Parvovirus B19

Question 1

Parvovirus B19 is a virus that only affects humans. This is also known as all of the following, EXCEPT which one?

1 - fifth disease
2 - slapped cheek syndrome
3 - rubella
4 - erythema infectiosum

Answer 1

3 - rubella

Question 2

Typically, does the rash affect adults or children?

Answer 2

• both

Question 3

Which of the following is NOT a risk factor for developing parvovirus?

1 - infected sibling
2 - child in nursery
3 - parent of infected child
4 - pregnancy

Answer 3

4 - pregnancy

There are risks in pregnancy, but this does not increase the risk of infection

Question 4

Is parvovirus a notifiable disease?

Answer 4

• No

Question 5

How is parovovirus typically transmitted?

1 - sexually transmitted
2 - faecal/oral route
3 - infected droplets
4 - contaminated water

Answer 5

3 - infected droplets

Can transmit from blood transfusion or during pregnancy to an unborn child during labour

Question 6

Parovovirus typically infects humans through the respiratory tract. However, the virus does NOT replicate here. Where does the virus replicate?

1 - liver
2 - spleen
3 - bones
4 - pancreas

Answer 6

3 - bones

Question 7

How does parvovirus infection typically present initially?

1 - mild fever
2 - coryza
3 - muscle aches
4 - lethargy
5 - all of the above

Answer 7

5 - all of the above

Essentially presents with flu like symptoms

Question 8

Following the initial flu like symptoms of parvovirus, how does it present? (select 2)

1 - slapped cheeks
2 - net like reticular mildly erythematous rash
3 - strawberry red tongue
4 - butterfly rash

Answer 8

1 - slapped cheeks
2 - net like reticular mildly erythematous rash

Reticular = net-like
Rash affects cheeks the trunk and limbs and can appear raised and is itchy.

Question 9

A net like rash and slapped cheeks is characteristic of parvovirus. How long does this rash typically take to disappear?

1 - 1-2 days
2 - 1-2 weeks
3 - 1-2 months
4 - 1-2 years

Answer 9

2 - 1-2 weeks

BUT it can return for months afterwards following a warm bath, sunlight, heat or fever will trigger a recurrence of the bright red cheeks and the rash itself

Question 10

Is a child infectious when the rash of parvovirus presents?

Answer 10

• no

Therefore no need to stop the child going to nursery or school

Question 11

How are patients infected with parvovirus treated?

1 - supportive (plenty of fluids and analgesia)
2 - acyclovir
3 - antibiotics
4 - isolation

Answer 11

1 - supportive (plenty of fluids and analgesia)

Question 12

Although parvovirus is typically self limiting, which of the following patients are at risk of complications?

1 - sickle cell patients
2 - pregnant women
3 - thalassaemia
4 - hereditary spherocytosis
5 - haemolytic anaemia
6 - all of the above

Answer 12

6 - all of the above

Can cause aplastic anaemia, which is low number of all blood cells from bone marrow

Question 13

If a pregnant woman is infected before a certain time point, she needs to be assessed for maternal IgG and IgM antibodies as these can cross the placenta. What time point is crucial in thus?

1 - <12 weeks
2 - <16 weeks
3 - <28 weeks
4 - <35 weeks

Answer 13

2 - <16 weeks

Risk increases witrh gestational age (25-70%)

Can cause hydrops fetalis, which is a fatal and severe swelling in the baby, and has a 50% mortality in infected babies

Question 14

If a pregnant women becomes infected with parvovirus and there is suspicion the baby may be infected, what imaging is performed to identify foetal anaemia present in hydrops fetalis?

1 - transvaginal ultrasound
2 - CTG
3 - MRI
4 - foetal ultrasound

Answer 14

4 - foetal ultrasound

If hydrops fetalis is identified they could have intrauterine foetal transfusion

Question 15

Which of the following is NOT a complication of parvovirus infection?

1 - Encephalitis or meningitis
2 - Pregnancy complications including fetal death
3 - Rarely hepatitis, myocarditis or nephritis
4 - Vision loss

Answer 15

4 - Vision loss