Parvovirus infection in children: symptoms, treatment, complications, diet

Unfortunately, infectious diseases can hardly be considered a rarity. Such problems are often encountered in pediatric practice. According to statistical studies, today parvovirus infection in children is often registered.

Most often the disease proceeds easily. Nevertheless, such a state can be very dangerous. That is why many parents are interested in additional information about this disease. What is its cause? What are the first signs of parvovirus infection? What difficulties can be encountered during treatment? Are there effective preventive measures? Answers to these questions will be useful to many readers.

Parvovirus infection: what is it?

A similar term in modern medicine is used to describe an acute infectious disease, which is accompanied by damage to the erythroid bone marrow and, consequently, temporary disturbances in hematopoiesis processes.

Most often, parvovirus infection in children is diagnosed. Symptoms of it can be different, ranging from fever and general malaise and ending with erythema, arthralgia and even aplastic crises. But in adults such a disease is observed much less often.

The main causes of the disease

The causative agent of parvovirus infection is parvovirus B19, which belongs to the family of parvoviruses. It is worth noting that only this strain of the virus is dangerous for humans. By the way, the causative agent was discovered in England, in 1975, during the investigation of donor blood. The name "B19" he received from a sample of serum, from which it was first isolated.

This is a small virus, whose diameter does not exceed 20-25 nm. It does not have an outer shell, and its capsid is characterized by an icosahedral shape. Structural proteins surround one "+" and one "-" DNA strand. It is worth noting that this strain of the virus is quite resistant to the environment - it can withstand a temperature of 60 degrees for 16 hours.

Virus B19 is not active against animals. In laboratory conditions, it can be cultivated only using red blood cell precursors, which are obtained from the bone marrow of a human, liver or umbilical cord of the fetus.

Similar diseases occur at any time of the year, but the most common outbreaks of infection in the winter and spring. During the epidemic, about 20-60% of children fall ill in schools and other public institutions. Nevertheless, in many infected, the disease proceeds without any noticeable symptoms.

Ways of transmission of the virus to the end has not yet been studied. It is believed that you can get infected during contact with the carrier of the infection, but only if his disease is at the stage of viremia (the virus actively multiplies in tissues). Viral particles are secreted into the external environment together with secretion and mucus from the upper respiratory tract. In addition, it is possible to transmit the infection along with blood from mother to baby during pregnancy.

Because of the wide spread of the virus, many parents are now interested in the question of what symptoms are accompanied by parvovirus infection. Treatment, complications, prevention - all this is extremely important information, which must be read.

Pathogenesis of infection

Parvovirus infection in children develops in two stages. In the first phase, active reproduction of viruses, intoxication of the organism, as well as the release of virus particles into the external environment are observed (infected patients at this time are extremely contagious).

Approximately on the third day after infection of the body, there are common symptoms of intoxication, which resemble the usual malaise or cold. In particular, patients complain of chills, a slight increase in body temperature, weakness and pain in the muscles, aches, small pruritus, headache. Approximately in the same period there is a slight decrease in hemoglobin, which persists for 7-10 days. When examining the blood, you can notice a mild neutron, lymph, and thrombocytopenia.

Approximately 17-18 days after infection, the second phase of the disease develops. Reproduction and isolation of viruses cease. On the 20th-22nd day, the child may have a characteristic skin rash, and after a few days - joint pain. On the other hand, these symptoms do not appear in every case - some children endure the disease as a common ailment.

Parvovirus infection in children and adults in the second phase is accompanied by the production of specific antibodies - immunoglobulins M and G, the titres of which are extremely important for proper diagnosis. By the way, immunoglobulins G persist in the blood for a long time, sometimes even until the end of life. Laboratory studies indicate that more than half of the world's population has these antibodies, although for many of them the disease has gone completely unnoticed.

Patients suffering from severe forms of anemia or immunodeficiency (including HIV infection), transfer the disease is much more difficult. Often, against the background of parvovirus activity, there is a significant destruction of the bone marrow and, accordingly, a violation of normal hematopoiesis processes up to life-threatening conditions. Moreover, in patients with a deficiency of the immune system, the processes of viremia do not stop, the multiplication of viruses continues, which is accompanied by more pronounced lesions of the body.

