Advisory: Increase in Human Parvovirus B19 Activity in the United States

HEALTH ADVISORY:

Increase in Human Parvovirus B19 Activity in the United States

SUMMARY

• The advisory below from the Centers for Disease Control and Prevention (CDC) alerts healthcare providers of current increases in human parvovirus B19 activity in the United States.
• Parvovirus B19 is a seasonal respiratory virus that is transmitted through respiratory droplets by people with symptomatic or asymptomatic infection.
• In the first quarter of 2024, public health authorities in 14 European countries observed unusually high numbers of cases of parvovirus B19.
• In the United States, there is no routine surveillance for parvovirus B19, and it is not a notifiable condition.
• Recently, CDC has received reports indicating increased parvovirus B19 activity in the United States. Data include increased test positivity for parvovirus B19 in clinical specimens and pooled plasma from a large commercial laboratory, and reports of clusters of parvovirus B19-associated complications among pregnant people and people with sickle cell disease.
• The proportion of people with IgM antibodies, an indicator of recent infection, increased among all ages from <3% during 20222024 to 10% in June 2024; the greatest increase was observed among children aged 59 years, from 15% during 20222024 to 40% in June 2024. Among plasma donors, the prevalence of pooled samples with parvovirus B19 DNA >104 IU/mL increased from 1.5% in December 2023 to 19.9% in June 2024.
• Healthcare providers are therefore reminded to:
• Have increased suspicion for parvovirus B19 among people presenting with compatible symptoms (i.e., fever, rash, arthropathy, or unexplained anemia with low reticulocyte count).
• Provide preventive counseling and have a low threshold to test people who present with compatible signs and symptoms if they are at higher risk of severe parvovirus B19 disease, including:
• Pregnant people
• People with severely immunocompromising conditions, including leukemia or other cancers, organ transplant, HIV infection, or who are receiving chemotherapy.
• People with chronic hemolytic blood disorders, including sickle cell disease, thalassemia, and hereditary spherocytosis.
• When treating people with suspected or confirmed parvovirus B19, inform them or their caregivers about high-risk groups and advise any exposed contacts in those groups (e.g., who may be pregnant) to consult with their healthcare providers.
• Follow standard of care (e.g., professional society guidelines) for testing pregnant people reporting exposure to parvovirus B19 infection or who present with compatible signs and symptoms of maternal or fetal parvovirus B19 disease.
• Promote CDC recommendations for core prevention strategies to prevent respiratory illness, including practicing good hand hygiene and taking steps for cleaner air to reduce spread of parvovirus B19 and other respiratory viruses.
• People at higher risk of severe outcomes or complications who work in settings with higher risk of parvovirus B19 exposure should practice hand hygiene, avoid sharing food or drinks, and consider wearing a respirator or mask while at work. There is no proven benefit to removing someone from work in settings with higher risk of parvovirus B19 exposure.
• Follow recommended infection control precautions for persons with parvovirus B19 in healthcare settings.

For questions: Please send an e-mail to bcdc@health.ny.gov.