|Year : 2017 | Volume
| Issue : 1 | Page : 138-140
Seroepidemiology of parvovirus B19 among different age groups & pregnant women in India
Rajlakshmi Viswanathan1, Babasaheb V Tandale2, Manisha S Tamayachekar1, Santoshkumar M Jadhav3, Kirtee A Khutwad1, Kiran R Munne1
1 Diagnostic Virology Group, ICMR-National Institute of Virology, Pune 411 021, Maharashtra, India
2 Epidemiology Group, ICMR-National Institute of Virology, Pune 411 021, Maharashtra, India
3 Bioinformatics & Data Management Group, ICMR-National Institute of Virology, Pune 411 021, Maharashtra, India
|Date of Submission||15-Jun-2016|
|Date of Web Publication||22-Nov-2017|
Diagnostic Virology Group, ICMR-National Institute of Virology, Pune 411 021, Maharashtra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Viswanathan R, Tandale BV, Tamayachekar MS, Jadhav SM, Khutwad KA, Munne KR. Seroepidemiology of parvovirus B19 among different age groups & pregnant women in India. Indian J Med Res 2017;146:138-40
|How to cite this URL:|
Viswanathan R, Tandale BV, Tamayachekar MS, Jadhav SM, Khutwad KA, Munne KR. Seroepidemiology of parvovirus B19 among different age groups & pregnant women in India. Indian J Med Res [serial online] 2017 [cited 2019 Dec 8];146:138-40. Available from: http://www.ijmr.org.in/text.asp?2017/146/1/138/219014
Parvovirus B19 (B19) can infect people of all ages, regions and social groups,,. Infection patterns in tropical and temperate countries, however, are variable,. Clinical presentation also varies depending on age, immune status and presence of underlying diseases. In healthy children, B19 infection can present as erythema infectiosum, an exanthematous childhood illness or mild febrile illness. B19 infection can lead to serious consequences in ‘at risk’ groups, such as organ transplant recipients, thalassaemia and sickle cell anaemia patients and foetus in utero. There are no population-based seroprevalence studies from India on parvovirus B19, although studies conducted among blood donors, and hospital-based studies are reported. Seroprevalence data of B19 in pregnant women are also lacking from India. The present study was, therefore, undertaken to provide information on seroprevalence of B19 in general population and also among pregnant women.
A descriptive cross-sectional survey was carried out in Pune, India – retrospective for general population and prospective for antenatal women. Ethical approval for the study was received from the Institutional Human Ethics Committee, ICMR- National Institute of Virology, Pune. Anonymized, archived serum samples collected from hospital staff, general practitioners, school children and staff who were surveyed as the risk group for pandemic flu infection in Pune district, in 2009, were tested for estimating community seroprevalence. For the present study, samples of 168 adults (20-60 yr), 350 adolescents (10 to <20 yr) and 150 children (<10 yr) were studied. Of the 1583 archived samples, 668 samples were selected by taking every alternate sample, maintaining male:female sex ratio (1.14:1 for children, 1.01:1 for adolescents and 1.02:1 for adults). As samples of children were limited, all samples were included. Samples selected included both seropositive and seronegative samples for pandemic influenza A (H1N1). For pregnant women, a sample size of 122 was calculated.
One hundred pregnant women were recruited during the study period (December 2014 - May 2015) at two hospitals (KEM Hospital and Bharati Hospital, Pune). Women up to 16 wk of gestation, attending antenatal clinic, who gave informed written consent were included in the study. Those with any history of immunosuppression or haemoglobinopathies were excluded. Anti-B19 IgG was determined using commercial kits – [SERION ELISA classic (virion\serion, Germany, and NovaLisa (NOVATEC IMMUNODIAGNOSTICA, GMBH, Germany)]. Five hundred and seven samples were tested by SERION ELISA classic and 261 by NovaLisa. IgM was estimated for equal number of age-matched IgG-positive (43) and IgG-negative (43) pregnant women.
Statistical analysis was performed using online software Openepi (http://www.openepi.com/Proportion/Proportion.htm). The presence of anti-B19 IgG antibodies was observed in 126/668 samples [18.86%, 95% confidence interval (CI) 16-22]. Seroprevalence of 6.7 per cent (4 of 59; 95% CI 2-16) in children below five years, 4.4 per cent (4 of 91; 95% CI 1-10) among 5-9 yr and 8.9 per cent (17 of 191; 95% CI 5-13) in 10-14 yr age group was noted. Older adolescents (15-19 yr) had a higher seroprevalence of 16.9 per cent (27 of 160; 95% CI 11-23). Seroprevalence of B19 increased significantly with age [Chi-square of trend=78.17 (P<0.001)]. Seroprevalence was similar in male and female children (M:F 3:1) and adolescents (M:F 0.92:1), but significantly (P<0.05) higher among adult females (M:F 0.68:1) (53%, 95% CI 42-63) as compared to males (35%, 95% CI26-46) [Table 1].
|Table 1: Age and gender distribution of seroprevalence of parvovirus B19|
Click here to view
Among pregnant women, estimated seroprevalence of B19 was 43 per cent (43 of 100; 95% CI 33-52). Three seronegative women were IgM positive, of whom two had a recent history of fever with rash. All three women had normal outcome of pregnancy. Seroprevalence of B19 in pregnant women (43/100; 43%, 95% CI 33-52) and non-pregnant women (39/88; 44%, 95% CI 33-55) of reproductive age group (18-40 yr) was similar.