Infectious erythema

Parvovirus infection in children (photo) is often accompanied by the appearance of erythema. This condition is considered the most common manifestation of this infection. Moreover, it is often called the "fifth illness". This name appeared around the end of the 19th century, since such a disease was one of the six most common infectious diseases that were accompanied by skin manifestations.

Most often this is the case for parvovirus infection in children - the rash has the form of large bright spots and appears mainly on the cheeks (this symptom is known as "cheeked cheeks"). Most often, rashes are spotty-papular, but sometimes they can be vesicular or even hemorrhagic. Some children easily tolerate the infection, while others complain of severe itching. The rash spreads quickly to the limbs, but in most cases disappears by itself after a few days.

Nevertheless, during the next few weeks, the appearance of repeated rashes may occur. Most often this occurs against the background of physical exertion, overheating, hypothermia, bathing, a sharp change in climatic conditions or under stress conditions.

Acute arthritis and arthralgia against infection

Immediately it is worth saying that parvovirus infection in a child is rarely accompanied by joint damage. Nevertheless, such a complication is still possible, and more often it is observed in adolescence (girls are more prone to such a phenomenon).

Lesions of joints can occur both on the general background of a viral disease, and be its only manifestation. Most often, the joints of the wrists, hands, ankle and knees are affected, although in theory the disease can cause inflammation of any joint. Sometimes patients have arthralgia accompanied by morning stiffness. Nevertheless, the development of full-fledged arthritis is also possible.

This is how parvovirus infection in children looks in some cases. These complications, however, do not entail the destruction of articular cartilage and, as a rule, pass several weeks later on their own. Occasionally soreness and stiffness of the joints remains for months, sometimes even years - in such cases additional diagnostic and therapeutic measures are needed.

Aplastic crisis

Parvovirus infection quite often becomes the cause of the so-called aplastic crisis. This is a rather dangerous condition, which is accompanied by a violation of normal hematopoiesis. There are some risk groups, among which the probability of developing a crisis is much higher. In particular, this condition is often observed in patients with chronic hemolytic anemia, autoimmune anemia, thalassemia, fermentopathy. Risk factors include sickle cell anemia, paroxysmal nocturnal hemoglobinuria and hereditary microspherocytosis.

Violation of the processes of hematopoiesis is what parvovirus infection of children can lead to. Symptoms of aplastic crisis are severe anemia, which is accompanied by strong weakness, drowsiness and severe pallor of the skin. In the study, it can be found that there are no cells of the erythroid germ in the bone marrow. Often there is a sharp drop in hemoglobin to low, life-threatening indicators. In such cases it is impossible to do without a blood transfusion.

It should also be noted that against the background of the aplastic crisis there is active viremia - the viruses multiply rapidly, enter the bloodstream and affect other tissues. Patients with this diagnosis are the carriers of the infection.

Intrauterine infection and its consequences

In gynecological and obstetrical practice, intrauterine parvovirus infection is sometimes recorded, the symptoms of which are much more difficult to notice. Immediately it is worth noting that in most cases, the infection of the mother's body during pregnancy does not lead to fetal infection and does not have any harmful effect on the fetus.

Nevertheless, the risk still exists. According to statistics and reviews of medical practitioners, the virus most often leads to complications in the first or second trimester of pregnancy. Infection of the fetal tissues (in particular normoblasts and erythroblasts) in approximately 13% of cases leads to spontaneous abortion.

There are some other complications. Against the background of infection, a growing child develops non-immune dropsy. Also, severe anemia and heart failure may occur, leading to fetal death.

On the other hand, if the presence of the disease can be detected at an early stage (with the help of ultrasound) and appropriate therapy is carried out, the child is born healthy, without any complications (occasionally there is a backlog in physical development, delay in gaining weight). In some cases, the baby immediately after birth is diagnosed with congenital anemia and hypogammaglobulinemia, which, however, are compatible with life and amenable to treatment.

If a pregnant woman contacts infected people, she is advised to regularly perform ultrasound examinations, as well as donate blood to determine the level of alpha-fetoprotein and the titer of immunoglobulins - this helps to detect the problem at an early stage and increases the chances of a successful and full recovery.

Modern diagnostic methods

Parvovirus infection in children and adults requires careful diagnosis. First of all, the doctor collects an anamnesis and conducts an examination. The clinical picture in this case is similar to some other diseases, therefore it is necessary to conduct additional laboratory tests.

