Epidemiology and Infection

Research Article

The burden of parvovirus B19 infection in women of childbearing age in England and Wales

A. J. VYSEa1 c1, N. J. ANDREWSa2, L. M. HESKETHa3 and R. PEBODYa1

a1 Health Protection Agency, Centre for Infections, Sero-Epidemiology Unit, Immunisation Department, London, UK

a2 Health Protection Agency, Centre for Infections, Statistics, Modelling and Bioinformatics Department, London, UK

a3 Lancashire Teaching Hospitals NHS Trust, Preston Microbiology Services, Royal Preston Hospital, Fulwood, Preston, Lancashire, UK

SUMMARY

A serological survey has been used to investigate the epidemiology of parvovirus B19 infection in England and Wales. A total of 2835 sera representing the complete age range were selected from a convenience collection obtained in 1996 that reflects the general population and screened for parvovirus B19-specific IgG. Antibody prevalence rose nonlinearly with age from 21% in those aged 1–4 years to >75% in adults aged xs2A7E45 years. Force-of-infection estimates were similar to those previously made in 1991, being highest in those aged <15 years. There was no association between evidence of previous infection and sex or region. Quantitatively strongest antibody responses were found in those aged 15–34 years and IgG levels in females were 28·5% higher than those found in males (P=0·004, 95% CI 8·2–52·6). Applying the upper 95% confidence interval for the force of infection to maternity estimates for England and Wales in 1996, parvovirus infection in pregnancy was estimated to occur on average in up to 1 in every 512 pregnancies each year. This represents 1257 maternal infections, causing up to an estimated 59 fetal deaths and 11 cases of hydrops fetalis annually. An analysis of all available laboratory-confirmed parvovirus infections found a mean of 944 infections per year in women aged 15–44 years highlighting a need for enhanced surveillance of maternal parvovirus B19 infection in England and Wales, including information on both pregnancy and outcome of pregnancy.

(Accepted November 20 2006)

(Online publication February 12 2007)

Correspondence:

c1 Author for correspondence: Dr A. J. Vyse, Health Protection Agency CfI – CDSC, Immunisation Department, 61 Colindale Avenue, London NW9 5EQ, UK. (Email: Andrew.vyse@HPA.org.uk)

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