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A school outbreak of parvovirus B19 infection investigated using salivary antibody assays

Published online by Cambridge University Press:  15 May 2009

P. S. Rice
Affiliation:
Department of Virology, Guy's and St Thomas' NHS Trust, London SE1 7EH, UK
B. J. Cohen
Affiliation:
Enteric and Respiratory Virus Laboratory, Virus Reference Division, Central Public Health Laboratory, Colindale Avenue, London NW9 5HT, UK
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An outbreak of parvovirus B19 infection at a primary school was investigated using saliva samples. Antibody capture immunoassays for salivary B19 IgG and IgM were developed using a recombinant B19 antigen and monoclonal antibody to B19 virus. Evaluation of the salivary IgG assay using paired serum and saliva samples from 43 staff at St Thomas' Hospital showed that it had a sensitivity of 100% and a specificity of 95%. Evaluation of the salivary B19 IgM assay using 87 paired blood and saliva samples from a study of general practitioner rubella notifications showed it had a sensitivity of 60% and a specificity of 98%. Using the salivary assay the level of B19 IgG within 2 weeks of the start of the outbreak ranged from 5–33% in children and 29% in staff. By detecting salivary B19 IgM and/or B19 IgG seroconversions, attack rates of 8–50 % in children in different classes and 47 % in staff were observed. Household transmission was also studied and an attack rate of 45 % was recorded in 11 susceptibles. After the outbreak, the level of B19 IgG in children with the highest attack rates was 60–70%, similar to that seen in adults in the UK. This study highlights the risk of B19 infection in an institutional setting and shows that saliva samples are a useful alternative to blood.

Type
Special Article
Copyright
Copyright © Cambridge University Press 1996

References

REFERENCES

1.Cohen, BJ, Mortimer, PP, Pereira, MS. Diagnostic assays with monoclonal antibodies for the human serum parvovirus-like virus (SPLV). J Hyg 1983; 91: 113130.Google Scholar
2. Communicable Diseases Surveillance Centre. Trends in rubella and parvovirus B19 infections. CDR Wkly 1993; 3, no. 28.Google Scholar
3.Brown, DWG, Ramsay, MEB, Richards, AF, Miller, E. Salivary diagnosis of measles: a study of notified cases in the United Kingdom, 1991–3. BMJ 1994; 308: 1015–7.Google Scholar
4.Parry, JV. Simple and reliable salivary tests for HIV and hepatitis A and B virus diagnosis and surveillance. Ann NY Acad Sci 1993; 694: 216–33.CrossRefGoogle Scholar
5.Connell, JA, Parry, JV, Mortimer, PP et al. , Preliminary report: accurate assays for anti-HIV in urine. Lancet 1990; 335: 1366–9.CrossRefGoogle ScholarPubMed
6.Miller, E, Tookey, P, Morgan-Capner, P et al. , Rubella surveillance to June 1994: third joint report from the PHLS and the National Congenital Rubella Surveillance Programme. CDR Rev 1994; 12: R14652.Google Scholar
7.Anderson, MJ, Lewis, E, Kidd, IM, Hall, SM, Cohen, BJ. An outbreak of erythema infectiosum associated with human parvovirus infection. J Hyg 1984; 93: 8593.Google Scholar
8.Turner, A, Olojugba, O. Erythema infectiosum in a primary school: investigation of an outbreak in Bury. Public Health 1989; 103: 391–3.Google Scholar
9.Jacobson, SK, Buttery, R, Parry, JV, Perry, KR, Wreghitt, TG. Investigation of a hepatitis A outbreak in a primary school by sequential salivary sampling. Clin Diag Virol 1995; 3: 173–80.Google Scholar
10.Gay, NJ, Hesketh, LM, Cohen, BJ et al. , Age specific antibody prevalence to parvovirus B19: how many women are infected in pregnancy? CDR Rev 1994; 4: 104–7.Google ScholarPubMed
11.Tuckerman, JG, Brown, T, Cohen, BJ. Erythema infectiosum in a village primary school: clinical and virological studies. J Roy Coll Gen Pract 1986; 36: 267–70.Google Scholar
12.Gillespie, SM, Cartter, ML, Asch, S et al. , Occupational risk of human parvovirus B19 infection for school and day-care personnel during an outbreak of erythema infectiosum. JAMA 1990; 263: 2061–5.Google Scholar
13.Bell, LM, Naides, SJ, Stoffman, P, Hodinka, RL, Plotkin, SA. Human parvovirus B19 infection among hospital staff members after contact with infected patients. N Engl J Med 1989; 321: 485–91.Google Scholar
14.Pillay, D, Patou, G, Hurt, S, Kibbler, CC, Griffiths, PD. Parvovirus B19 outbreak in a children's ward. Lancet 1992; 339: 107–9.Google Scholar
15.Seng, C, Watkins, P, Morse, D et al. , Parvovirus B19 outbreak on an adult ward. Epidemiol Infect 1994; 113: 345–53.CrossRefGoogle Scholar
16.Lauer, BA, MacCormack, JN, Wilfert, C. Erythema infectiosum (an elementary school outbreak). Am J Dis Child 1976; 130: 252–4.CrossRefGoogle ScholarPubMed
17.Bull, AR, Kimmance, KJ, Parry, JV, Perry, KR. Investigation of an outbreak of hepatitis A simplified by salivary antibody testing. Epidemiol Infect 1989; 103: 371–6.Google Scholar
18.Parry, JV, Perry, KR, Panday, S, Mortimer, PP. Diagnosis of hepatitis A and B by testing saliva. J Med Virol 1989; 28: 255–60.CrossRefGoogle Scholar
19.Mortimer, PP, Parry, JV. Non-invasive virological diagnosis: are saliva and urine specimens adequate substitutes for blood? Rev Med Virol 1991; 1: 73–8.Google Scholar
20.Mortimer, PP, Parry, JV. Detection of antibody to HIV in saliva: a brief review. Clin Diag Virol 1994; 2: 231–43.Google Scholar
21.Cohen, BJ, Bates, CM. Evaluation of 4 commercial test kits for parvovirus B19-specific IgM. J Virol Methods 1995; 55: 1125.Google Scholar