Our study showed lower seroprevalence of B19 antibodies among children and adolescents when compared with available data from India. The pattern of seroprevalence in our study was consistent with that of developing Asian countries, and other tropical countries,,, but lower than temperate countries,. This suggests that age of acquisition of parvovirus B19 infection may be slightly higher in tropical countries as compared to temperate countries,. Significantly higher seroprevalence was observed in adult females. This may be because adult women are more likely to be involved with the care of children and thus more likely to acquire infection from them. More individuals need to be tested to confirm this finding. A previous study has reported evidence of B19 infection in women with bad obstetric history from India.
In conclusion, our study provided baseline data from India, on seroprevalence of B19 in healthy pregnant women. As B19 infection is not vaccine preventable, the only means of prevention is a reinforcement of hygienic precautions. Awareness needs to be generated among physicians and population including pregnant women about this infection, its consequences and methods of prevention.
| Acknowledgment|| |
Authors thank the obstetric consultants at KEM and Bharti Hospital, Pune; Dr Gajanan N Sapkal and all study participants.
Conflicts of Interest:
| References|| |
Berns KI, Parrish CR. Parvoviridae. In: Knipe DM, Howley PM, editors. Fields virology
. Philadelphia: Lippincott Williams & Wilkins; 2013. p. 1768-91.
Kaslow RA, Evans AS. Surveillance and seroepidemiology. In: Kaslow RA, Evans AS, editors. Viral infections of humans epidemiology and control
. New York: Plenum; 1997. p. 89-115.
Röhrer C, Gärtner B, Sauerbrei A, Böhm S, Hottenträger B, Raab U, et al.
Seroprevalence of parvovirus B19 in the German population. Epidemiol Infect
Brown KE, Young NS. Parvovirus B19 infection. In: Kaslow RA, Evans AS, editors. Viral infections of humans epidemiology and control
. New York: Plenum; 1997. p. 569-82.
Matsunaga Y, Goh KT, Utagawa E, Muroi N. Low prevalence of antibody to human parvovirus B19 in Singapore. Epidemiol Infect
Heegaard ED, Brown KE. Human parvovirus B19. Clin Microbiol Rev
Kishore J, Srivastava M, Choudhary N. Standardization of B19 IgG ELISA to study the seroepidemiology of parvovirus B19 in North Indian voluntary blood donors. Asian J Transfus Sci
Kumar S, Gupta RM, Sen S, Sarkar RS, Philip J, Kotwal A, et al.
Seroprevalence of human parvovirus B19 in healthy blood donors. Med J Armed Forces India
Abraham M, Rudraraju R, Kannangai R, George K, Cherian T, Daniel D, et al.
A pilot study on the seroprevalence of parvovirus B19 infection. Indian J Med Res
Tandale BV, Pawar SD, Gurav YK, Chadha MS, Koratkar SS, Shelke VN, et al.
Seroepidemiology of pandemic influenza A (H1N1) 2009 virus infections in Pune, India. BMC Infect Dis
Census of India; 2011. Available from: http://www.census2011.co.in/census/city/375-pune.html
, accessed on May 5, 2015.
Miron D, Horovitz Y, Luder A, Ohnona FS, Schlesinger Y. Age-related immunoglobulin G seroprevalence of human parvovirus B-19 in Israeli children. Isr Med Assoc J
Lin KH, You SL, Chen CJ, Wang CF, Yang CS, Yamazaki S. Seroepidemiology of human parvovirus B19 in Taiwan. J Med Virol
Abarca K, Cohen BJ, Vial PA. Seroprevalence of parvovirus B19 in urban Chilean children and young adults, 1990 and 1996. Epidemiol Infect
Wasfy S, Nishikawa J, Petric M. Seroprevalence of immunoglobulin G antibody to parvovirus B19 in Ontario. Can J Infect Dis
Kelly HA, Siebert D, Hammond R, Leydon J, Kiely P, Maskill W. The age-specific prevalence of human parvovirus immunity in Victoria, Australia compared with other parts of the world. Epidemiol Infect
van Rijckevorsel GGC, Bovée LPMJ, Damen M, Sonder GJB, Schim van der Loeff MFS, van den Hoek A. Increased seroprevalence of IgG-class antibodies against cytomegalovirus, parvovirus B19, and varicella-zoster virus in women working in child day care. BMC Public Health
Kishore J, Misra R, Paisal A, Pradeep Y. Adverse reproductive outcome induced by parvovirus B19 and TORCH infections in women with high-risk pregnancy. J Infect Dev Ctries