Parvovirus B19

Parvovirus B19 is single-stranded DNA virus that causes the common childhood illness, erythema infectiosum, also called Fifth disease. The illness typically presents with a characteristic red rash on the child's cheeks ("slapped cheek" rash), fever, headache, and runny nose. The rash may spread to other areas of the body. Duration is 7-10 days. Adults who become infected may develop painful or swollen joints (polyarthropathy syndrome) which usually resolves in several weeks.

Parvovirus B19 infections in people with weakened immune systems cause result in serious complications, such as anemia. It, also, poses a potentially serious risk for miscarriage, stillbirth, and fetal health complications if infection occurs when pregnant.

Dr. John Chia, an infectious disease specialist, has listed parvovirus B19 as one of the viruses that may trigger chronic fatigue syndrome in a subset of patients. Dr. Modra Murovska, a virologist, has found a higher B19 viral load present in patients with ME/CFS than in healthy individuals. Dr. Kenny de Meirleir concluded in a 2009 study that "Parvovirus B19 may be involved in the pathogenesis of CFS, at least for a subset of patients."

Notable studies

 * 2016, Occurrence, phase and status of human parvovirus B19 infection in patients with myalgic encephalomyelitis/chronic fatigue syndrome"'Conclusions: Results demonstrate finding of human parvovirus B19 persistent infection in active phase significantly more frequent and with higher B19 load among patients with ME/CFS than apparently healthy individuals indicating on implication of B19 infection in pathogenesis of ME/CFS. Therefore markers of active B19 infection could be used as one of biomarkers in ME/CFS diagnostics. Association of persistent B19 infection in active phase with part of typical ME/CFS clinical symptoms shows possible B19 involvement in disease development and reactivation of B19 may be a risk factor for ME/CFS. B19 infection statuses and onset of symptoms allow suggesting the feasible role of B19 infection as a trigger factor for ME/CFS."
 * 2014, Neurological aspects of human parvovirus B19 infection: a systematic review "'Abtract: Parvovirus B19 has been linked with various clinical syndromes including neurological manifestations. However, its role in the latter remains not completely understood. Although the last 10 years witnessed a surge of case reports on B19-associated neurological aspects, the literature data remains scattered and heterogeneous, and epidemiological information on the incidence of B19-associated neurological aspects cannot be accurately extrapolated. The aim of this review is to identify the characteristics of cases of B19-associated neurological manifestations. A computerized systematic review of existing literature concerning cases of B19-related neurological aspects revealed 89 articles describing 129 patients; 79 (61.2%) were associated with CNS manifestations, 41 (31.8%) were associated with peripheral nervous system manifestations, and 9 (7.0%) were linked with myalgic encephalomyelitis. The majority of the cases (50/129) had encephalitis. Clinical characteristic features of these cases were analyzed, and possible pathological mechanisms were also described. In conclusion, B19 should be included in differential diagnosis of encephalitic syndromes of unknown etiology in all age groups. Diagnosis should rely on investigation of anti-B19 IgM antibodies and detection of B19 DNA in serum or CSF. Treatment of severe cases might benefit from a combined regime of intravenous immunoglobulins and steroids. To confirm these outcomes, goal-targeted studies are recommended to exactly identify epidemiological scenarios and explore potential pathogenic mechanisms of these complications. Performing retrospective and prospective and multicenter studies concerning B19 and neurological aspects in general, and B19 and encephalitic syndromes in particular, are required.'"
 * 2009, Detection of Herpesviruses and Parvovirus B19 in Gastric and Intestinal Mucosa of Chronic Fatigue Syndrome Patients Abstract: "Background: Human herpesvirus-6 (HHV-6), Epstein-Barr virus and parvovirus B19 have been suggested as etiological agents of chronic fatigue syndrome but none of these viruses is consistently detected in all patients. However, active viral infections may be localized in specific tissues, and, therefore, are not easily detectable. The aim of this study was to investigate the presence of HHV-6, HHV-7, EBV and parvovirus B19 in the gastro-intestinal tract of CFS patients. Patients and Methods: Using real-time PCR, viral DNA loads were quantified in gastro-intestinal biopsies of 48 CFS patients and 35 controls. Results: High loads of HHV-7 DNA were detected in most CFS and control biopsies. EBV and HHV-6 were detected in 15-30% of all biopsies. Parvovirus B19 DNA was detected in 40% of the patients versus less than 15% of the controls. Conclusion: Parvovirus B19 may be involved in the pathogenesis of CFS, at least for a subset of patients. The gastro-intestinal tract appears as an important reservoir of infection for several potentially pathogenic viruses."
 * 1997, Parvovirus B19 and Chronic Fatigue Syndrome Abstract - "Objective: To investigate the skeletal muscle of patients with chronic fatigue syndrome (CFS) for parvovirus B19. Methods: DNA was extracted from skeletal muscle biopsies from six patients with CFS diagnosed according to the criteria of the Centers for Disease Control and Prevention and six control cases. Extracted DNA was checked for purity by agarose gel electrophoresis and examined for the presence of B19 DNA by a nested polymerase chain reaction (PCR) method. Results: One of the six biopsies from the CFS group and one of the six from the control group were positive for B19 DNA (Two-tailed P value = 1). Nucleotide sequencing of the PCR product from the CFS patient revealed one silent mutation from A -> G at nucleotide 1530 when compared with the published sequence. Nucleotide sequencing of the PCR product from the control patient with mild arthralgia revealed 10 mutations when compared with the published sequence, all silent except the one at nt 1466 (G -> C), which resulted in an amino acid change from serine to threonine. Conclusion: The incidence of parvovirus B19 detected in muscle is not increased in patients with CFS compared with controls and the virus in unlikely to play a role in the aetiology of this disorder."

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