Flu-like disease found in pregnant women

SHARJAH - Human Parvovirus B19, a single strand DNA virus discovered in 1975, has recently been found in some pregnant women in the UAE, which necessitated a fetal blood transfusion to save the unborn baby's life.

By Hani M Bathish

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Published: Sun 16 May 2004, 12:24 PM

Last updated: Thu 2 Apr 2015, 2:24 PM

The virus has been recognised as a cause of intrauterine fetal death as it results in fetal anaemia and affects the production of red blood cells.

Speaking to Khaleej Times, Dr Afshin Pour Mirza, from the Fetal Medicine Clinic in Sharjah, emphasised the highly contagious nature of this flu-like disease, especially the risk of infection of pregnant women through nursery or kindergarten environments.

"Parvovirus B19, also known as the "fifth disease" in children, is such a common childhood virus among five to 15-year-olds that 50 per cent of women of childbearing age are immune to it.

"Among susceptible individuals, approximately 50 per cent acquire it through household contact and 20 per cent of school teachers develop an infection during a community epidemic. The incidence of B19 infection in pregnancy is low unless there is an outbreak in the community," Dr Mirza said.

He stressed the urgency of a prompt diagnosis and assured that treatment is easy and effective, adding that fetal blood transfusions need only be administered for three to four weeks to allow the fetus to recover, after which all signs of fetal anaemia will disappear.

A fetus infected with the virus could die if not treated in time, thus the need to diagnose the condition early.

Human parvovirus is transmitted via respiratory droplets from infected persons.

B19 incubates for approximately seven days and viremia ensues for five days. Exposure to a household member infected with parvovirus B19 is associated with approximately 50 per cent risk of zero conversion. The risk of transmission in a child-care setting or classroom is lower, ranging from 25 to 50 per cent.

Malaise, myalgias and low-grade fevers may occur at the time of viremia. Seven days after viremia, symptoms such as rash, arthralgia and arthritis may occur. Approximately 20 per cent of adults may not display any symptoms during an infection. The infected person generally is no longer infectious with the onset of the rash.

"Transplacental transmission of B19 is estimated to occur in 33 per cent of pregnancies when the mother has the virus. Between six weeks and four months of gestation, red blood cells are predominantly in the liver and early infection affects the liver. Later infections involve the bone marrow," Dr Mirza said.

The virus prevents the maturation of red blood cells leading to an aplastic crisis of approximately 10 days duration. Adults with chronic hemolytic anaemias may develop an aplastic crisis, but normal adults tolerate this event well with minimal anaemia.

"A rapid turnover of red blood cells occurs in the fetus such that the fetal red blood cell life is half that in an adult. Thus, a profound anaemia may occur in the fetus infected with parvovirus B19," Dr Mirza said.

In a letter to obstetricians and gynaecologists in the country, D. Mirza advises performing a scan and blood test for parvovirus among pregnant patients to mitigate the impact of the disease. Blood test results at the fetal medicine clinic come out in one day.

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