, viraemia occurs, during which reticulocyte numbers fall dramatically resulting in a temporary drop in haemoglobin of 1 g/dl in a normal person. Clearance of viraemia is dependent on development of specific antibody to the B19 structural proteins, VP1 and VP2. The red cell receptor for the virus is blood group P antigen. Diagnosis in immunocompetent persons depends on detection of specific IgM in serum. Diagnosis in immunocompromised persons depends on detection of B19 antigen or DNA in serum. There is no specific treatment for B19 infection; however, human normal immunoglobulin may be used as a source of specific antibody in chronically infected persons. A recombinant parvovirus B19 vaccine is under development.