# Differential patterns of human parvovirus B19 seropositivity among diabetic and febrile children and adolescents: evidence from the Aseer region of Saudi Arabia

## TL;DR

This study found higher rates of past exposure to human parvovirus B19 in diabetic children compared to others in Saudi Arabia's Aseer region.

## Contribution

The study reports novel B19V seroprevalence data in diabetic and febrile children in the Aseer region of Saudi Arabia.

## Key findings

- B19V IgG seropositivity increased significantly with age among children.
- Children with type 1 diabetes had higher B19V IgG seropositivity than other groups.
- No significant association was found between B19V IgM and underlying health conditions.

## Abstract

Human parvovirus B19 (B19V) is a significant causative agent of a diverse range of clinical manifestations in children. It is the primary cause of pediatric “erythema infectiosum,” also known as “fifth disease.” The virus can also cause hydrops fetalis during in-utero infections. Global serosurveys indicate that approximately 50% of individuals acquire protective immunity against the virus by the age 15; however, seroprevalence data vary depending on the geographic region and population studied.

In the present study, we report epidemiological data on B19V infectivity among pediatric patients in the southern region (Aseer region) of the Kingdom of Saudi Arabia (KSA). A cross-sectional survey was conducted among 437 pediatric patients (225 males and 212 females) attending major regional hospitals in the Aseer region of Saudi Arabia. Serum samples were tested for B19V-specific IgG and IgM antibodies using an indirect ELISA system. The seroprevalence of the virus was evaluated, and its association with age, gender, and clinical conditions (including diabetes and febrile illness) among children was analyzed.

The overall seropositivity rates for B19V-specific IgG and IgM were 32.5% and 6.2%, respectively, while 2.8% of the total tested patients were positive for both IgG and IgM antibodies. Anti-B19V IgG seropositivity increased significantly with age among the children (p = 0.001), whereas no significant differences in anti-B19V IgM seropositivity were observed across the different age groups (p = 0.193). Furthermore, anti-B19V IgG seropositivity was significantly higher among patients with type 1 diabetes mellitus (T1DM) compared with those with other clinical conditions. The IgG seroprevalence rates were 40.1%, 18.8%, and 38.3% among T1DM, febrile, and other pediatric patients, respectively. In contrast, no statistically significant association was observed between anti-B19V IgM seropositivity and underlying health condition, with corresponding rates of 3.1%, 9.4%, and 8.3% among diabetic, febrile, and other pediatric patients, respectively.

These findings suggest cumulative childhood exposure to the virus, even though no major outbreaks were reported in the region during the study period. The results also underscore the need for larger, community-based surveillance studies to enable timely outbreak detection and the implementation of appropriate control measures to limit virus transmission.