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15 July 2006

Volume 194, Number 2
The Journal of Infectious Diseases 2006;194:146–153
© 2006 by the Infectious Diseases Society of America. All rights reserved.
0022-1899/2006/19402-0003$15.00
DOI: 10.1086/505082
MAJOR ARTICLE

Parvovirus B19 Infection Contributes to Severe Anemia in Young Children in Papua New Guinea

James Wildig,1,a

Pascal Michon,2,a

Peter Siba,3

Mata Mellombo,2

Alice Ura,2

Ivo Mueller,2,3 and

Yvonne Cossart1

1Department of Infectious Diseases and Immunology, University of Sydney, Australia; 2Papua New Guinea Institute of Medical Research, Madang, and 3Papua New Guinea Institute of Medical Research, Goroka

Background.Severe anemia (hemoglobin level, <50 g/L) is a major cause of death among young children, and it arises from multiple factors, including malaria and iron deficiency. We sought to determine whether infection with parvovirus B19 (B19), which causes the cessation of erythropoiesis for 3–7 days, might precipitate some cases of severe anemia.

Methods.Archival blood samples collected in the Wosera District of Papua New Guinea, from 169 children 6 months–5 years old with severe anemia and from 169 control subjects matched for age, sex, and time were tested for B19 immunoglobulin M (IgM) by enzyme immunoassay and for B19 DNA by nested polymerase chain reaction (PCR). A total of 168 separate samples from children in the Wosera District were tested for B19 IgG.

Results.A strong association between acute B19 infection (positive by both IgM and PCR) and severe anemia was found (adjusted odds ratio, 5.61 [95% confidence interval, 1.93–16.3]). The prevalence of parvovirus B19 IgG reached >90% in 6‐year‐olds.

Conclusions.B19 infections play a significant role in the etiology of severe anemia in this area of malarial endemicity. Given the high levels of morbidity and mortality associated with severe anemia in such regions, the prevention of B19 infection with a vaccine might be a highly effective public health intervention.

Received 20 December 2005; accepted 16 February 2006; electronically published 14 June 2006.

  • (See the editorial commentary by Pasvol, on pages 141–2.)

Reprints or correspondence: Dr. Yvonne Cossart, Dept. of Infectious Diseases and Immunology, University of Sydney, D06, Sydney NSW 2006, Australia ().

Cited by

Geoffrey Pasvol. (2009) Editorial Commentary: Are Children with Homozygous Sickle Cell Disease Really at a Disadvantage in the Face of Malaria? The Malaria Hypothesis Revisited. Clinical Infectious Diseases 49:2, 223-224
Online publication date: 15-Jul-2009.
Citation-Full Text-PDF Version (162 kB)
Angel C. Bassols. (2008) Editorial Commentary: Parvovirus B19 and the New Century. Clinical Infectious Diseases 46:4, 537-539
Online publication date: 15-Feb-2008.
Citation-Full Text-PDF Version (188 kB)
A. Corcoran, S. Kerr, G. Elliott, M. Koppelman, S. Doyle. (2007) Improved detection of acute parvovirus B19 infection by immunoglobulin M EIA in combination with a novel antigen EIA. Vox Sanguinis 93:3, 216-222
Online publication date: 1-Nov-2007.
CrossRef
Geoffrey Pasvol. (2006) Parvovirus Infection, Malaria, and Anemia in the Tropics—a New Hidden Enemy?. The Journal of Infectious Diseases 194:2, 141-142
Online publication date: 15-Jul-2006.
Citation-Full Text-PDF Version (47 kB)

  • Potential conflicts of interest: none reported.

    Financial support: Biotrin International, Ireland (parvovirus IgM and IgG test kits); PanBio Limited (Australia; assistance with shipping); University of Sydney, Faculty of Medicine Postgraduate Research Support Scheme; and Daphne Goulston Scholarship (travel assistance to J.W.).

  • J.W. and P.M. contributed equally to the study.

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