Parvovirus infection

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at August 4, 2016
StartDiseasesParvovirus infection

Parvovirus infection or Parvovirus B19 infection can cause fifth disease and is a type of viral infection caused by the parvovirus. Fifth disease is found frequently in younger children, and it is rarely seen in teenagers or adults.

Contents

Definition & Facts

The parvovirus is part of a family of DNA viruses that can cause infection in humans. Parvum means tiny in Latin, and the name literally translates to "small virus" from Latin to English. Only the B19 strain of the parvovirus infection can be a danger to people, and B19 can only be transmitted from human to human. There are strains that are especially contagious among dogs though these do not affect people.

Parvovirus B19 strain was discovered in 1974. It is a common pathogen and affects people around the world. Over 85% of elderly people have developed antibodies to the virus. Around half of all adults possess immunity against the parvovirus infection. Immunity is usually attributed to an unnoticed childhood case of the infection.

Parvovirus B19 infections usually present as either fifth disease in children, arthropathy in adults in which a person experiences joint pain, or fetal complications. Fifth disease is usually recognizable by a facial rash children tend to get when they are afflicted with it. This facial rash can resemble how the cheek looks after it has been slapped which is why fifth disease is sometimes called slapped-cheek syndrome. Fifth disease is also known as erythema infectiosum.

Symptoms & Complaints

The early symptoms of fifth disease in children consist of symptoms similar to many other illnesses and infections including the common cold. Nonetheless, they include nausea, abdominal cramping, painful headaches that do not subside, and fever.

Symptoms that follow include a bright red rash that starts to appear on the face after the initial symptoms begin to wane and wear off. Generally, the face is the focal point of the onset of the prominent rash, especially on the cheeks.

The rash will often spread to the arms and legs, torso, buttocks, and the upper thighs. The rash on the thighs and buttocks usually carries a more colorful pattern, and the rash will be lacy, pink and it may be slightly raised up off of the skin.

It is possible the rash will cause some physical irritation in the form of slightly raised and itchy skin similar to symptoms caused by an allergic reaction. This irritation can affect the soles of the feet in particular. When the rash appears it is usually an indication that the parvovirus is in its final stages.

Parvovirus infection can cause additional conditions other than fifth disease. It can cause severe joint pain and may mimic symptoms of rheumatoid arthritis among adults.

Parvovirus infections are especially dangerous for pregnant women and can lead to fetal death. If untreated, parvovirus B19 infection can cause hydrops fetalis in which fluid accumulates in the womb – a condition which is fatal in half of all cases. It may take six weeks between when the mother is infected with the parvovirus to when the fetus begins to develop symptoms. Parvovirus infection can also cause congenital anemia.

Causes

The most commonly affected group consists of children in elementary school. The virus spreads through mucus from the nose, saliva, and sputum. The infection is contagious even without a rash present. The groups of people most at risk for having the infection are people who work in schools such as teachers and daycare workers. Parvovirus infections are most common in the late winter and early spring.

Diagnosis & Tests

Medical history, family history, and symptom presentation will be assessed by the physician in rendering a diagnosis. A physical examination will occur in which the characteristic rash of fifth disease will be noted if present.

Blood tests may be taken to detect the presence of antibodies that the body's immune system generates specifically to fight the parvovirus. The enzyme-linked immunosorbent assay or ELISA is one such diagnostic exam. Polymerase chain reaction is another test that is used to detect the presence of parvovirus DNA and involves analysis of a patient's secretions.

For infected pregnant women, ultrasounds are crucial for detecting any fetal abnormalities that may arise such as hydrops.

Treatment & Therapy

Treatment for simple cases of a parvovirus infection is relatively straightforward for both children and adults. Bed rest and hydration will enable recovery for patients with healthy immune systems. This is true for children with fifth disease and adults with arthopathy caused by parvovirus infection. Joint problems almost always subside once the body has fought off the parvovirus infection.

However, treatment must be tailored to populations that are most at-risk for developing severe complications. Pregnant women are at a higher risk for complications because they could have serious bleeding, and they are in danger of becoming very anemic.

Patients with diseases compromising their immune systems like acquired immunodeficiency syndrome (HIV AIDS) are also at risk for severe anemia and may suffer complications from parvovirus. People with cancer are also at a high risk for developing complications.

These immunocompromised groups may require immunoglobulin therapy which can help fight off the infection and speed up recovery time. Other patients will need to be hospitalized in order to get blood transfusions. Blood transfusions are crucial for helping pregnant women recover and for improving fetal health.

Prevention & Prophylaxis

There is no vaccine to treat parvovirus yet, so the best way to prevent an infection is through practicing proper hygiene. Routinely washing hands throughout the day, after physical contact with others, before and after meals, and after use of the bathroom are good habits to form, and they will help prevent parvovirus infection.

Additionally, avoiding contact with others while sick, avoiding others who are sick, covering one's mouth while sneezing or coughing are all commonsense measures for preventing parvovirus infection and its spread.

People who are pregnant should have regular prenatal checkups and closely monitor the health of the fetus if they struggle with pre-existing anemia.