| Erythrovirus |
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| Electron micrograph of Parvoviruses in blood |
| Virus classification |
| Group: |
Group II (ssDNA) |
| Family: |
Parvoviridae |
| Genus: |
Erythrovirus |
| Species: |
Parvovirus B19 |
The B19 virus, generally referred to as parvovirus B19[1] or sometimes erythrovirus B19,[2] was the first (and until 2005 the only) known human virus in the family of parvoviruses, genus erythrovirus. B19 virus causes a childhood rash called fifth disease or erythema infectiosum which is commonly called slapped cheek syndrome.[3][4]
The virus was discovered by chance in 1975 by Australian virologist Yvonne Cossart.[4][5] It gained its name because it was discovered in well B19 of a large series of microtiter plates labelled in this way.[4][6]
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Contents
- 1 Virology
- 2 Transmission
- 3 Infectivity
- 4 Epidemiology
- 5 Role in disease
- 5.1 Fifth disease
- 5.2 AIDS
- 5.3 Arthritis
- 5.4 Aplastic crisis
- 5.5 Hydrops fetalis
- 6 See also
- 7 References
- 8 External links
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Virology
Erythroviruses belong to the Parvoviridae family of small DNA viruses.[7] It is a non-enveloped, icosahedral virus that contains a single-stranded linear DNA genome. Approximately equal proportions of DNA of positive and negative sense are found in separate particles. At each end of the DNA molecule there are palindromic sequences which form "hairpin" loops. The hairpin at the 3' end serves as a primer for the DNA polymerase.[8] It is classified as erythrovirus because of its capability to invade red blood cell precursors in the bone marrow. Three genotypes (with subtypes) have been recognised.[9]
In humans the P antigen (also known as globoside) is the cellular receptor for parvovirus B19 virus that causes Erythema infectiosum (fifth disease) in children. This infection is sometimes complicated by severe aplastic anemia caused by lysis of early erythroid precursors.
Transmission
The virus is primarily spread by infected respiratory droplets; blood-borne transmission, however, has been reported.[10] The secondary attack risk for exposed household persons is about 50%, and about half of that for classroom contacts.[4][11]
Infectivity
Symptoms begin some six days after exposure (between 4 and 28 days, with the average being 16 to 17 days[12]) and last about a week. Infected patients with normal immune systems are contagious before becoming symptomatic, but probably not after then.[13] Individuals with B19 IgG antibodies are generally considered immune to recurrent infection, but reinfection is possible in a minority of cases.[14] About half of adults are B19-immune due to a past infection.
Epidemiology
A significant increase in the number of cases is seen every three to four years; the last epidemic year was 1998.[citation needed] Outbreaks can arise especially in nurseries and schools.
Parvovirus B19 causes an infection in humans only. Cat and dog parvoviruses do not infect humans. There is no vaccine available for human parvovirus B19,[15] though attempts have been made to develop one.[16]
However, there is a vaccine available for parvovirus that infects small mammals.
Role in disease
Child showing signs of erythema infectiosum, also known as fifth disease.
Fifth disease
Fifth disease or erythema infectiosum is only one of several expressions of Parvovirus B19. Any age may be affected, although it is most common in children aged six to ten years, it is so named, because it was the fifth pink-red infectious rash to be described by physicians.
After being infected, patients usually develop the illness after an incubation period of four to fourteen days. The disease commences with fever and malaise while the virus is most abundant in the bloodstream, and patients are usually no longer infectious once the characteristic rash of this disease has appeared.[15]
Teenagers or young adults may develop the so called "Papular Purpuric Gloves and Socks Syndrome".[15] Unlike young children, these patients may be infectious with this rash.[citation needed]
The "slapped cheek" appearance typical of fifth disease.
