Pillay D, Patou G, Hurt S, Kibbler C C, Griffiths P D
Division of Communicable Diseases, Royal Free Hospital and School of Medicine, London, UK.
Lancet. 1992 Jan 11;339(8785):107-9. doi: 10.1016/0140-6736(92)91009-w.
Parvovirus B19 infection can cause severe complications in pregnant women, individuals with haemolytic anaemia, and those who are immunocompromised. In a hospital outbreak of this infection, a balance should be struck between protection of these individuals and the maintenance of medical services. The index case of an outbreak of parvovirus B19 infection among staff and patients of a paediatric ward was not identified. 58 members of staff were screened for B19 markers and 4 of the 6 susceptible men and 6 of the 24 susceptible women became infected (p = 0.05) as defined by serum IgM and viraemia. 1 of the 11 adults (10 members of staff and 1 parent) infected remained symptom-free. 12 immunocompromised patients were also assessed, and symptom-free infection developed in 2 of these. During the outbreak staff with symptoms were put on sick leave, immunocompromised patients (there were none with haemolytic anaemia) were given normal human immunoglobulin and nursed in single rooms by B19 IgG-positive, IgM-negative staff, and the ward was closed to B19 IgG-negative pregnant women. However, the limitation of spread of infection cannot be attributed with certainty to the measures taken.
细小病毒B19感染可在孕妇、溶血性贫血患者以及免疫功能低下者中引发严重并发症。在医院发生的此类感染暴发中,应在保护这些个体与维持医疗服务之间取得平衡。某儿科病房工作人员和患者中发生的细小病毒B19感染暴发的首例病例未被查明。对58名工作人员进行了B19标志物筛查,按照血清IgM和病毒血症的定义,6名易感男性中有4名、24名易感女性中有6名被感染(p = 0.05)。11名受感染的成年人(10名工作人员和1名家长)中有1名没有症状。还对12名免疫功能低下的患者进行了评估,其中2名发生了无症状感染。在暴发期间,有症状的工作人员休病假,免疫功能低下的患者(无溶血性贫血患者)接受了正常人免疫球蛋白治疗,并由B19 IgG阳性、IgM阴性的工作人员在单人病房护理,该病房对B19 IgG阴性的孕妇关闭。然而,感染传播的受限不能确定归因于所采取的措施。