Parvovirus B19

Parvovirus B19- Opportunistic, Chronic or Tick Borne?

Parvoviruses are some of the smallest viruses found in nature. Patients with chronic Lyme disease may test positive for parvovirus B19. Studies are needed to determine if parvovirus is reactivated after a Lyme infection in some people, if it is passed along by ticks with Lyme bacteria and many other known coinfections or if it is a chronic illness that can surface when the immune system is busy fighting new infections.

What is parvovirus B19 (aka "fifth disease or slapped-cheek syndrome)?"

Parvo B-19 is an illness that occurs most commonly in children. The child may have a "slapped-cheek" rash on the face and/or a lacy red rash on the trunk and limbs. Occasionally, the rash may itch. The child may have a fever, malaise, or a "cold" a few days before the rash breaks out. The rash may disappear on its own, with no treatment.

What causes parvovirus B19?

This particular virus (B19) infects humans. Pet dogs or cats may be immunized against "parvovirus," but these are animal parvoviruses that are not known to infect humans. Therefore, a child cannot "catch" parvovirus from a pet dog or cat, and a pet cat or dog cannot catch human parvovirus B19 from an ill child.

Can adults get parvovirus B19?

Yes, they can. An adult who can be infected with parvovirus B19 and either have no symptoms or develop the typical rash, joint pain or swelling, or both. The joints most frequently affected are the hands, wrists, and knees. The joint pain and/or swelling may resolve in a week or two, but they may last several months or years.

Is parvovirus B19 contagious?

Yes. A person infected with parvovirus B19 is contagious during the early part of the illness, before the rash appears.

How does someone get infected with parvovirus B19?

Parvovirus B19 has been found in the respiratory secretions (e.g., saliva, sputum, or nasal mucus) of infected persons before the onset of rash, when they appear to "just have a cold." The virus is probably spread from person to person by direct contact with those secretions, such as sharing drinking cups or utensils.

How soon after infection with parvovirus B19 does a person become ill?

A susceptible person usually becomes ill 3 days to 14 days after being infected with the virus, but may become ill for as three weeks after being infected.

Does everyone who is infected with parvovirus B19 become ill?

No. During outbreaks of fifth disease, about 20% of adults and children who are infected with parvovirus B19 do not develop symptoms. Others infected with the virus may have a illness that is not characteristic.

How is parvo B19 disease diagnosed?

A physician can often diagnose fifth disease by seeing the typical rash during a physical examination. In cases in which it is important to confirm the diagnosis, a blood test may be done to look for antibodies to parvovirus.

Is it serious?

Parvo B19 is usually a mild illness. Joint pain and swelling in adults may resolve on their own without long-term disability. Parvovirus B19 infection may cause a serious illness in persons with sickle-cell disease or similar types of chronic anemia. In such persons, parvovirus B19 can cause an acute, severe anemia. The ill person may be pale, weak, and tired. (The typical rash is rarely seen in these persons.)

Once the infection is controlled, the anemia resolves. Some people may also develop a chronic anemia with parvovirus B19 infection that requires medical treatment. People who have leukemia or cancer, who are born with immune deficiencies, who have received an organ transplant, or who have human immunodeficiency virus (HIV) infection are at risk for serious illness due to parvovirus B19 infection. Serious complications may develop from parvovirus B19 infection during pregnancy.

How are parvovirus B19 infections treated?

Treatment of symptoms such as fever, pain, or itching is usually all that is needed. Adults with joint pain and swelling may need to rest, restrict their activities, and take medicines such as aspirin or ibuprofen to relieve symptoms. The few people who have severe anemia caused by parvovirus B19 infection may need to be hospitalized and receive blood transfusions. Some people may need special medical care, including treatment with immune globulin (antibodies), to help their bodies get rid of the infection.

Can parvovirus B19 infection be prevented?

There is no vaccine or medicine that prevents parvovirus B19 infection. Frequent handwashing is recommended as a method to decrease the chance of becoming infected.

For more information see medical abstracts below.