The rash of fifth disease is typically described as "slapped cheeks", with erythema across the cheeks and sparing the nasolabial folds, forehead, and mouth. Because of this rash, fifth disease is sometimes called "slapped cheek syndrome".[4] Fifth disease is also known for "lace-like" rashes on the arms, legs, torso, and back. These rashes can last for up to 5 weeks and are worse after sun exposure, exercise, or hot baths.[citation needed]
AIDS
Parvovirus B19 is a cause of chronic anemia in individuals who have AIDS. It is frequently overlooked. Treatment with erythropoetin or intravenous immunoglobulin have been helpful in some patients. The parvovirus infection may trigger an inflammatory reaction in AIDS patients who have just begun antiretroviral therapy.[17]
Arthritis
In adults (and perhaps some children), parvovirus B19 can lead to a seronegative arthritis which is usually easily controlled with analgesics. Women are approximately twice as likely as men to experience arthritis after parvovirus infection. Possibly up to 15% of all new cases of arthritis are due to parvovirus, and a history of recent contact with a patient and positive serology generally confirms the diagnosis.[13] This arthritis does not progress to other forms of arthritis. Typically joint symptoms last 1–3 weeks, but in 10–20% of those affected, it may last weeks to months.[4][15]
Aplastic crisis
Although most patients have an arrest of erythropoiesis (production of red blood cells) during parvovirus infection, it is most dangerous in patients who have sickle cell anemia or hereditary spherocytosis,[18][19] and are therefore heavily dependent on erythropoeisis due to the reduced lifespan of the red cells. This is termed "aplastic crisis" (also called reticulocytopenia). It is treated with blood transfusion.[4][15]
Hydrops fetalis
Micrograph showing viral changes in fetal red blood cells in a case of parvovirus infection. H&E stain.
Parvovirus infection in pregnant women is associated with hydrops fetalis due to severe fetal anemia, sometimes leading to miscarriage or stillbirth.[15][20] The risk of fetal loss is about 10% if infection occurs before pregnancy week 20 (especially between weeks 14 and 20), but minimal after then. Routine screening of the antenatal sample would enable the pregnant mother to determine the risk of infection.[citation needed] Knowledge of her status would allow the mother to avoid the risk of infection.[citation needed] The risk to the fetus will be reduced with correct diagnosis of the anemia (by ultrasound scans) and treatment (by blood transfusions). There is some evidence that intrauterine Parvovirus B19 infection leads to developmental abnormalities in childhood.[21]
See also
- Human bocavirus
- Erythema infectiosum
References
- ^ Servey JT, Reamy BV, Hodge J (February 2007). "Clinical presentations of parvovirus B19 infection". Am Fam Physician 75 (3): 373–376. PMID 17304869.
- ^ Kahn JS, Kesebir D, Cotmore SF, et al. (July 2008). "Seroepidemiology of human bocavirus defined using recombinant virus-like particles". J. Infect. Dis. 198 (1): 41–50. doi:10.1086/588674. PMID 18491974.
- ^ Vafaie J, Schwartz RA (2004). "Parvovirus B19 infections". Int J Dermatol 43 (10): 747–749. doi:10.1111/j.1365-4632.2004.02413.x. PMID 15485533.
- ^ a b c d e f g Sabella C, Goldfarb J (October 1999). "Parvovirus B19 infections". Am Fam Physician 60 (5): 1455–60. PMID 10524489. http://www.aafp.org/afp/991001ap/1455.html. Retrieved 2009-11-06.
- ^ Heegaard ED, Brown KE (2002). "Human parvovirus B19". Clin. Microbiol. Rev. 15 (3): 485–505. doi:10.1128/CMR.15.3.485-505.2002. PMC 118081. PMID 12097253. http://cmr.asm.org/cgi/pmidlookup?view=long&pmid=12097253.
- ^ Cossart YE, Field AM, Cant B, Widdows D (1975). "Parvovirus-like particles in human sera". Lancet 1 (7898): 72–73. doi:10.1016/S0140-6736(75)91074-0. PMID 46024.
- ^ Brown KE (2004). "Variants of B19". Dev Biol (Basel) 118: 71–77. PMID 15645675.
- ^ G. Siegl and P. Cassinotti, Parvoviruses Chapter 14, Topley and Wison's Microbiology and Microbial Infections, Vol. 1, Virology, 1998 pp. 261-280
- ^ Molenaar-de Backer MW, Lukashov VV, van Binnendijk RS, Boot HJ, Zaaijer HL (2012) Global co-existence of two evolutionary lineages of parvovirus B19 1a, different in genome-wide synonymous positions. PLoS One 7(8):e43206
- ^ Pattison JR, Patou G (1996). Parvoviruses. In: Barron's Medical Microbiology (Barron S et al., eds.) (4th ed.). Univ of Texas Medical Branch. ISBN 0-9631172-1-1.
- ^ Young NS, Brown KE (February 2004). "Parvovirus B19". N Engl J Med 350 (6): 586–597. doi:10.1056/NEJMra030840. PMID 14762186.
