Skip to main content Accessibility help
×
Home

Parvovirus B19 outbreak on an adult ward

  • C. Seng (a1), P. Watkins (a2), D. Morse (a1), S. P. Barrett (a2), M. Zambon (a2), N. Andrews (a1), M. Atkins (a2), S. Hall (a1), Y. K. Lau (a3) and B. J. Cohen (a4)...

Summary

In November and December 1992, an outbreak of parvovirus B19 infection occurred among patients and staff on an adult mixed surgical ward at a large hospital in London. Three patients and 15 staff members were serologically confirmed as acute cases. The attack rate among susceptible members of staff was 47%. In those infected, arthralgia (80%) and rash (67%) were the most common symptoms. Of six susceptible in-patients on the ward, three became infected. One of the in-patients who had carcinoma of the mouth was viraemic for more than 10 days with marrow suppression resulting in the postponement of chemotherapy until intravenous immunoglobulin was given and he was no longer viraemic. Control measures taken included closure of the ward to new admissions, transfer of only immune staff to the ward, and restriction of the ward nursing staff to working only on that ward. Although no specific exposure was conclusively identified as a risk factor, there was a suggestion of an increased risk of acquiring parvovirus B19 infection among those staff who did not adopt strict hand washing procedures after each physical contact with a patient (RR = 2·33; P = 0·07). Knowledge of parvovirus B19 among interviewed health care workers was poor: only 42% reported knowing about parvovirus B19 and only 38% could name a patient category at risk of a severe outcome following infection. This is the first report of a nosocomial outbreak affecting an adult ward and of possible transmission of parvovirus B19 infection from staff to in-patients. Hospital control of infection teams should include parvovirus B19 in their outbreak containment plans.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Parvovirus B19 outbreak on an adult ward
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Parvovirus B19 outbreak on an adult ward
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Parvovirus B19 outbreak on an adult ward
      Available formats
      ×

Copyright

Corresponding author

* Author for correspondence: Dr C. Seng, Brent and Harrow Health Agency, Grace House, Bessborough Road, Harrow HA1 3EX.

References

Hide All
1.Cossart, Ye, Field, AM, Cant, B, Widdows, D, Parvovirus like particles in human sera. Lancet 1975; i: 72–3.
2.Anderson, MJ, Cohen, BJ, Human parvovirus B19 infections in United Kingdom 1984–1986. Lancet 1987; i: 738–9.
3.Courouce, AM, Ferchal, F, Morinet, F et al. , Human parvovirus infection in France. Lancet 1984; i: 160.
4.Naides, SJ, Erythema infectiosum (fifth disease) occurrence in Iowa. Am J Public Health 1988; 78: 1230–1.
5.Cohen, BJ, Human parvovirus B19 and Fifth disease. In: Mortimer, PP, ed. Public health virology: twelve reports. London: Public Health Laboratory Service, 1986: 130–43.
6.Plummer, FA, Hammond, GW, Forward, K et al. , An erythema infectiosum like illness caused by human parvovirus infection. N Engl J Med 1985; 313: 74–9.
7.Woolf, AD, Campion, GVChiswick, et al. , Clinical manifestations of human parvovirus B19 in adults. Arch Intern Med. 1989; 149: 1153–6.
8.Pattison, JR, Jones, SE, Hodgson, J et al. , Parvovirus infections and hypoplastic crisis in sickle cell anaemia. Lancet 1981: i: 644–5.
9.Serjeant, GR, Topley, JM, Mason, K et al. , Outbreak of aplastic crises in sickle cell anaemia associated with parvovirus like agent. Lancet 1981; ii: 595–7.
10.Chorba, T, Coccia, P, Holman, RC, The role of parvovirus B19 in aplastic crisis and erythema infectiosum (fifth disease). J Infect Dis 1986; 154: 383–93.
11.Rao, KR, Patel, AR, Anderson, MJ, Jones, SE, Pattison, JR, Infection with parvovirus like virus and aplastic crisis in chronic haemolytic anaemia. Ann Intern Med 1983; 98: 230–2.
12.Koch, WC, Massey, G, Russell, CE, Adler, SP, Manifestations and treatment of human parvovirus B19 infection in immunocompromised patients. J Pediatr 1990; 116: 355–9.
13.Kurtzman, GJ, Cohen, B, Meyers, P, Amunullah, A, Young, NS, Persistent B19 parvovirus infection as a cause of severe chronic anaemia in children with acute lymphocytic leukemia. Lancet 1988; ii: 1159–62.
14.Van Horn, DK, Mortimer, PP, Young, N, Hason, GR, Human parvovirus associated red cell aplasia in the absence of underlying haemolytic anaemia. Am J Pediatr Hematol Oncol 1986; 8: 235–9.
15.Anderson, LJ, Hurwitz, ES, Human parvovirus in pregnancy. Clin Perinatol 1988; 15: 273.
16.Hall, SM, Parvovirus B19 and pregnancy. Rev Medical Microbiol 1990; 1: 160–7.
17.Pillay, D, Patou, G, Hurt, S, Kibbler, CC, Griffiths, PD, Parvovirus B19 outbreak in a children's ward. Lancet 1992; 339: 107–9.
18.Bell, LM, Naides, SJ, Stoffman, P, Hodinka, RL, Plotkin, SA, Human parvovirus B19 infection among hospital staff members after contact with infected patients. N Eng J Med 1989; 321: 485–91.
19.Anderson, MJ, Higgins, PG, Davis, LR, et al. Experimental parvoviral infection in humans. J Infect Dis 1985; 152: 257–65.
20.Communicable Disease Surveillance Centre. Trends in rubella and parvovirus B19 infections. Commun Dis Rep 1993; 3: 125.
21.Cohen, BJ, Mortimer, PP, Pereira, MS, Diagnostic assays with monoclonal antibodies for the human serum parvovirus-like virus (SPLV). J Hyg 1983; 91: 113–30.
22.Mori, J, Field, AM, Clewley, JP, Cohen, BJ, Dot blot hybridisation assay of B19 virus DNA in clinical specimens. J Clinical Microbiol 1989; 27: 459–64.
23.Centers for Disease Control. Risks associated with human parvovirus B19 infections. MMWR 1989; 38: 81–8. 93–7.
24.Koziol, DE, Kurtzman, G, Ayub, J, Young, NS, Henderson, DK, Nosocomial human parvovirus B19 infection: Lack of transmission from a chronically infected patient to hospital staff. Infect Cont Hosp Epidemiol 1992; 13: 343–8.
25.Goldmann, D, Larson, E, Hand-washing and nosocomial infections. N Engl J Med 1992; 327: 120–7.
26.Isaacs, D, Dickson, H, O'Callaghan, , Sheaves, R, Winter, A, Moxon, ER, Handwashing and cohorting in prevention of hospital acquired infections in respiratory syncytial virus. Arch Dis Child 1991; 66: 227–31.
27.Hall, CB, Douglas, RG Jr. Modes of transmission of respiratory syncytial virus. J Pediatr 1981; 99: 100–3.
28.Hall, CB, Douglas, RG Jr, Geiman, JM, Possible transmission by fomites of respiratory syncytial virus. J Infect Dis 1980; 141: 98102.

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed