The Rate of Parvovirus B19 Infection among Children with Clinically Suspected Erythema Infectiosumin Diyala Province, Iraq

Abstract

Background: Parvovirus B19 (PVB19V) infection is widespread and associated with a heterogeneous clinical spectrum, ranging from asymptomatic to potentially life-threatening aplastic crisis in chronic haemolyticanaemia, hydrops fetal is, neurologic diseases and arthroplasty. PVB19 infection usually causes erythema infectiosumin (EI), a benign self-limiting disease characterized by typical cutaneous manifestations (slapped cheek appearance with per oral sparing followed by a diffuse maculopapular rash evolving to a reticular pattern).

Objectives: The present study was conducted to explore the rate of human PVB19 infection rate among children with fever and skin rash and to figure out the role of attribute factors.

Materials and methods: The present cross-sectional study was conducted between December 2019 and June 2020 in Diyala province, Iraq. Data and samples were collected from different teaching hospitals and healthcare centers. Sixty apparently healthy children were enrolled as control group and200 patients clinically presented with skin rash and fever.  The age group was (1-14) years. A special questionnaire form was pre-constructed for this study including: Sociodemographic factors, clinical manifestation and history of underlining conditions. Blood samples were aseptically drawn from all studied groups. Part of the blood was used for the determination of complete blood count (CBC). The remaining was placed in plane tubes, left at room temperature for 30 minutes. Thereafter, serum samples were separated, labeled and stored at −20°C till use. ELISA technique was used for determination of anti-PVB19 IgM and IgG in serum (DIA-PRO, Italy). Human privacy was respected by obtaining verbal consent from their patents. Statistical analysis was done by SPSS version 25 and P values less than 0.05 were considered significant.

Results: The anti-PVB19 IgG positivity rate in children with EI patients was 198(95.0%) which is significantly higher compared to that of control (P= 0.0001). The anti-PVB19 IgM positivity rate among children with EI was 907(45.0%), versus 2(3.3%) among healthy control. thus the difference was significantly higher (P= 0.0001). Furthermore, the mean ± SD of the anti-PVB19 IgG as well as anti-PVB19 IgM titers in children with EI were significantly higher than that of children in control (P= 0.0001 and P= 0.0001) respectively. Moreover, the anti-PVB19 IgG and anti-PVB19 IgM titers were insignificantly associated with age, sex, and residence of EI patients. Regarding the blood indices,the PCV (%), WBC (x103), and MCV (fL),MCH (pg/cell).MCHC (gm/dl) and the PLT (x103) were significantly higher in children with EI compared to their counterparts of control.

Conclusion: The infection rate and seroprevalence of parvovirus B19 among children with fever-rash illness are high suggesting that parvovirus B19 should be considered in the differential diagnosis of all children with fever and rash in Diyala province, Iraq.