Wildig James, Michon Pascal, Siba Peter, Mellombo Mata, Ura Alice, Mueller Ivo, Cossart Yvonne
Department of Infectious Diseases and Immunology, University of Sydney, Sydney, Australia.
J Infect Dis. 2006 Jul 15;194(2):146-53. doi: 10.1086/505082. Epub 2006 Jun 14.
Severe anemia (hemoglobin level, <50 g/L) is a major cause of death among young children, and it arises from multiple factors, including malaria and iron deficiency. We sought to determine whether infection with parvovirus B19 (B19), which causes the cessation of erythropoiesis for 3-7 days, might precipitate some cases of severe anemia.
Archival blood samples collected in the Wosera District of Papua New Guinea, from 169 children 6 months-5 years old with severe anemia and from 169 control subjects matched for age, sex, and time were tested for B19 immunoglobulin M (IgM) by enzyme immunoassay and for B19 DNA by nested polymerase chain reaction (PCR). A total of 168 separate samples from children in the Wosera District were tested for B19 IgG.
A strong association between acute B19 infection (positive by both IgM and PCR) and severe anemia was found (adjusted odds ratio, 5.61 [95% confidence interval, 1.93-16.3]). The prevalence of parvovirus B19 IgG reached >90% in 6-year-olds.
B19 infections play a significant role in the etiology of severe anemia in this area of malarial endemicity. Given the high levels of morbidity and mortality associated with severe anemia in such regions, the prevention of B19 infection with a vaccine might be a highly effective public health intervention.
重度贫血（血红蛋白水平<50 g/L）是幼儿死亡的主要原因，其由多种因素引起，包括疟疾和缺铁。我们试图确定感染细小病毒B19（B19）（可导致红细胞生成停止3 - 7天）是否会引发一些重度贫血病例。
对在巴布亚新几内亚沃塞拉地区采集的存档血液样本进行检测，这些样本来自169名6个月至5岁的重度贫血儿童以及169名年龄、性别和时间匹配的对照受试者，采用酶免疫测定法检测B19免疫球蛋白M（IgM），采用巢式聚合酶链反应（PCR）检测B19 DNA。对来自沃塞拉地区儿童的总共168份独立样本检测B19 IgG。
发现急性B19感染（IgM和PCR均呈阳性）与重度贫血之间存在强关联（调整后的优势比为5.61 [95%置信区间为1.93 - 16.3]）。细小病毒B19 IgG在6岁儿童中的患病率达到>90%。
在这个疟疾流行地区，B19感染在重度贫血的病因中起重要作用。鉴于此类地区与重度贫血相关的高发病率和死亡率，用疫苗预防B19感染可能是一种非常有效的公共卫生干预措施。
