Journal Mobile Options
Table of Contents
Vol. 216, No. 4, 2008
Issue release date: May 2008
Dermatology 2008;216:341–346

Chronic Fatigue Syndrome after Human Parvovirus B19 Infection without Persistent Viremia

Seishima M. · Mizutani Y. · Shibuya Y. · Arakawa C.
Department of Dermatology, Ogaki Municipal Hospital, Ogaki City, Japan

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


Background: It is unclear how often chronic fatigue syndrome (CFS) appears after human parvovirus B19 (B19) infection and whether prolonged B19 viremia or some other factors cause CFS. Objectives: To determine how often CFS appears after B19 infection and whether prolonged B19 DNA presence, antibody production and persistently reduced complement levels occur in CFS patients after B19 infection. Methods: Clinical findings were examined in 210 patients after B19 infection, and CH50, C3 and C4 levels were determined. B19 DNA and antibodies to B19 were also tested in 38 patients’ sera including 3 with CFS. Results: Serum B19 DNA disappeared after 4–5 months in all 18 patients tested. There are no differences in B19 DNA-positive period between patients with and without persistent symptoms. IgM antibody titers to B19 became reduced after 2 months in all 38 patients. Complement levels persistently decreased in a greater proportion of patients with persistent symptoms. Conclusions: The present study suggests that we should consider the possibility of CFS after B19 infection and that CFS may be derived from several aspects other than prolonged B19 DNA presence in sera.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Seishima M, Kanoh H, Izumi T: The spectrum of cutaneous eruptions in 22 patients with isolated serological evidence of infection by parvovirus B19. Arch Dermatol 1999;135:1556–1557.
  2. Seishima M, Oyama Z, Yamamura M: Two-year follow-up study after human parvovirus B19 infection. Dermatology 2003;206:192–196.
  3. Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A, the International Chronic Fatigue Syndrome Study Group: The chronic fatigue syndrome: a comprehensive approach to its definition and study. Ann Intern Med 1994;121:953–959.
  4. Kerr JR, Coyle PV, DeLeys RJ, Patterson CC: Follow-up study of clinical and immunological findings in patients presenting with acute parvovirus B19 infection. J Med Virol 1996;48:68–75.
  5. Jacobson SK, Daly JS, Thorne GM, Mclntosh K: Chronic parvovirus B19 infection resulting in chronic fatigue syndrome: case history and review. Clin Infect Dis 1997;24:1048–1051.
  6. Kerr JR, Bracewell J, Laing I, Mattey DL, Bernstein RM, Bruce IN, Tyrrell DJ: Chronic fatigue syndrome and arthralgia following parvovirus B19 infection. J Rheumatol 2002;29:595–602.
  7. Sevall JS: Detection of parvovirus B19 by dot-blot and polymerase chain reaction. Mol Cell Probes 1990;4:237–246.
  8. Pawlikowska T, Chalder T, Hirsch SR, Wallace P, Wright DJM, Wessely SC: Population based study of fatigue and psychological distress. BMJ 1994;308:763–766.
  9. White PD, Thomas JM, Kangro HO, Bruce-Jones WDA, Amess J, Crawford DH, Grover SA, Clare AW: Predictions and association of fatigue syndromes and mood disorders that occur after infectious mononucleosis. Lancet 2001;358:1946–1954.
  10. Speyer I, Breedveld FC, Dijkmans BA: Human parvovirus B19 infection is not followed by inflammatory joint disease during long-term follow-up: a retrospective study of 54 patients. Clin Exp Rheumatol 1998;16:576–578.
  11. Minowa M, Jiamo M: Descriptive epidemiology of chronic fatigue syndrome based on a nationwide survey in Japan. J Epidemiol 1996;6:75–80.
  12. Lindblom A, Isa A, Norbeck O, Wolf S, Johansson B, Broliden K, Tolfvenstam T: Slow clearance of human parvovirus B19 viremia following acute infection. Clin Infect Dis 2005;41:1201–1203.
  13. Soderlund-Venermo M, Hokynar K, Nieminen J, Rautakorpi H, Hedman K: Persistence of human parvovirus B19 in human tissues. Pathol Biol (Paris) 2002;50:307–316.
  14. Dobec M, Juchler A, Flaviano A, Kaeppeli F: Prolonged parvovirus B19 viremia in spite of neutralizing antibodies after erythema infectiosum in pregnancy. Gynecol Obstet Invest 2007;63:53–54.
  15. Heegaard ED, Brown KE: Human parvovirus B19. Clin Microbiol Rev 2002;15:485–505.
  16. Isa A, Kasprowicz V, Norbeck O, Loughry A, Jeffery K, Broliden K, Klenerman P, Tolfvenstam T, Bowness P: Prolonged activation of virus-specific CD8+ T cells after acute B19 infection. PLoS Med 2005;2:1280–1291.
  17. Peterlana D, Puccetti A, Corrocher R, Lunardi C: Serological and molecular detection of human parvovirus B19 infection. Clin Chim Acta 2006;372:14–23.
  18. Kerr JR, Barah F, Mattey DL, Laing I, Hopkins SJ, Hutchinson IV, Tyrrell DAJ: Circulating tumour necrosis factor-α and interferon-γ are detectable during acute and convalescent parvovirus B19 infection and are associated with prolonged and chronic fatigue. J Gen Virol 2001;82:3011–3019.
  19. Isa A, Norbeck O, Hirbod T, Lundqvist A, Kasprowicz V, Bowness P, Klenerman P, Broliden K, Tolfvenstam T: Aberrant cellular immune responses in humans infected persistently with parvovirus B19. J Med Virol 2006;78:129–133.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50