2017 Volume 32 Issue 2 Pages 89-93
Parvovirus B19 causes mild infection of erythema infectiosum characterized by facial rash, but this infection in pregnant women can lead to fetal death (8.6%) and hydrops fetalis (2.9%). In addition, this infection is not one of the vaccine-preventable diseases, and contagiousness from the patients does not exist at the onset of characteristic facial rash but precedes the onset by approximately 7 days. In Japan, this infection prevails every 4-6 years, and the seropositive rates have been reported as approximately 50% in pregnant women or adults. Therefore, this virus is important for pregnant women as a nosocomial infection. We reported secondary infection from a patient with aplastic crisis to a nurse. IgG and IgM antibodies were determined in nurses working in the same ward, and new measures were started against parvovirus B19 based on this experience. The secondary infection occurred in a nurse after incidences of exposure, such as drawing blood from the patient, although standard and droplet precautions were taken in the ward. In Japan, the IgM antibody against parvovirus B19 can be measured in pregnant women only after exposure; moreover, the IgG antibody is not included in the screening tests during pregnancy, and it cannot be confirmed as an immune status by the Japanese medical insurance system. There were two pregnant and two wishing-pregnancy nurses in the ward, and of them a first-trimester pregnant nurse had a few chances of exposure although she used a mask. The IgG and IgM antibodies were determined from 31 nurses in the ward. New measures such as the use of masks during working hours for pregnant and wishing-pregnancy nurses were started. The positive rate of the IgG antibody was 65%, and no asymptomatic infection and rash were confirmed by the IgM antibody positive. Subsequently, the IgG antibody was measured in midwives and maternity nurses to know their own immunity status because they teach pregnant women for a relatively long time. There has been a report of infection from a midwife to two colleagues and a pregnant patient. Because the infection risk is the highest from their own children, we advocate workers in our hospital to prevent expanding the infection to other colleagues by using a surgical mask, and let pregnant women among colleagues prevent this infection with a mask and hand washing immediately after workers noticed the facial rash in their children.
