Human Parvovirus 4 in Nasal and Fecal Specimens from Children, Ghana

Jan Felix Drexler, Ulrike Reber, Doreen Muth, Petra Herzog, Augustina Annan, Fabian Ebach, Nimarko Sarpong, Samuel Acquah, Julia Adlkofer, Yaw Adu-Sarkodie, Marcus Panning, Egbert Tannich, Jürgen May, Christian Drosten, and Anna Maria Eis-Hübinger

Author affiliations: University of Bonn Medical Centre, Bonn, Germany (J.F. Drexler, U. Reber, D. Muth, A. Annan, F. Ebach, C. Drosten, A.M. Eis-Hübinger); Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P. Herzog, J. Adlkofer, E. Tannich, J. May); Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana (A. Annan, N. Sarpong, S. Acquah); Kwame Nkrumah University of Science and Technology, Kumasi (Y. Adu-Sarkodie); and Freiburg University Medical Center, Freiburg, Germany (M. Panning)

Abstract

Nonparenteral transmission might contribute to human parvovirus 4 (PARV4) infections in sub-Saharan Africa. PARV4 DNA was detected in 8 (0.83%) of 961 nasal samples and 5 (0.53%) of 943 fecal samples from 1,904 children in Ghana. Virus concentrations ≤6–7 log₁₀ copies/mL suggest respiratory or fecal–oral modes of PARV4 transmission.

Human parvovirus 4 (PARV4; human partetravirus) is a single-stranded DNA virus discovered in 2005 (1). PARV4 has been detected in persons at risk for parenteral infections, suggesting blood-borne transmission (2,3) although other transmission routes have not been ruled out. Studies in northern Europe demonstrated a high prevalence of antibodies against PARV4 in injection drug users, persons co-infected with HIV and hepatitis C virus, and persons with hemophilia who were exposed to nonvirally inactivated clotting factors; however, antibodies were not detected in the general population (4,5).
In contrast, PARV4 seroprevalence was 25%–37% in adults in the Democratic Republic of Congo, Cameroon, and Burkina Faso who were not infected with HIV and hepatitis C virus (6). PARV4 DNA was detected in blood of 8.6% of children 15 or 24 months of age in Ghana (7). There was no history of exposure to multiple-use needles or blood transfusion in any of these children. These data suggested alternative modes of PARV4 transmission in countries in Africa. Nonparenteral modes of transmission of PARV4 have also been suggested in South Africa (6), Taiwan (8), India (9), China (10), and Thailand (11).
PARV4 has been classified into 3 genotypes. Genotypes 1 and 2 are found in North America, Europe, and Asia (1–3,9–11), and genotype 3 is found in in sub-Saharan Africa (7,12). To investigate whether PARV4 is found in the respiratory or intestinal tract, we analyzed previously collected specimens from 1,904 children in Ghana.