Alma Robo1, Artan Simaku1, Elona Kureta1, Majlinda Dhimolea1, Silva Bino1,2
1 Institute of Public Health, Tirana, Albania;
2 Faculty of Medicine, University of Medicine, Tirana, Albania.
Aim: The aim of the study was to investigate a cluster of illnesses in school children with generalized petechial rashes to determine whether parvovirus was the causative agent.
Methods: Epidemiologic investigationwasinitiated on June, 17, 2016, to determine the etiology and extent of the outbreak. A case-patient was defined as anyone who developed a new rash from April 1, 2016 to the present date. Serum specimens were collected and tested at the virology laboratory of IPH for IgM antibody against parvovirus B19 with ELISA.
Results: Twenty three cases, all of them school children, were registered over a period of 10 weeks. The index case was on January 26. The median age was nine years with a range was 8-14 years. 49% were males. The mean duration of symptoms was four days, range (1 to 8 days). The symptoms included, headache, fever, cough, nasal drip, and joint pain. Sera were obtained from 6 (26.1%) out of the total of 23 cases who were in acute phase. Four (66.7%) out of six cases tested positive for parvovirus IgM. Primary healthcare facilities and the obstetric hospitals were also informed. Two positive serum samples were sent to the reference laboratory in Luxembourg for sequencing. The phylogenetic tree showed that sequences belonged to genotype 1a.
Conclusions: Parvovirus was the cause of petechial rash in children. In the context of measles and rubella elimination it is very likely that a high proportion of infectious non-vesicular exanthemas will be due to B19 infections.
Keywords: epidemiologic investigation, infectious diseases, Parvovirus.