Insights into epidemiology of human parvovirus B19 and detection of an unusual genotype 2 variant, Bulgaria, 2004 to 2013

• Published in: Euro surveillance : bulletin européen sur les maladies transmissibles Vol. 21; no. 4; p. 1
• Main Authors: Ivanova, Stefka Krumova, Mihneva, Zafira Georgieva, Toshev, Andon Krumov, Kovaleva, Valentina Pavlova, Andonova, Lubena Georgieva, Muller, Claude P, Hübschen, Judith M
• Format: Journal Article
• Language: English
• Published: Sweden Centre Europeen pour la Surveillance Epidemiologique du SIDA (European Centre for the Epidemiological Monitoring of AIDS) 28.01.2016
• Subjects: Adolescent; Adult; Age Distribution; Antibodies, Viral - blood; Bulgaria - epidemiology; Child; Child, Preschool; Epidemiology; Erythema Infectiosum - epidemiology; Erythema Infectiosum - virology; Exanthema - virology; Female; Fever - virology; Genetic Variation; Genotype; Genotype & phenotype; Humans; Immunoglobulin M - blood; Infant; Male; Middle Aged; Molecular Epidemiology; Molecular Sequence Data; Parvovirus B19, Human - classification; Parvovirus B19, Human - genetics; Parvovirus B19, Human - isolation & purification; Phylogenetics; Phylogeny; Polymerase chain reaction; Polymerase Chain Reaction - methods; Proteins; Viral Proteins - genetics; Young Adult; Bulgaria; IgM antibodies; human parvovirus B19; PCR; ELISA; genotype
• ISSN: 1560-7917; 1025-496X; 1560-7917
• DOI: 10.2807/1560-7917.ES.2016.21.4.30116

The present study aimed to determine the role of human parvovirus В19 (B19V) as an aetiological agent in measles and rubella negative fever/rash patients from Bulgaria between 2004 and 2013. A total of 1,266 sera from all over the country were tested for B19V IgM antibodies and all positives were further investigated by polymerase chain reaction (PCR). Overall, 280 sera (22%) were B19V IgM positive and 227 of these (81%) were also PCR positive. The highest number of IgM positives was found among five to nine year-old children (27%). Eight infected women gave birth to healthy children; one fetus was aborted with hydrops fetalis. Of the 55 genetic sequences obtained, 54 belonged to genotype 1a and one grouped as a genotype 2 outlier. Phylogenetic analysis of all available genotype 2 sequences covering the 994 nucleotide non-structural protein 1(NS1)/capsid viral protein 1 (VP1) unique region junction, showed that only one other sequence grouped with the outlier strain, forming a clearly distinct and well-supported cluster of genotype 2 (between-group genetic distance: 3.32%). In accordance with B19V nomenclature, this cluster may represent a new subgenotype 2b. The study showed that B19V infections may be falsely identified as rubella or measles in ca 22% of cases, emphasising the need for laboratory confirmation.