Maternal Exposure to Parvovirus B1
Contributor: Sharon Keiser, MD, Maternal-Fetal Medicine
Last Update 7/2017
Pathogenesis
Human parvovirus B19 is the most commonly reported infectious cause of fetal anemia. This is a small, non-enveloped single-stranded DNA virus, and is the only parvovirus known to cause disease in humans. It preferentially infects rapidly dividing cells and is cytotoxic to erythroid progenitor cells. In addition, it may stimulate a cellular process initiating apoptosis.
B19 viremia begins approximately 6 days after exposure and lasts for one week in immunocompetent individuals. It can be detected in blood and secretions 5-10 days after exposure.
Maternal Effects
20-30% asymptomatic
Reticular rash on trunk
Peripheral arthropathy
Transient aplastic crisis (in patients with underlying hemoglobinopathy)
Fetal Effects
Spontaneous resolution
Fetal Anemia
Fetal Hydrops (up to 8 weeks after maternal infection)
Spontaneous abortion (1-11 weeks after maternal infection)
Maternal Transmission
Respiratory droplets
Hand-to-mouth contact
Infected person is infectious 5-10 days after exposure (before onset of symptoms)
Risk of Transmission:
Exposure to an infected household member – 50% risk of seroconversion
Exposure in a childcare setting/classroom – 20-50% risk of seroconversion
Transmission to Fetus
17-33%
Highest risk is when transmission occurs prior to 22 weeks EGA
References
J Prenat Med. 2010 Oct-Dec; 4(4):63-66
ACOG Practice Bulletin #151https://www.mombaby.org/ob-algorighms?#medical-complications-infections
Clin Lab Med. 2016 Jun;36(2):407-19
UNC Center for Maternal and Infant Health OB Algorithms (https://www.mombaby.org/ob-algorighms?#medical-complications-infections.
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