Nosocomial outbreak of parvovirus B19 infection in a renal transplant unit.
BACKGROUND
Parvovirus B19 (B19) infection is known to cause chronic infection leading to anemia in immunocompromised patients. Although nosocomial B19 infections in immunocompetent patients have been documented, no outbreaks in immunocompromised patients have been previously reported. Whether transmission can occur from a patient with chronic infection is also unknown.


METHODS
An outbreak of B19 infection in a renal transplant unit was investigated by molecular analysis of the virus strains and a case-control study.


RESULTS
Three patients had genetically identical virus strains suggesting the occurrence of nosocomial transmission. The index case transmitted infection many weeks after the onset of her clinical symptoms. Other patients at risk of acquiring infection were those most intensively immunosuppressed. Viral load in the serum correlated with the hematological response. A rebound in the viral load was associated with clinical relapse and the failure of i.v. immunoglobulin therapy.


CONCLUSIONS
Nosocomial transmission of B19 can occur from immunocompromised patients even when they are in the chronic stage of the infection. The clinical and virological response to i.v. immunoglobulin therapy is variable and depends on the overall level of immunosuppression of the patient.
Lui
S L
SL
Department of Medicine, Queen Mary Hospital and The University of Hong Kong, Pokfulam, SAR, China.
Luk
W K
WK
Cheung
C Y
CY
Chan
T M
TM
Lai
K N
KN
Peiris
J S
JS
D000328:Adult; D016022:Case-Control Studies; D003428:Cross Infection / Q000635:transmission*; D004279:DNA, Viral / Q000097:blood; D004196:Disease Outbreaks; D005260:Female; D006757:Hospital Units / Q000458:organization & administration; D006801:Humans; D016030:Kidney Transplantation; D008875:Middle Aged; D010322:Parvoviridae Infections / Q000635:transmission*; D016732:Parvovirus B19, Human
D004279:DNA, Viral