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Parvo-19 (PARVO VIRUS B 19)
Sep 14, 2007

What is Parvo-19 & can an adult have it? How long does it stay in the system & is it contagious

Response from Dr. Frascino

Hi,

Are you HIV positive? This is an HIV information Web site. I'll reprint some information about parvovirus B-19 below. If this does not answer your question and you are HIV positive, please write back with additional information, including CD4 count, viral load, current meds, symptoms, etc.

Dr. Bob

parvo virus b19 infection in adults Jan 11, 2003

Hi!

I have parvo virus b19 and have had it since the middle of September. I was first thought to have rheumatic fever. But tested positive for the virus. I have been suffering we joint pain (fingers, hands, elbow, shoulders,knees, ankles and feet) plus swelling (serious). I am being treated with a form of steriod (4 mg) and a water pill. I have be tested to arthiritus and don't have this. My Kidney's are a problem (cyst have been found) but not serious. I am scared that this is going to go on forever. Is there anything else that can be done. By doctor is watching me carefully, but any suggestion you could give would be great. It is a pain being in pain all the time.

Thanks

Donnawinky

Response from Dr. Frascino

Hello Donnawinky,

I like the name! Sorry to hear about your recent parvovirus B19 problems. Are you also HIV-positive? This is an HIV information website and parvovirus in the setting of HIV disease can be a significant opportunistic infection. From the information in your question, I'm guessing you are not HIV-positive, which means I shouldn't be answering your question here; however, since parvovirus can cause anemia, let me at least make a quick comment.

Infection with parvovirus B19 is very common. About 60% of adults worldwide have B19 antibodies in their bloodstream, indicating they had past infection and are now immune. The virus is spread via the respiratory route or via blood and blood products (transfusions, etc.). It can cause a variety of clinical conditions. Normal children with parvo B19 get Erythema Infectiosum, also called Fifth Disease or Slapped-Cheek Syndrome. Normal adults can develop polyarthropathy, which is what you most likely are experiencing. I'll get back to that in a moment. HIV+ folks can develop persistent, very severe anemia.

A fetus can develop congenital anemia ("Hydrops Fetalis") in the uterus. There are other more rare conditions involving the heart and liver as well.

So what do you have? Adult women are most likely to experience symmetrical pain in joints. The small joints of the hands and feet are primarily involved with swelling and stiffness. Joint symptoms usually last 1 to 3 weeks, although in about 20 percent of affected women, joint pain and inflammation can persist or recur for up to 2 years.

Treatment? The majority of cases are quite benign and self-limited. Certainly non-steroidal anti-inflammatory drugs, like aspirin or Advil, can be helpful for discomfort. The other recommended treatment is IVIG (intravenous gamma globulin). Patients with normal immune systems usually recover quite quickly and completely. Patients with immunodeficiency (such as AIDS) may require repeated or even regular (every month) infusions of IVIG to suppress the parvovirus B19 infection.

Ask your doctor about IVIG. (I recommend "Gammaimmune N.") If he is not familiar or comfortable using this product, ask to be referred to a hematologist or infectious disease specialist. If you are HIV-positive, discuss IVIG with your HIV/AIDS specialist.

You should be feeling much improved very soon! Hang in there. Appropriate treatment is highly effective!

Dr. Bob

Parvo 19 virus Aug 1, 2002

Please described the symptoms of the Parvo 19 human virus. Apparently the Canine Parvo virus can be fatal. How serious is it in humans? Is there a treatment for the human virus?

Response from Dr. Frascino

Hi,

Parvovirus B19 is a small DNA virus. Epidemiological studies have shown about half of the adult population has antibodies to Parvo B19, which means that they had some form of the viral infection some time during their lives. Most of these infections occur in childhood and often are completely asymptomatic.

The symptomatic conditions caused by parvovirus include:

1. Fifth Disease (Erythema Infectiosum). This is a common childhood viral syndrome, which includes an evanescent rash often referred to as "slapped" cheek rash. 2. In adults, acute infection with Parvovirus can cause rheumatic complaints like symptoms similar to arthritis, fibromyalgia, or systemic lupus erythematosus. 3. Transient Aplastic Crisis. Parvovirus B19 can interrupt the normal production of red blood cells and result in problems for people who have other blood-related problems like hereditary spherocytosis or hemolytic anemia. 4. Hydrops Fetalis and Congenital Infection. Parvovirus infection in pregnant women can be transmitted to the developing fetus, resulting in liver problems, spontaneous abortion, or death in utero. Congenital infections can produce chronic anemia. 5. Sever chronic anemia in HIV-infected people.

