Epidemiology

Erythema infectiosum affects people worldwide, of any age group (it is most common in children aged 6-10 years), and can occur sporadically throughout the year.[8] Epidemics are common, usually seen in the late winter and early spring and possibly follow a 6-year cycle.[9] In the UK, infection peaks in spring and early summer, with 3 to 4 year cycles of increased incidence.[10] Erythema infectiosum presents in up to 10% of paediatric patients, up to 60% of female patients, and up to 30% of male patients.[11]

Spread is via direct contact and respiratory droplets, and infection is most common in school-aged children and household contacts. The virus can be transmitted transplacentally from mother to fetus. Spread has also been reported via blood or blood products.[12][13] Seroprevalence for parvovirus B19 increases with age and by 15 years old, over 50% of adolescents have antiparvovirus antibodies.[9]

Recent data indicates an increase in parvovirus B19 activity, the virus responsible for erythema infectiosum. Since March 2024, there has been a significant rise in cases reported in 14 European countries, and in August 2024, the US Centers for Disease Control and Prevention (CDC) issued a Health Alert about increased activity in the US. This recent surge in cases has affected all age groups, with the largest increase seen among children aged 5-9 years. Parvovirus B19 is highly transmissible through respiratory droplets and can also be transmitted transplacentally from mother to fetus. Recent reports indicate a higher incidence of infections among pregnant individuals, with an increased number of fetal complications. The maternal-to-fetal transmission rate during acute infection ranges from 17% to 33%, with a 5% to 10% risk of adverse fetal outcomes, particularly if the infection occurs between 9 and 20 weeks of gestation. Additionally, an increased number of cases have been reported in individuals with sickle cell disease, underscoring the virus's impact on vulnerable populations.​[14][15][16]

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