- ^ http://kidshealth.org/parent/infections/skin/fifth.html
- ^ a b Corcoran A, Doyle S (2004). "Advances in the biology, diagnosis and host-pathogen interactions of parvovirus B19". J Med Microbiol 53 (Pt 6): 459–75. doi:10.1099/jmm.0.05485-0. PMID 15150324.
- ^ Lehmann HW, von Landenberg P, Modrow S (2003). "Parvovirus B19 infection and autoimmune disease". Autoimmun Rev 2 (4): 218–223. doi:10.1016/S1568-9972(03)00014-4. PMID 12848949.
- ^ a b c d e f Servey JT, Reamy BV, Hodge J (February 2007). "Clinical presentations of parvovirus B19 infection". Am Fam Physician 75 (3): 373–376. PMID 17304869. http://www.aafp.org/afp/20070201/373.html. Retrieved 2009-11-06.
- ^ Ballou WR, Reed JL, Noble W, Young NS, Koenig S (2003). "Safety and immunogenicity of a recombinant parvovirus B19 vaccine formulated with MF59C.1". J Infect Dis 187 (4): 675–8. doi:10.1086/368382. PMID 12599085.
- ^ Doldan Silvero AM, Acevedo-Gadea CR, Pantanowitz L, Dezube BJ, Johari V (June 4, 2009). "Images in HIV/AIDS. Unsuspected parvovirus B19 infection in a person with AIDS". The AIDS Reader 19 (6): 225–227. PMID 19642240. http://www.consultantlive.com/aids/article/1145619/1419436. Retrieved 2009-11-06.
- ^ Fjaerli, H. O.; Vogt, H.; Bruu, A. L. (1991). "Human parvovirus B19 as the cause of aplastic crisis in hereditary spherocytosis". Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke 111 (22): 2735–2737. PMID 1658972. edit
- ^ Beland, S. S.; Daniel, G. K.; Menard, J. C.; Miller, N. M. (1997). "Aplastic crisis associated with parvovirus B19 in an adult with hereditary spherocytosis". The Journal of the Arkansas Medical Society 94 (4): 163–164. PMID 9308316. edit
- ^ Ergaz Z, Ornoy A (May 2006). "Parvovirus B19 in pregnancy". Reprod. Toxicol. 21 (4): 421–35. doi:10.1016/j.reprotox.2005.01.006. PMID 16580942. http://linkinghub.elsevier.com/retrieve/pii/S0890-6238(05)00025-0.
- ^ Nagel, Hélène T. C. MD; de Haan, Timo R. MD; Vandenbussche, Frank P. H. A. MD, PhD; Oepkes, Dick MD, PhD; Walther, Frans J. MD, PhD (2007). "Long-Term Outcome After Fetal Transfusion for Hydrops Associated With Parvovirus B19 Infection". Obstetrics & Gynecology 109 (1): 42–47. doi:10.1097/01.AOG.0000249611.67873.94 (inactive 2010-03-17). PMID 17197586. http://journals.lww.com/greenjournal/Abstract/2007/01000/Long_Term_Outcome_After_Fetal_Transfusion_for.8.aspx. Retrieved 2010-01-30.
External links
- Parvovirus B19 Information
- fifthdisease.org
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Baltimore (virus classification)
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| DNA |
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I: dsDNA viruses
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Caudovirales
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- Myoviridae
- Podoviridae
- Siphoviridae
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Herpesvirales
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- Alloherpesviridae
- Herpesviridae
- Malacoherpesviridae
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Ligamenvirales
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- Lipothrixviridae
- Rudiviridae
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Unassigned
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- NLCDV: Asfarviridae
- Iridoviridae
- Marseilleviridae
- Megaviridae
- Mimiviridae
- Phycodnaviridae
- Poxviridae
- nonenveloped: Adenoviridae
- Papillomaviridae
- Papovaviridae (obsolete)
- Polyomaviridae
- Ampullaviridae
- Ascoviridae
- Baculoviridae
- Bicaudaviridae
- Clavaviridae
- Corticoviridae
- Fuselloviridae
- Globuloviridae
- Guttaviridae
- Hytrosaviridae
- Nimaviridae
- Plasmaviridae
- Tectiviridae
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II: ssDNA viruses
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- Anelloviridae
- Bacillariodnaviridae
- Circoviridae
- Geminiviridae
- Inoviridae
- Microviridae
- Nanoviridae
- Parvoviridae
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| RNA |
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III: dsRNA viruses
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- Birnaviridae
- Chrysoviridae
- Cystoviridae
- Hypoviridae
- Partitiviridae
- Reoviridae
- Totiviridae
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IV: (+)ssRNA viruses (primarily icosahedral)
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Nidovirales
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- Arteriviridae
- Coronaviridae
- Roniviridae
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Picornavirales
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- Dicistroviridae
- Iflaviridae
- Marnaviridae
- Picornaviridae
- Secoviridae
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Tymovirales
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- Alphaflexiviridae
- Betaflexiviridae
- Gammaflexiviridae
- Tymoviridae
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Unassigned
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- Astroviridae
- Barnaviridae
- Bromoviridae
- Caliciviridae
- Closteroviridae
- Comoviridae
- Flaviviridae
- Flexiviridae
- Leviviridae
- Luteoviridae
