Exindari M, Chatzidimitriou D, Melidou A, Gioula G, Ziogou L, Diza E
2 Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Greece.
Hippokratia. 2011 Apr;15(2):157-60.
Background. Parvovirus B19 infects children and adults, often causing erythema infectiosum, polyarthritis, but also aplastic crisis in patients with chronic haemolytic anaemia, rash, fever and fetal hydrops or fetal death. This study aims at the detection of acute parvovirus B19 infections during 2006-2009 in northern Greece on epidemiological and clinical aspect.Material and methods. Specimens were obtained from 63 patients, who addressed to hospitals, suspected for acute parvovirus B19 infection (17 in 2006, 29 in 2007, 10 in 2008 and 7 in 2009). Thirty (47.6%) were children (one day - 15 years old) and 33 (52.4%) were adults (16-65 years old). The infection was shown by PCR in whole blood and/or pleural fluid and supported by detection of specific IgM antibodies in the patients' blood serum, which was performed by ELISA.Results. Twenty (31.7%) out of the 63 specimens were found to be positive: 3/17 (17.6 %) in 2006, 16/29 (55.2 %) in 2007, none in 2008 and 1/7 (14.3%) in 2009, p=0.0002. Positive children were found 10/30 (33.3%) and positive adults 10/33 (30.3%). Specific IgM antibodies were detected in all 20 positive patients. Children developed hematological disorders, mainly types of anemia (6 cases), hydrothorax/ascites (2 cases), arthritis (1 case), and liver transplant rejection (1 case). Adults were presented with pregnancy complications (2 cases), arthralgia/arthritis (4 cases), febrile syndromes (3 cases) and atypical rash (1 case).Conclusions. In conclusion, an annual variation in the circulation of parvovirus B19 was noticed, presenting an increase of acute infections in northern Greece during 2007. Regarding serious cases, although children and adults seemed equally affected, differences in clinical manifestations were observed between them, with hematological dysfunctions predominant in childhood.
背景。细小病毒B19可感染儿童和成人,常引起传染性红斑、多关节炎,还可导致慢性溶血性贫血患者发生再生障碍危象、皮疹、发热以及胎儿水肿或胎儿死亡。本研究旨在从流行病学和临床方面检测2006 - 2009年希腊北部急性细小病毒B19感染情况。
材料与方法。从63例因疑似急性细小病毒B19感染而前往医院就诊的患者中获取标本(2006年17例,2007年29例,2008年10例,2009年7例)。其中30例(47.6%)为儿童(1天至15岁),33例(52.4%)为成人(16至65岁)。通过全血和/或胸腔积液的聚合酶链反应(PCR)检测感染情况,并通过酶联免疫吸附测定法(ELISA)检测患者血清中的特异性IgM抗体来辅助诊断。
结果。63份标本中有20份(31.7%)检测呈阳性:2006年3/17(17.6%),2007年16/29(55.2%),2008年无,2009年1/7(14.3%),p = 0.0002。儿童阳性率为10/30(33.3%),成人阳性率为10/33(30.3%)。所有20例阳性患者均检测到特异性IgM抗体。儿童出现血液系统疾病,主要为贫血类型(6例)、胸腔积液/腹水(2例)、关节炎(1例)以及肝移植排斥反应(1例)。成人出现妊娠并发症(2例)、关节痛/关节炎(4例)、发热综合征(3例)和非典型皮疹(1例)。
结论。总之,注意到细小病毒B19的传播存在年度变化,2007年希腊北部急性感染有所增加。关于重症病例,尽管儿童和成人似乎受影响程度相当,但观察到他们之间临床表现存在差异,儿童以血液系统功能障碍为主。