Treatment and prevention

There is no specific treatment for parvovirus B19 infection. However when managing patients with the infection, host factors such as underlying diseases and immunodeficiency status should be taken into account e.g. -

• in immunocompetent individuals - normally no treatment is needed, anti-inflammatory drugs can be used for people with arthralgia
• in patients with transient aplastic crisis - hospitalisation and erythrocyte transfusion
• in immunosuppressed patients - intravenous immune globulin (IVIG) has been proven beneficial in patients with persistent B19 infection
• persistent infection in immunocompetent individuals - IVIG does not respond well, but a transient remission can be seen (1)

Currently no vaccine is available for the prevention of the infection. The use of normal immunoglobulin for post-exposure prophylaxis has not been assessed (2).

During outbreaks

• at homes, daycare centers, schools and the work place
  • prevention of the disease transmission is difficult since the greatest risk of transmission is seen before the appearance of the rash
  • Centers for Disease Control and Prevention (CDC) has proposed hand washing as a method which may reduce the risk of transmission
  • parents and employees should be educated about the risk of transmitting the infection to others and acquiring the infection themselves and also about the groups of people at risk of serious complications (2)
• at hospitals
  • the risk of spreading of infection should be reduced in high-risk groups such as people with haematological diseases or with immunodeficiency, and susceptible pregnant woman
  • control measures that can be used include:
    • respiratory isolation of patients with transient aplastic crisis or chronic infection
    • exclusion of susceptible pregnant staff
    • patients and visitors from affected wards
    • testing of healthcare workers and allowing only B19 IgG positive staff to care for high-risk patients (2)

Reference:

• 1. Broliden K, Tolfvenstam T, Norbeck O. Clinical aspects of parvovirus B19 infection. J Intern Med. 2006;260(4):285-304
• 2. Health Protection Agency (HPA) 2008. General information on parvovirus: parvovirus B19 (Slapped cheek syndrome, Fifth disease or Erythema infectiosum) - general information