PARVOVIRUS B19 AND NECROTIZING ENTEROCOLITIS (NEC)

Necrotizing enterocolitis can occur in epidemics. Various infectious agents have been associated with these clusters, but so far there has been no report of Parvovirus B19 infection and NEC in previously healthy premature infants. We report here an epidemic of NEC linked to Parvo B19 infection Within 10 days 8 premature infants developed the clinical picture of NEC, 6 of them within 24 hours. Their GA ranged from 27 - 32 weeks, their postnatal age from 4 days to 6 weeks. Prior to the onset of severe abdominal pain wiih bloody stools all infants had tolerated their enteral feedings well. Three infants required exploratory laparatomy. The entire small and large intestines were intraoperatively found to be cyanotic with no focal lesion or focal necrosis. Stool and blood cultures were negative for enteric pathogens and Rotavirus Parvo B19 DNA was found in stool and serum samples of 3 infants by the Polymcrase-Chain-Reaction (PCR), 3 infants were negative and 2 infants were not studied. Primers were selected from the VP1 region, so they bracketed a 240 base pair fragment of the Parvovirus B19 genome. Sequence analysis of the PCR-products revealed characteristics typical of Parvo B19 in all investigated positive cases. There were 2 isolated cases of Parvo B19 pos. NEC 4 month later. Summary: Parvovirus B 19 could be detected with PCR in 5 of 10 infants with NEC, but only in 2 of 19 healthy control infants. Since 2 sick infants were not examined no definite statement can be made, but we believe that there is now some evidence that Parvovirus B19 infection can cause necrotizing enterocolitis in neonates. Further prospective studies are needed to elucidate this association.