1054. Clinical and Laboratoy Characteristics of Parvovirus B19 Infection During 2013/2014 Outbreak in Zagreb, Croatia
Session: Poster Abstract Session: Adult Viral Infection
Friday, October 6, 2017
Room: Poster Hall CD
Background: Human 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.

Methods: We 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.

Results: Outbreak 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-value 

Age, years

8.8±4.1

39±10.7

Male sex

31 (59.6%)

26 (12.3%)

0.0001

Clinical presentation

Biphasic presentation

8 (15.4%)

48 (30.0 %)

0.0460

Fever

26 (50.0%)

110 (68.7%)

0.0194

Rash

51 (98.1%)

127 (79.4%)

0.0008

Myalgia

5 (9.6%)

50 (31.2%)

0.0017

Arthralgia

9 (17.3%)

100 (62.5%)

0.0001

Headache

3 (5.8%)

34 (21.2%)

0.0107

„Slapped cheeks“

29 (55,8%)

24 (15.0%)

0.0001

Peripheral edema

6 (11.5%)

63 (39.4%)

0.0001

Anemia

4 (7.7%)

19 (11.8%)

0.6076

Leukopenia

1 (1.9%)

23 (14.5%)

0.0111

Thrombocytopenia

4 (7.7%)

35 (21.8%)

0.0231

Hepatitis 

1 (1.9%)

11 (6.87%)

0.3011

Vasculitis

1 (1.9%)

2 (1.25%)

0.5721

Other

2 (3.8%)

3 (1.9%)

0.5982

Conclusion: 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.

Mia Ajdukovic, MD, University Hospital for Infectious Diseases Dr. Fran Mihaljevic, Zagreb, Croatia, Lucija Pejic, MD, ika-Senj County Emergeny Medical Institute, Senj, Croatia, Neven Papic, MD, PhD, University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia and Adriana Vince, MD, University Infectious Disease Hospital, Zagreb, Croatia

Disclosures:

M. Ajdukovic, None

L. Pejic, None

N. Papic, None

A. Vince, None

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