- Narnaviridae
- Nodaviridae
- Potyviridae
- Sequiviridae
- Tetraviridae
- Togaviridae
- Tombusviridae
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V: (-)ssRNA viruses (primarily helical)
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Mononegavirales
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- Bornaviridae
- Filoviridae
- Paramyxoviridae
- Rhabdoviridae
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Unassigned
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- Arenaviridae
- Bunyaviridae
- Orthomyxoviridae
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| RT |
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VI: ssRNA-RT viruses
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- Metaviridae
- Pseudoviridae
- Retroviridae
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VII: dsDNA-RT viruses
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- Caulimoviridae
- Hepadnaviridae
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cutn/syst (hppv/hiva, infl/zost/zoon)/epon
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drug(dnaa, rnaa, rtva, vacc)
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Infectious skin disease: Viral cutaneous conditions, including viral exanthema (B00–B09, 050–059)
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DNA virus
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Herpesviridae
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Alpha
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HSV (Herpes simplex, Herpetic whitlow, Herpes gladiatorum, Herpetic keratoconjunctivitis, Herpetic sycosis, Neonatal herpes simplex, Herpes genitalis, Herpes labialis, Eczema herpeticum, Herpetiform esophagitis) · Herpes B virus (B virus infection)
VZV (Chickenpox, Herpes zoster, Herpes zoster oticus, Ophthalmic zoster, Disseminated herpes zoster, Zoster-associated pain, Inflammatory skin lesions following zoster infection, Modified varicella-like syndrome)
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Beta
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Human herpesvirus 6/Roseolovirus (Exanthema subitum, Roseola vaccinia)
Cytomegalic inclusion disease
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Gamma
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KSHV (Kaposi's sarcoma)
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Poxviridae
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Ortho
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Variola (Smallpox, Alastrim) · MoxV (Monkeypox) · CV (Cowpox) · VV (Vaccinia, Generalized vaccinia, Eczema vaccinatum, Progressive vaccinia)
Buffalopox
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Para
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Farmyard pox: Milker's nodule · Bovine papular stomatitis · Pseudocowpox · Orf
Sealpox
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Other
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Yatapoxvirus: Tanapox · Yaba monkey tumor virus
MCV (Molluscum contagiosum)
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Papillomaviridae
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HPV (Wart/Plantar wart, Heck's disease, Genital wart (giant), Laryngeal papillomatosis, Butcher's wart, Bowenoid papulosis, Epidermodysplasia verruciformis, Verruca plana, Pigmented wart, Verrucae palmares et plantares )
BPV (Equine sarcoid)
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Parvoviridae
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Parvovirus B19 (Erythema infectiosum, Reticulocytopenia, Papular purpuric gloves and socks syndrome)
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Polyomaviridae
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Merkel Cell Polyomavirus (Merkel Cell carcinoma)
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RNA virus
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Paramyxoviridae
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MeV (Measles)
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Togaviridae
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Rubella virus (Rubella, Congenital rubella syndrome) · Alphavirus infection · Chikungunya fever
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Picornaviridae
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CAV (Hand, foot and mouth disease, Herpangina) · FMDV (Foot-and-mouth disease) · Boston exanthem disease
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| Ungrouped |
unknown/multiple: Asymmetric periflexural exanthem of childhood · Post-vaccination follicular eruption · Lipschütz ulcer · Eruptive pseudoangiomatosis · Viral-associated trichodysplasia · Gianotti–Crosti syndrome
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cutn/syst (hppv/hiva, infl/zost/zoon)/epon
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drug(dnaa, rnaa, rtva, vacc)
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noco(i/b/d/q/u/r/p/m/k/v/f)/cong/tumr(n/e/d), sysi/epon
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proc, drug (D2/3/4/5/8/11)
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