SPECTRUM OF PARVOVIRUS B19 INFECTION - ANALYSIS OF AN OUTBREAK OF 43 CASES IN CADIZ, SPAIN

In the spring of 1993, an epidemic of infection with human parvovirus B19 occurred in Cadiz, Spain. Evaluation of the 43 patients in whom th is diagnosis was confirmed revealed four groups of predominant manifes tations: (1) hematologic manifestations in six cases (13.9%), includin g four of aplastic crisis and two of pancytopenia; (2) dermatologic ma nifestations in 23 cases (53.4%), including 10 of erythema infectiosum and one of erythema multiforme ampullosum; (3) arthralgias/arthritis in nine cases (20.9%), including two with a chronic course; and (4) in fection during pregnancy in three cases (7.0%), including two that end ed in abortion. Of the 43 patients, 37.2% presented with fever and ade nopathies, and these were the only manifestations in two cases. The ap pearance of clinical disease correlated with modifications in isotype and serum level of specific antibodies to parvovirus B19; the disappea rance of IgM antibodies coincided with the resolution of clinical mani festations. Although their presence did not correlate with the course of the disease, the detection of circulating immune complexes in 81.6% of cases supports the possibility that some manifestations were immun e mediated.