Comprehensive surveillance data suggest a prominent role of parvovirus B19 infection in Belarus and the presence of a third subtype within subgenotype 1a

Marina A Yermalovich,Alina M Dronina,Galina V Semeiko,Judith M Hübschen,Elena O Samoilovich,Aurelie Sausy,Vladislav V Khrustalev

doi:10.1038/s41598-020-79587-2

Abstract

Human parvovirus B19 (B19V) infection is not notifiable in Belarus and its most common clinical presentation erythema infectiosum (EI) is often difficult to distinguish from other exanthematous diseases. The objective of this study was to provide comprehensive data about EI epidemiology in Belarus based on the serological and molecular investigation of samples from measles and rubella discarded cases collected between 2005 and 2019. Overall, 4919 sera were investigated for IgM antibodies against B19V and the positive cases were analysed according to year, season and age. B19V DNA was amplified by PCR in a total of 238 sera from all over the country, and sequenced for phylogenetic analyses. B19V infection was confirmed in 1377 (27.8%) measles and rubella discarded cases. Two high incidence periods and a seasonal increase of EI between mid-February to mid-July were identified. Children from 4 to 6 and from 7 to 10 years of age represented the largest groups of patients (22.51% and 22.66% of all cases, respectively), followed by adults between 20 and 29 years of age (14.23%). Among the 238 B19Vs sequenced, one belonged to subgenotype 3b and 237 to subgenotype 1a with 81 (34.2%) clustering with subtypes 1a1 and 153 (64.6%) with 1a2. Three strains (1.2%) formed an additional, well-supported cluster suggesting the presence of another subtype of 1a, tentatively named 1a3. The epidemiological and molecular analyses highlighted not only the prominent role of B19V in exanthematous diseases in Belarus, but also suggested a previously underestimated diversity of subgenotype 1a sequences with a third subtype 1a3.

Highlights

Human parvovirus B19 (B19V) infection is not notifiable in Belarus and its most common clinical presentation erythema infectiosum (EI) is often difficult to distinguish from other exanthematous diseases
The main clinical presentation of human parvovirus B19 (B19V) infection is erythema infectiosum (EI) or “fifth disease”, which is common in childhood but may be observed in a dults[1]
Diagnosis of B19V infection was introduced in Belarus as an additional investigation of cases that previously would have been classified only as “neither measles nor rubella”

Summary

Introduction

Human parvovirus B19 (B19V) infection is not notifiable in Belarus and its most common clinical presentation erythema infectiosum (EI) is often difficult to distinguish from other exanthematous diseases. The objective of this study was to provide comprehensive data about EI epidemiology in Belarus based on the serological and molecular investigation of samples from measles and rubella discarded cases collected between 2005 and 2019. The epidemiological and molecular analyses highlighted the prominent role of B19V in exanthematous diseases in Belarus, and suggested a previously underestimated diversity of subgenotype 1a sequences with a third subtype 1a3. Laboratory diagnosis of B19V infection was started in Belarus in 2005 at the National laboratory as an additional investigation of samples from suspected measles and rubella cases and continues to be carried out only in this laboratory for patients from all over the country. We present the results of the serological and molecular investigation of B19V infection based on samples received between 2005 and 2019, providing comprehensive data about EI prevalence and epidemiology in Belarus

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Conclusion