In particular, the child is sampling blood and tissue to measure the titers of specific immunoglobulins M and G. Usually, the amount of IgM is increased on the third day after the infection is activated. But an increased amount of immunoglobulin G is observed even a year after the infection. When aplastic crisis in the samples is determined not only a high number of proteins, but also the virus itself and its DNA. In addition, in bone marrow studies, it is possible to detect erythroid germ hypoplasia and the presence of characteristic giant erythroblasts.

When diagnosing the disease in patients with immunodeficiency antibodies can not be detected, but it is possible to identify a large number of viral particles.

If it is a diagnosis of intrauterine infection, then careful ultrasound is needed (to help detect fetal dropsy). A laboratory study of the blood of the mother and amniotic fluid for the presence of viral DNA and specific antibodies is also conducted.

Parvovirus infection in children: treatment

If you have even the slightest suspicion of having a similar disease, it is worthwhile to see a doctor. Only a specialist knows how to treat a parvovirus infection.

It is worth noting that in mild cases the child does not even need hospitalization. Nevertheless, it is necessary to limit his communication with healthy people, since in the first phase the disease is rather contagious. How is parvovirus infection treated in children at home? Komarovsky, a famous children's doctor, recommends bed rest. The child needs to rest, drink more fluid (to eliminate the symptoms of intoxication). But active games and physical activities are contraindicated. Parents must always adhere to the rules of hygiene, wash their hands after contact with the baby, regularly do wet cleaning, change bed linens, etc.

An equally important part of therapy is diet. In parvovirus infection, a child needs a balanced balanced diet of caloric and easily assimilated foods. It is also worth taking care to ensure that enough vitamins and minerals are present in the dishes, which are necessary to strengthen immunity (the menu necessarily includes fruits and vegetables). Also, food should be rich in iron and animal proteins, as the disease is accompanied by anemia and a decrease in the level of hemoglobin.

As a rule, the symptoms of the disease go away by themselves after 1-2 weeks. Nevertheless, in some cases more specific treatment is required. For example, with severe fever, the use of antipyretic drugs ("Aspirin", "Paracetamol", "Analgin", etc.) is required. If the patient develops arthritis, the symptoms of which do not go away for several weeks, non-steroidal anti-inflammatory drugs (Ibuprofen, Diclofenac, Nurofen, etc.) are advisable.

If we are talking about the treatment of patients with immunodeficiency, it is possible intravenous immunoglobulin, which contains a specific antibodies to the virus B19. This method does not provide a complete cure, but it helps to suppress the activity of the infection. A severe aplastic crisis is an indication for transfusion of erythrocyte mass.

Chronic form of parvovirus infection

In some cases, in the absence of treatment or improper therapy, the acute form of the disease becomes chronic. This condition is extremely dangerous, since its symptoms are less pronounced. It is difficult to diagnose and treat. Chronic parvovirus infection is accompanied by anemia, which flows undulating. Often, this form of the disease becomes the cause of idiopathic aplasia of the erythroid bone marrow. It is extremely difficult to get rid of this disease. Blood transfusions and the introduction of immunoglobulins help maintain normal body function.

Basic methods of prevention

It can be noted that parvovirus infection in a child can be really dangerous. Therefore, many parents are interested in questions about whether there are effective remedies.

Unfortunately, there is currently no vaccine for this virus. Nevertheless, the possibility of obtaining a drug that does not cause the development of the disease, but possesses immunogenic properties, is actively being investigated. It is possible that in the near future a similar medicine will still appear.

In some cases, people after contact with infection are recommended to be treated with intravenous immunoglobulin. In particular, similar procedures are shown to pregnant women, patients with chronic hemolytic anemia or immunodeficiency. Nevertheless, to date, it has not been established exactly whether such prevention is effective.

The only means of protection against the virus is the absence of contact with carriers of infection, which, unfortunately, is not so easy. In addition, it is recommended to follow the rules of personal hygiene, in particular to wash hands after contact with patients, before eating, etc.

Patients with a chronic form of the disease, as well as those with an aplastic crisis, are active spreaders of the infection. That is why they need immediate hospitalization in the infectious department and the lack of direct contacts with healthy people until the end of therapy.