Инфекция и иммунитет (Sep 2016)
DETECTION OF CASES OF PARVOVIRUS INFECTION IN THE SYSTEM FOR EPIDEMIOLOGICAL SURVEILLANCE OF EXANTHEMATIC DISEASES
Abstract
The drastic decrease of the incidence of Measles and Rubella at the stage of elimination of these infections is notified on the territory of North- Western Federal Region (NWFR) of Russia. At the same time the number of cases with the error clinical diagnosis of Measles and Rubella increased. The most frequent error is the infection caused by Parvovirus (PVI). The disease is of the independent particular medical and social significance for obstetrics, maternity and childhood protection, blood donation service, transplantation of organs/tissue etc. The aim of the current study was to estimate the prevalence of PVI on the territory of NWFR of Russia in different periods of 2009–2012 and 2015–2016. The data of the laboratory diagnosis of PVI for patients with exanthema were analyzed. Materials and methods. The serum specimens of patients with exanthema from bank of sera of St. Petersburg Subnational Measles/Rubella laboratory, collected in 2009–2012 (n = 495) and in 2015 (n = 336) as well as 69 sera of patients with exanthema from the “Infectious Disease Hospital N30” in St. Petersburg, collected in March-May, 2016 were studied. The specific IgM-PV B19 antibodies were determined by the «recomWELL Parvovirus B19 IgM» (MICROGEN GmbH, Germany) ELISA test-system. The presen ce of the specific IgM-PV B19 antibodies in sera of patients was the evidence of the acute PVI. Results. The obtained results demonstrated the prevalence of PVI on the territory of NWFR. In 2009–2012 as well as in 2015 years PVI was revealed on the overwhelming majority (9 of 11) of administrative territories of the NWFR. The essential predominance of PVI was determined in St. Petersburg and bordering territories of NWFR (Kaliningrad Oblast’, Leningrad Oblast’, Republic of Karelia). In 2010, 2011 and 2015 years the part of sera detected as IgM-PV B19 positive on an average was equal to 14%. Meanwhile in 2012 the part of the detected IgM-PV B19 positive sera was statistically higher (p < 0.05) and consisted 45.5% of those tested in St. Petersburg Subnational Measles/Rubella laboratory. According to the results obtained the epidemical increase of PVI incidence was observed on the territory of NWFR in 2012. Among the cases with the laboratory confirmed PVI (i.e. IgM-PV B19 positive sera) the part of cases with the error clinical diagnosis of Rubella consisted 56.2% in 2012 and 34.0% in 2015. Comparing the initial clinical diagnosis of patients from the “Infectious Di sease Hospital N 30” in St. Petersburg in March-May, 2016, with the results of IgM-PV B19 ELISA of sera we revealed that none of patients with the laboratory confirmed PVI had the initial clinical diagnosis PVI at the stage of hospitalization. Thus the results obtained evidence the prevalence of PVI on the territory of NWFR; clinical diagnosis of PVI turns to be the problem for clinicians; the differential diagnosis of PVI with Rubella is necessary and of extremely importance at the stage of elimination of Measles and Rubella in Russia.
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