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A symposium entitled ‘Zoonoses in the '8os: New Developments and Prospects for Control’
I I2
Letters to the Editor
T h e pathogenesis of the petechial rash is not clear. T h e n u m b e r and function of platelets were normal. Although the patient was viraemic at the time of presentation, an i m m u n e complex-mediated pathogenesis of the rash is unlikely. Tests for both I g M and I g G were negative at that time. It is probable that the virus is responsible for a vasculitis. We have since seen a 42-year-old m a n who presented with fever and an intense purpuric eruption concentrated in the groin and on both hands and feet. B I 9 virus particles were seen by electron microscopy at 3 days, and a high anti-B19 I g M titre was found at 6 days after onset of the rash. Li L o o n g and colleagues describe a similar case. ~ Although the rash usually associated with B I 9 virus infection is that of erythema infectiosum, it is apparent that other exanthemata may occur. T h e patient himself showed two distinct rashes; the macular erythematous eruption associated with the slapped cheek look and also the fine petechial rash. Neither he nor any m e m b e r of his family illustrated the typical lacy, reticular appearance of the rash of erythema infectiosum. T h e story of this recently identified, potentially damaging virus, continues to unfold. We provide further evidence of Parvovirus B 19 virus associated vascular purpura, and laboratory confirmation of the spread of infection within the family. (We thank D r J. Stevenson for his advice and for allowing us to report on this patient, and Miss M. M. Buckley and Miss J. Mori for technical assistance.)
Infectious Diseases Department Seacroft Hospital Leeds
S . P . Conway
Virus Referenc e Laboratory Central Public Health Laboratory London
B . J . Cohen A. M. Field
Virology Department Public Health Laboratory Leeds
M. H. Hambling
References i. Anderson MJ, Jones SE, Fisher-Hoch SP et al. Human parvovirus, the cause of erythema infectiosum (fifth disease)? Lancet I983: i: I378. 2. Plummer FA, Hammond GW, Forward K et al. An erythema infectiosum-like illness caused by human parvovirus infection. N Engl J Med I985 ; 313 : 74-79. 3. Lefrere J J, Courouce AM, Muller JY, Clark M, Soulier JP. Human parvovirus and purpura. Lancet I985: ii: 730. 4- Mortimer PP, Cohen BJ, Rossiter MA, Fairhead SM, Rahman AFMS. Human parvovirus and purpura. Lancet I985; ii: 730-73 I. 5. Li Loong TC, Coyle PV, Anderson MJ, Allen GE, Connolly JH. Human serum parvovirus associated vasculitis. Postgrad Med J 1986; 62: 493-494.
A s y m p o s i u m entitled 'Zoonoses in the '8os: New D e v e l o p m e n t s and Prospects for Control' Sir, T h i s symposium, which was held on 31 October I985, was organised by the British Small A n i m a l Veterinary Association (BSAVA) and the Public Health L a b o r a t o r y Service C o m m u n i c a b l e Disease Surveillance Centre in liaison with the Faculty of C o m m u n i t y Medicine of the Royal College of Physicians and the British Medical Association. A balanced view of diseases transmitted between animals and m a n was
Letters to the Editor
II3
presented and positive recommendations for disease control were given. Accordingly, people may continue to enjoy the considerable benefits resulting from pet ownership and livestock farming, while any health hazards are reduced to a minimum. The Proceedings of the symposium have been published and are available from the British Small Animal Veterinary Association, 5 St George's Terrace, Cheltenham, Glos. GL5o 3PT, price £4.75. The Red House North Marston Bucks M K x 8 3PD C. J. Price
Letters to the Editor
T h e pathogenesis of the petechial rash is not clear. T h e n u m b e r and function of platelets were normal. Although the patient was viraemic at the time of presentation, an i m m u n e complex-mediated pathogenesis of the rash is unlikely. Tests for both I g M and I g G were negative at that time. It is probable that the virus is responsible for a vasculitis. We have since seen a 42-year-old m a n who presented with fever and an intense purpuric eruption concentrated in the groin and on both hands and feet. B I 9 virus particles were seen by electron microscopy at 3 days, and a high anti-B19 I g M titre was found at 6 days after onset of the rash. Li L o o n g and colleagues describe a similar case. ~ Although the rash usually associated with B I 9 virus infection is that of erythema infectiosum, it is apparent that other exanthemata may occur. T h e patient himself showed two distinct rashes; the macular erythematous eruption associated with the slapped cheek look and also the fine petechial rash. Neither he nor any m e m b e r of his family illustrated the typical lacy, reticular appearance of the rash of erythema infectiosum. T h e story of this recently identified, potentially damaging virus, continues to unfold. We provide further evidence of Parvovirus B 19 virus associated vascular purpura, and laboratory confirmation of the spread of infection within the family. (We thank D r J. Stevenson for his advice and for allowing us to report on this patient, and Miss M. M. Buckley and Miss J. Mori for technical assistance.)
Infectious Diseases Department Seacroft Hospital Leeds
S . P . Conway
Virus Referenc e Laboratory Central Public Health Laboratory London
B . J . Cohen A. M. Field
Virology Department Public Health Laboratory Leeds
M. H. Hambling
References i. Anderson MJ, Jones SE, Fisher-Hoch SP et al. Human parvovirus, the cause of erythema infectiosum (fifth disease)? Lancet I983: i: I378. 2. Plummer FA, Hammond GW, Forward K et al. An erythema infectiosum-like illness caused by human parvovirus infection. N Engl J Med I985 ; 313 : 74-79. 3. Lefrere J J, Courouce AM, Muller JY, Clark M, Soulier JP. Human parvovirus and purpura. Lancet I985: ii: 730. 4- Mortimer PP, Cohen BJ, Rossiter MA, Fairhead SM, Rahman AFMS. Human parvovirus and purpura. Lancet I985; ii: 730-73 I. 5. Li Loong TC, Coyle PV, Anderson MJ, Allen GE, Connolly JH. Human serum parvovirus associated vasculitis. Postgrad Med J 1986; 62: 493-494.
A s y m p o s i u m entitled 'Zoonoses in the '8os: New D e v e l o p m e n t s and Prospects for Control' Sir, T h i s symposium, which was held on 31 October I985, was organised by the British Small A n i m a l Veterinary Association (BSAVA) and the Public Health L a b o r a t o r y Service C o m m u n i c a b l e Disease Surveillance Centre in liaison with the Faculty of C o m m u n i t y Medicine of the Royal College of Physicians and the British Medical Association. A balanced view of diseases transmitted between animals and m a n was
Letters to the Editor
II3
presented and positive recommendations for disease control were given. Accordingly, people may continue to enjoy the considerable benefits resulting from pet ownership and livestock farming, while any health hazards are reduced to a minimum. The Proceedings of the symposium have been published and are available from the British Small Animal Veterinary Association, 5 St George's Terrace, Cheltenham, Glos. GL5o 3PT, price £4.75. The Red House North Marston Bucks M K x 8 3PD C. J. Price