Parvovirus B19

Objectives
1. morphology
2. Pathogenesis
3. Diseases
4. Lab diagnosis
5. Treatment
 Parvovirus B19

the smallest
DNA virus
18-26nm in
diameter
Structure
 Morphology
* Family : Parvovaridie ( erythrovirus )
* Size : The smallest DNA virus ( 18-24nm )
* Nucleic acid : ss DNA virus ( the only ss DNA
virus)
* Envelope : Non enveloped ( high resistant )
* Shape : Icosahedral
* Site of replication : Replicate in nucleus of
highly dividing cells
Mode of transmission
Pathogenesis
Replication of virus in highly dividing
erythrocyte progenitor cells
 Pathogenesis
The virus enter the body through respiratory system and it
moves to the blood until it reaches the bone marrow
In bone marrow it infects erythroid progenitor cells or
proerythroblast
Due to
1. They have ( P antigen ) and co-receptor (b1a5) on their
surface important for the penetration of the virus
( endocytosis )
2. Mitotic active for virus replication
they replicate producing structural proteins and non structural
proteins (responsible for apoptosis of infected cells and viremia )
 Pathogenesis
After 4 days of infection DNA of virus can be detected in blood ,
reticulocyte and erythrocyte start to decrease and general
symptoms will appear (myalgia ,fever ,malaise and headache) .
B cells of immune system IgM appear through 8 days and IgG
appear through 12 days they will end viremia by forming
immune complex.
The general symptoms will disappear and number of
reticulocytes will return normal
Immune complexes will deposite in body organs causing skin
rash ( erythema infectiosum or Fifth disease or slapped cheek
appearance) in joints of (hands ,wrists ,feets and knees)
causing arthritis
 Diseases
1. Fifth disease ,erythema infectiosum , slapped
cheek appearance
2. Arthritis in wrest ,knee, hands ,feet
3. May complicated in immunocompromised into
persistant chronic anemia pure red cell aplasia
 Diseases
4. Transient aplastic crisis
in Patients with (sickle cell anemia , Thalassemia)
have massive decrease in RBCs when infected with
parvovirus B19 cause transient aplastic crisis
5. Hydrops fetalis and congestive heart failure in
pregnant infection the heart will beat rapidly to carry
oxygen to cells which decreased by decreasing RBCs
so blood plasma start to leak outside the capillaries
causing hydrous fetalis and congestive heart failure
 Fifth disease
Fifth disease known to cause a rash in
children
Ms VRPR
1. Measles
2. Scarlet fever
3. Varicella
4. Rubella
5. Parvovirus
6. Roseola infuntum (sixth disease )
Slapped cheek syndrome
Arthritis
Transient aplastic crisis
Transient aplastic crisis
Hydrops fetalis
Hydrops fetalis
 Diagnosis

1. PCR for viral DNA

2. Antibody detection IgM by ELISA
 Treatment

1. Blood transfusion in aplastic crisis

2. Passive immunity by immunoglobulin in
immunocompromised patients and
pregnant woman