So to answer your questions, how serious is it in humans? Usually not serious at all, but on occasion, it can cause significant problems as I indicated above. Is there a treatment? Yes, the best treatment is Intravenous Gamma Globulin. This is a product made form pooled serum antibodies from blood donors. As I mentioned, 50% of the adult population has antibodies in their blood stream, which indicates past infection. These antibodies are also the immune system's response to infection. By collecting and infusing these antibodies into someone with symptomatic Parvovirus B19, the symptoms can usually be brought under control quite quickly.

Canine Parvo is not the same things as Parvovirus B19 that infects humans.

OK, that was probably a lot more information than you wanted to know, right? Bottom line - Parvovirus usually doesn't cause significant problems in humans, but when it does, we have an excellent treatment. Second, no problem cuddling up with Fido and giving him a big hug. In fact, my pooch is sitting right here on my lap as I write this response. We both send our good wishes.

Dr. Bob

PARVO REACURANCE? Apr 9, 2005

Dear Dr. Frascino Can you please help me ? I am HIV pos for about 15 years now.

About 4 years ago I started to become tired, pail , felt like hell I was tested, and I was anemic I was given a transfusion . it helped for about week but I became sick again, so this process continued ,a transfusion a week every week for almost a year. The Doctors said it was aids related or the med's .

My mom who has always been my advocate researched on the web and found Parvo to match my symptoms the Dr. tested me and it WAS positive for Parvo . The cure she found was gama iv push very slow three ivs over a short period of time

I was given only ONE and it was NOT done slow. I ended up in the hospital with a headache and vomiting like you would not believe

For the last three years now I have been suffering with server join muscle pain I am week and my color is pale /green it is getting worse I am becoming a cripple I have been REtested for Parvo again but the tests are coming up negative .(it was a D.N.A. test)

I don't care what the test comes up I know my body and I have NEVER felt the same . is this because I did not get three doses of gama ? this is a quality of life issue, I am really in pain here

my t cells are at 480 the highest in years and am undetectable

I thank you in advance for any information that you may have

BRIAN

Response from Dr. Frascino

Hello Brian,

Infection with parvovirus B19 is very common. In fact, about 60% of adults worldwide have parvo B19 antibody in their bloodstream, which indicates past infection with that virus and immunity to it.

Parvovirus can cause a variety of clinical conditions, most of which are mild and self-limited. However, parvovirus B19 can be an opportunistic infection in people who are immunodeficient, including those with severe HIV disease. In that case, the impaired immune system is not able to fight off parvovirus. Consequently, instead of a self-limited, relatively mild condition, an immunosuppressed individual could have a persistent parvovirus B19 infection. This can lead to a condition known as red-cell aplasia with severe anemia. It is most effectively treated with intravenous gammaglobulin (IgIV), which is a good source of neutralizing antibodies. Relapses in patients with AIDS or other conditions associated with severe immunodeficiency are common, but respond well to repeated doses of IgIV.

Parvovirus can cause symmetrical joint problems (swelling and stiffness). This is seen most frequently in women and involves the small joints of the hands and feet primarily. This can evolve into a rather persistent arthritis, which can last for several years.

Regarding treatment, as mentioned above, most parvovirus infections are benign and self-limited and require no treatment other than symptomatic relief. Patients with joint pain and inflammation usually respond to nonsteroidal anti-inflammatory drugs. Persistent or highly symptomatic parvovirus B19 infection can be treated with intravenous immune globulin (IgIV), which, although not curative, is often dramatically effective. Without additional information, I cannot determine if your current problem is parvovirus-related or not. Your physician should be able to monitor your response to IgIV by following your reticulocyte count and measuring the parvovirus B19 DNA viral load. IgIV, which is administered too quickly, can lead to side effects, such as the ones you describe. The number of infusions is not as important as the total dose given. I suggest you discuss your concerns with your HIV specialist. Are you still anemic? And if so, why? What is the cause of your joint and muscle pain and weakness? If he cannot determine the cause, he should refer you to an HIV-knowledgeable rheumatologist for further evaluation.

Good luck.

Dr. Bob


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