In healthy individuals, parvovirus B19 infection has a very low mortality rate.(1)
In immunocompromised patients’ persistence of parvovirus B19 may cause pure red cell aplasia and chronic anemia.(2)
What Diseases Does Parvovirus B19 Cause & How Long Can Parvovirus Last In Humans?
Parvovirus B19 causes a variety of diseases both in healthy and immunocompromised people. The most common disease that B19V is associated with is erythema infectiosum. It is also known as the fifth disease or slapped cheek disease due to the same appearance of ‘slapped cheek’ in infected children. The prodromal symptoms include fever, headache, cold, and nausea. They are followed by facial erythema with some areas of pallor in the cheek area. After 1-4 days later, rashes appear in the trunk and limbs, which may be transient or recurrent. The rash is in the form of pink maculae and is lacy or reticular in appearance with central fading giving a festooned appearance. The rash may also be accompanied by itching, scaly dermatitis, and vesicle formation. The rash may recur and last for several weeks and be precipitated by sunlight, exercise, and stress.(2)
B19V has also been associated with an atypical rash in adults. B19V may also manifest as purpura, erythema multiforme, or itching of the soles of the feet. It resembles a papular-purpuric gloves-and-socks syndrome (PPGSS) of the hands and feet with a distinct margin at the wrist and ankle joints. PPGSS is mainly seen in young adults and may present as painful redness and induration of the hands and feet in the initial stages. It resolves in 1-3 weeks without any scar formation.(1)
In adults B19V infection (<10% of children affected) is associated with transient small joint arthropathy. Most of the patients only complain of pain, but some may progress to arthritis. B19V is not associated with chronic degenerative arthritis and the symptoms may last 1-3 weeks or maybe months. The knee joint is the most commonly affected joint.(1)
B19V may also infect pregnant women and causes hydrops fetalis, which may be associated with abortion, congenital anemia, or stillbirth or may result in a self-limiting asymptomatic episode. 11-23 weeks of gestation is associated with the adverse fetal outcome after B19V infection in pregnant women.(2)
B19V infection also induces thrombocytopenia (mostly in children) and may result in subclinical or overt thrombocytopenia. It is associated with most cases of idiopathic thrombocytopenic purpura (ITP). In some children, the disease may occur for a brief duration whereas in some it may become chronic.(2)
B19V causes other diseases in healthy humans, including transient erythroblastopenia (TEC) and neutropenia. TEC may lead to red cell aplasia and other cytopenias in children. It may also be associated with transient aplastic crisis, neurologic diseases, myocarditis, and hepatitis. It is also suggested in various diseases including Kawasaki disease, purpura, thrombotic renal graft microangiopathy, Henoch-Schonlein purpura, Raynaud’s phenomenon, polyarteritis nodosa, systemic lupus erythematosus, dermatomyositis, Behcet’s disease, severe pneumonia, acute glomerulonephritis, and conjunctivitis.(2)
In immunocompromised patients, it is associated with chronic pure red cell aplasia, AIDS (B19V-induced anemia), acute lymphatic leukemia, and virus-associated hemophagocytic syndrome. All in all, in immunocompetent patients the virus infection is brief with the development of antibodies while in immunocompromised patients the virus is associated with chronic diseases.(2)
Parvovirus B19 (B19V) of the Parvoviridae family is a single-stranded DNA virus that is the only known pathogen to humans. The incubation period of the virus ranges from 4-14 days to as long as 3 weeks from the initial infection. B19V infection is very common in children as well as adults and the incidence of the virus in adults >60 years is approximately 90%. In otherwise healthy children and adults, B19V infection is associated with very low mortality rates. The infection is very common in young children who then transmit the infection to their siblings and parents. The infection shows the seasonal variation with a peak during the late winter and early spring.(1)
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