Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-19T16:22:29.337Z Has data issue: false hasContentIssue false
  • English
  • Français

Parvovirus B19 outbreak on an adult ward

Published online by Cambridge University Press:  15 May 2009

C. Seng ,
P. Watkins ,
D. Morse ,
S. P. Barrett ,
M. Zambon ,
N. Andrews ,
M. Atkins ,
S. Hall ,
Y. K. Lau  and
B. J. Cohen
C. Seng*
Affiliation:
PHLS Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ
P. Watkins
Affiliation:
Department of Medical Microbiology and Virology, St Mary's Hospital Medical School, London W2
D. Morse
Affiliation:
PHLS Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ
S. P. Barrett
Affiliation:
Department of Medical Microbiology and Virology, St Mary's Hospital Medical School, London W2
M. Zambon
Affiliation:
Department of Medical Microbiology and Virology, St Mary's Hospital Medical School, London W2
N. Andrews
Affiliation:
PHLS Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ
M. Atkins
Affiliation:
Department of Medical Microbiology and Virology, St Mary's Hospital Medical School, London W2
S. Hall
Affiliation:
PHLS Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ
Y. K. Lau
Affiliation:
Department of Public Health Medicine, Kensington, Chelsea and Westminster District Health Authority, 16 South Wharf Rd, London W2 1NY
B. J. Cohen
Affiliation:
Virus Reference Division, Central Public Health Laboratory, 61 Colindale Avenue, London NW9 5EQ
*
* Author for correspondence: Dr C. Seng, Brent and Harrow Health Agency, Grace House, Bessborough Road, Harrow HA1 3EX.
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

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.

Type
Research Article
Information
Epidemiology & Infection , Volume 113 , Issue 2 , October 1994 , pp. 345 - 353
Copyright
Copyright © Cambridge University Press 1994

References

REFERENCES

1.Cossart, Ye, Field, AM, Cant, B, Widdows, D, Parvovirus like particles in human sera. Lancet 1975; i: 72–3.CrossRefGoogle Scholar
2.Anderson, MJ, Cohen, BJ, Human parvovirus B19 infections in United Kingdom 1984–1986. Lancet 1987; i: 738–9.CrossRefGoogle Scholar
3.Courouce, AM, Ferchal, F, Morinet, F et al. , Human parvovirus infection in France. Lancet 1984; i: 160.CrossRefGoogle Scholar
4.Naides, SJ, Erythema infectiosum (fifth disease) occurrence in Iowa. Am J Public Health 1988; 78: 1230–1.CrossRefGoogle ScholarPubMed
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.Google Scholar
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.CrossRefGoogle ScholarPubMed
7.Woolf, AD, Campion, GVChiswick, et al. , Clinical manifestations of human parvovirus B19 in adults. Arch Intern Med. 1989; 149: 1153–6.CrossRefGoogle ScholarPubMed
8.Pattison, JR, Jones, SE, Hodgson, J et al. , Parvovirus infections and hypoplastic crisis in sickle cell anaemia. Lancet 1981: i: 644–5.Google Scholar
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.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar
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.CrossRefGoogle Scholar
15.Anderson, LJ, Hurwitz, ES, Human parvovirus in pregnancy. Clin Perinatol 1988; 15: 273.CrossRefGoogle Scholar
16.Hall, SM, Parvovirus B19 and pregnancy. Rev Medical Microbiol 1990; 1: 160–7.Google Scholar
17.Pillay, D, Patou, G, Hurt, S, Kibbler, CC, Griffiths, PD, Parvovirus B19 outbreak in a children's ward. Lancet 1992; 339: 107–9.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
19.Anderson, MJ, Higgins, PG, Davis, LR, et al. Experimental parvoviral infection in humans. J Infect Dis 1985; 152: 257–65.CrossRefGoogle ScholarPubMed
20.Communicable Disease Surveillance Centre. Trends in rubella and parvovirus B19 infections. Commun Dis Rep 1993; 3: 125.Google Scholar
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
23.Centers for Disease Control. Risks associated with human parvovirus B19 infections. MMWR 1989; 38: 81–8. 93–7.Google Scholar
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.CrossRefGoogle ScholarPubMed
25.Goldmann, D, Larson, E, Hand-washing and nosocomial infections. N Engl J Med 1992; 327: 120–7.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
27.Hall, CB, Douglas, RG Jr. Modes of transmission of respiratory syncytial virus. J Pediatr 1981; 99: 100–3.CrossRefGoogle ScholarPubMed
28.Hall, CB, Douglas, RG Jr, Geiman, JM, Possible transmission by fomites of respiratory syncytial virus. J Infect Dis 1980; 141: 98–102.CrossRefGoogle ScholarPubMed