title: Insights into epidemiology of human parvovirus B19 and detection of an unusual genotype 2 variant, Bulgaria, 2004 to 2013.
abstract: The present study aimed to determine the role of human parvovirus В19 (B19V) as an aetiological agent in measles and rubella negative fever/rash patients from Bulgaria between 2004 and 2013. A total of 1,266 sera from all over the country were tested for B19V IgM antibodies and all positives were further investigated by polymerase chain reaction (PCR). Overall, 280 sera (22%) were B19V IgM positive and 227 of these (81%) were also PCR positive. The highest number of IgM positives was found among five to nine year-old children (27%). Eight infected women gave birth to healthy children; one fetus was aborted with hydrops fetalis. Of the 55 genetic sequences obtained, 54 belonged to genotype 1a and one grouped as a genotype 2 outlier. Phylogenetic analysis of all available genotype 2 sequences covering the 994 nucleotide non-structural protein 1(NS1)/capsid viral protein 1 (VP1) unique region junction, showed that only one other sequence grouped with the outlier strain, forming a clearly distinct and well-supported cluster of genotype 2 (between-group genetic distance: 3.32%). In accordance with B19V nomenclature, this cluster may represent a new subgenotype 2b. The study showed that B19V infections may be falsely identified as rubella or measles in ca 22% of cases, emphasising the need for laboratory confirmation.
authors: National Center of Infectious and Parasitic Diseases, Department Virology, National Reference Laboratory of Measles, Mumps and Rubella, Sofia, Bulgaria.
authors: Stefka Krumova
authors: SK
authors: Ivanova
authors: Zafira Georgieva
authors: ZG
authors: Mihneva
authors: Andon Krumov
authors: AK
authors: Toshev
authors: Valentina Pavlova
authors: VP
authors: Kovaleva
authors: Lubena Georgieva
authors: LG
authors: Andonova
authors: Claude P
authors: CP
authors: Muller
authors: Judith M
authors: JM
authors: Hübschen
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000914:Antibodies, Viral / Q000097:blood; D002031:Bulgaria / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D016731:Erythema Infectiosum / Q000453:epidemiology* / Q000821:virology*; D005076:Exanthema / Q000821:virology; D005260:Female; D005334:Fever / Q000821:virology; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood*; D007223:Infant; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D016732:Parvovirus B19, Human / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D010802:Phylogeny; D016133:Polymerase Chain Reaction / Q000379:methods; D014764:Viral Proteins / Q000235:genetics*; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D007075:Immunoglobulin M; D014764:Viral Proteins
keywords: ELISA; IgM antibodies; PCR; genotype; human parvovirus B19