Clinical and Laboratoy Characteristics of Parvovirus B19 Infection During 2013/2014 Outbreak in Zagreb, Croatia

Abstract

BackgroundHuman Parvovirus B19 (HPV-B19) occurs worldwide and causes mild, acute exanthematous disease that occurs in a form of cyclic local epidemics. The aim of this study was to analyze clinical features and complication rates of acute HPV-B19 infection in different age groups.MethodsWe retrospectively reviewed the charts of 718 consecutive patients clinicaly diagnosed with acute HPV-B19 infection who visited outpatient department at the University Hospital for Infectious Diseases in Zagreb, Croatia during 2013–2014 outbreak. In 212 patients (of 298 tested) diagnosis was confirmed by positive IgM antibodies and/or HPV-B19 DNA in peripheral blood.ResultsOutbreak started in June 2013 and had a peak in April 2014, with highest prevalence in schoolchildren. There were no difference in clinical presentation or laboratory findings between clinicaly and serologicaly diagnosed patients. Biphasic presentation, fever, myalgia, arthralgia, headache and peripheral edema were more frequent in adults, but „slapped cheeks” was found predominantly in children. Complications were more common in adults, most commonly hematological disordes (mild anemia, thrombocytopenia and leukopenia), vasculitis, hepatitis and aseptic meningitis. There were no deaths in our cohort.Children (n = 52)Adults (n = 160) P-valueAge, years8.8 ± 4.139 ± 10.7Male sex31 (59.6%)26 (12.3%)0.0001Clinical presentationBiphasic presentation8 (15.4%)48 (30.0 %)0.0460Fever26 (50.0%)110 (68.7%)0.0194Rash51 (98.1%)127 (79.4%)0.0008Myalgia5 (9.6%)50 (31.2%)0.0017Arthralgia9 (17.3%)100 (62.5%)0.0001Headache3 (5.8%)34 (21.2%)0.0107“Slapped cheeks”29 (55,8%)24 (15.0%)0.0001Peripheral edema6 (11.5%)63 (39.4%)0.0001Anemia4 (7.7%)19 (11.8%)0.6076Leukopenia1 (1.9%)23 (14.5%)0.0111Thrombocytopenia4 (7.7%)35 (21.8%)0.0231Hepatitis1 (1.9%)11 (6.87%)0.3011Vasculitis1 (1.9%)2 (1.25%)0.5721Other2 (3.8%)3 (1.9%)0.5982Conclusion Parvovirus B19 infection has different clinical presentation, laboratory findings and complications in children and adults. Since the diversity of the clinical manifestations in adults may be misleading, the infection in adults should be suspected when disease is prevalent in children.Disclosures `All authors: No reported disclosures.