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Parvovirus outbreak in kindergarten kills 3.5-year-old child in Thessaloniki

A 3.5-year-old girl died in Thessaloniki after an outbreak of the Parvovirus B19 in a kindergarten in Greece’s second biggest city. A second child currently hospitalized with the same infection is not in danger.

The deceased child showed clinical signs of acute myocarditis caused by the Parvovirus B19. It was transferred from Thessaloniki to the Heart Center in Athens where it died in March [!] , media reported. The child had no underlying health problems.

Parallel to the above mentioned two children, another 10 children aged 3 to 5 have shown elevated troponin values in their blood. Troponin is a protein found in the cells of the heart muscle.

According to a report by the National Public Health Organization EODY,

 

Greece’s Public Health Organization EODY

Greece’s National Public Health Organization (EODY) immediately recommended the shutdown of the school for a period of two weeks, provided information on the transmission of viral infections (parvovirus, enteroviruses and adenoviruses), advised on the cleanliness and disinfection of the school unit, and initiated an epidemiological investigation of the cases to identify the responsible infectious agents.

EODY informed medical associations across Greece about the child’s death and the surge of cases of parvovirus among children attending a kindergarten in Thessaloniki.

EODY put all medical associations on alert after the death of a child in Thessaloniki from parvovirus infection (Parvovirus B 19), about two months ago, healthreport.gr reported.

EODY sent a letter to the Medical Associations on May 1 in order to inform them that on April 10, it was informed by nursing institutions of the Region of Central Macedonia (Thessaloniki Regional Unit) regarding an influx of cases with elevated troponin in children attending a kindergarten in the region.

According to grtimes.gr, in a document shared with Medical Associations of Greece on May 1, EODY emphasized that according to data collected until April 26, eleven children aged 3-5 presented elevated troponin.

  • One child manifested a clinical picture of acute myocarditis and ended.
  • One child presented a clinical picture of myopericarditis and continues to be hospitalized.
  • Two asymptomatic children presented with a small collection of pericardial fluid with normal contractility.
  • The remaining children were asymptomatic with normal cardiac function.

The epidemiological investigation of the cases is under way and in particular the role of parvovirus B19 and other viruses in myocardial infection in children is being investigated, state-run news agency amna.gr reported on Thursday.

Expert: Child’s death is an “isolated incident”

Experts characterized the death of a 3.5-year-old girl in a childcare center in Thessaloniki who was infected with parvovirus as an isolated incident and recommend caution and calmness to parents. However, they are advising parents to check their children for symptoms without panicking.

Speaking to local news website thesstoday.gr, Professor of Pediatrics – Infectious Diseases of the Aristotle University of Thessaloniki Emmanuel Roilidis appeared reassuring, explaining that Parvovirus B19 causes a common infection that in most cases has mild symptoms.

In healthy children, it does not cause anything special, it is more threatening to children and adults with certain blood disorders or with a weakened immune system and can even make them anemic, he said.

According to the Roilidis, the girl’s death is a rare outcome since she did not suffer from any other illness. “The little girl had no other health issues, she was healthy. However, she developed a complication, a myocarditis and suffered a cardiac arrest. She was transferred to Onassio Heart Centers from Thessaloniki where she died,” he said.

Red cheeks, an intensive rash are the most striking symptoms, but also fever. Special attention should be paid by pregnant women and their fetus are particularly vulnerable to the virus.

What is Parvovirus B-19?

Parvovirus B19 is part of a family of viruses that can cause infection. Most parvoviruses infect animals, such as cats and dogs.  People cannot get infected with these parvoviruses. Dogs and cats can get vaccinated to protect them from parvoviruses that commonly affect them.

Parvovirus B19 only infects people. It does not infect animals. Someone with a parvovirus B19 infection may have a range of symptoms depending on their age and overall health.

One of the common presentations of parvovirus B19 infection is Fifth disease (or Erythema Infectiosum). Fifth disease is typically recognized by the hallmark “slapped cheek” rash. It occurs most often in young children. Fifth disease got its name because it was fifth in a list of historical classifications of common skin rash illnesses in children.

In the United States, people tend to get infected with parvovirus B19 more often in late winter, spring, and early summer. Minor outbreaks of parvovirus B19 occur about every 3 to 4 years.

Parvovirus B19 can spread:

  • From person to person through:
    • Respiratory droplets, such as saliva, sputum, or nasal mucus
    • Blood or blood products
  • During pregnancy (from mother to baby)

Prevention

There is no vaccine or treatment that can prevent parvovirus B19 infection. You can protect yourself and others from parvovirus B19 by taking everyday preventive measures such as:

  • Wash your hands often with soap and water
  • Cover your mouth and nose when you cough or sneeze
  • Avoid touching your eyes, nose, and mouth
  • Avoid close contact with people who are sick
  • Stay home when you are sick

It is important to follow standard infection control practices to prevent parvovirus B19 from spreading. For information about handwashing.

Treatment

Parvovirus B19 infections are usually mild and will go away on their own. Children and adults who are otherwise healthy usually recover completely. Treatment usually involves relieving symptoms, such as fever, itching, and joint pain and swelling.

People who have complications (I.e., low blood count, chronic joint pain) from a parvovirus B19 infection and those who are infected while pregnant should see their healthcare provider to determine if additional clinical management is necessary.

Parvovirus B19 information via CDC, the US-based Centers for Disease Control and Prevention.

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