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» LymeNet Flash » Questions and Discussion » Medical Questions » Parvovirus B19 should be included in Lyme differential Dx!!!! (Page 1)

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Author Topic: Parvovirus B19 should be included in Lyme differential Dx!!!!
AliG
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[Eek!]

J Clin Virol. 2008 Oct;43(2):226-9. Epub 2008

Persistent parvovirus B19 infection and arthralgia in a patient mistakenly treated for Lyme disease.

Dobec M, Kaeppeli F, Cassinotti P, Satz N.

Medica, medizinische Laboratorien Dr. F. Kaeppeli, Wolfbachstrasse 17, CH-8024 Zurich, Switzerland.

We report a case of a 37-year-old woman with persistent parvovirus B19 infection and arthralgia mistakenly treated for Lyme disease.

This case indicates that poor standardization of both screening and confirmatory assays for Lyme disease can lead to an incorrect diagnosis of Lyme disease.

Before making a final diagnosis of Lyme arthritis in an endemic region, other causative agents of arthritis, such as parvovirus B19, should be excluded to avoid unnecessary treatment or to add appropriate therapy in the case of co-infections.

Since parvovirus B19 is often associated with arthralgia and can mimic rheumatoid arthritis and autoimmune diseases, it should be included in the differential diagnosis of arthralgia.


PMID: 18653379 [PubMed - in process]

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Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner.

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AliG
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J Gen Intern Med. 2007 Jun;22(6):877-8. Epub 2007 Mar 24.

Secondary symptomatic parvovirus B19 infection in a healthy adult.

Kaufmann J, Buccola JM, Stead W, Rowley C, Wong M, Bates CK.

Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, E/CC-6, 330 Brookline Avenue, Boston, MA 02215, USA.


Parvovirus B19 is a common infection in adults and children. There are reports of secondary parvovirus infection in immunocompromised persons, but no reports of symptomatic secondary infection in healthy persons.

We describe a healthy 39-year-old woman who presented with fever, rash, and arthralgia. Her symptoms were thought most compatible with parvovirus B19 infection, but she reported prior positive parvovirus antibody 2 years earlier during prenatal care.

Tests were therefore also sent for HIV, streptococcal infection, hepatitis C, and Lyme disease.

Testing revealed both elevated IgG and IgM antibodies for parvovirus B19; previously, the patient was positive only for IgG.

On a subsequent visit she related that a community outbreak of parvovirus developed in her town and church group.

We believe this case demonstrates that a symptomatic secondary infection with parvovirus can occur in healthy persons, and that prior positive antibody test does not preclude the development of acute infection.

PMID: 17384979 [PubMed - indexed for MEDLINE]

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Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner.

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AliG
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Dermatology. 2008;216(4):341-6. Epub 2008 Feb 15.

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. [email protected]

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 2008 S. Karger AG, Basel.

PMID: 18277075 [PubMed - indexed for MEDLINE]

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Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner.

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AliG
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Symptoms of Parvovirus from wrongdiagnosis.com:

* In children: a mild disease with slapped face syndrome
* Rash on face
* Fever. In adults: joint pain and inflammation
* Rash
* Fever. In sickle cell anaemia patients: failure of blood cells
* Tiredness
* Fatigue

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Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner.

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lymielauren28
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Weird! I had a lady here in Mississippi that I was corresponding with via e-mail. She'd contacted me regarding finding a lyme doc.

She had seventeen "Lyme symptoms" and she sure sounded like a Lymie to me. She had been tested by a regular doc for Lyme which was negative - I of course told her that didn't mean a hill of beans.

She actually made an appt. with an LLMD I'd recommended and when she told her regular doc about it, as a last ditch effort, he tested her for parvovirus - and that's what she had!!

Scary how similar the symptoms are! Soo, after this experience, yes I agree - people should be tested for Parvovirus B19!!

Lauren

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"The only way out is through"

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jamieL
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If a person is positive on Band 31 of the Igenex WB, they can do a Band confirmation test to make sure it isn't cross-reacting with a virus.

Is there a treatment for Parvovirus?

--------------------
Diagnosed with :yme and mycoplasma pneumonia Aug 08.
Treating with Doxy and Ceftin ever since. 15 sessions in hyperbaric o2 chamber

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TerryK
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Thanks for posting. I've seen this mentioned in a differential diagnosis for lyme but I've never been tested.

Makes sense that anyone who hasn't had the normal response to treatment should be tested for this.

Terry

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emla999/Lyme
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Another scary thing about the Parvovirus B19 infection is that it can cross react with the Western blot test.


And according to the researchers of the study on the link bellow this could lead to a miss diagnoses of Lyme Disease.


http://tinyurl.com/5xdhp5


You can access the full article on the link bellow.


http://www.bjbs-online.org/article.asp?id=222

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AliG
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emedicine-parvovirus lists treatments.

AAFP - info on Parvovirus

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Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner.

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AliG
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Research Article

Possible transmission of parvovirus B19 from intravenous immune globulin

Dean D. Erdman 1 *, Barbara C. Anderson 1, Thomas J. Trk 1, Terri H. Finkel 2, Larry J. Anderson 1


Abstract
To look for genetic changes in human parvovirus B19 that might be associated with chronic infection, we sequenced B19 DNA obtained from serum specimens collected over an approximately 1-year period from a patient with systemic vasculitis.

A comparison of the nucleotide sequences of the VP1/VP2 gene from four specimens revealed an abrupt change in the B19 genotype that coincided with initiation of intravenous immune globulin (IVIG) therapy.

We suspect that one or more of the lots of IVIG administered to the patient were contaminated with B19.

If true, this finding suggests that investigators must be careful in linking B19 infection to disease based on detection of B19 DNA in persons who have received multiple unit blood products.

J. Med. Virol. 53:233-236, 1997. Published 1997 Wiley-Liss, Inc.[Note ][This article was prepared by a group consisting of both United States government employees and non-United States government employees, and as such is subject to 17 U.S.C. Sec. 105.]

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Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner.

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AliG
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Could this be tick-transmitted?

Could it be a co-infection?

Could it be re-activated by Lyme?

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Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner.

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Lymetoo
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quote:
Originally posted by AliG:
Could this be tick-transmitted?

Could it be a co-infection?

Could it be re-activated by Lyme? [/QB]

I wonder the same thing. I know someone who had Parvo and nearly died. I wanted her to get tested for Lyme.

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emla999/Lyme
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Intravenous Immune Globulin (IVIG) may be useful in the treatment of Parvovirus B19 infection.


http://tinyurl.com/3ofe3a


http://tinyurl.com/497gej

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lymeHerx001
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Im positive IGG and not IGM on parvovirusb19.


LLMD gave me Valtrex and I feel better in different ways.

I think it might be helping, of course I have to test again.

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emla999/Lyme
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I found a Parvovirus B19 discussion group called the Miranda Mission.



http://groups.msn.com/TheMirandaMissionHumanParvoVirus/general.msnw?action=get_threads&Dir=0&CType=-2&ID_Last=5868


http://tinyurl.com/4lgrcl


Unfortunately, it looks like that discussion group has been invaded by the spammers for the past several weeks. So, you have to weed through the spammers posts.


There seems to be some good info on that discussion group though.

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jam338
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Interesting, thanks for this thread on Parvovirus B19. My test was through Quest.

The reference range for both IgG and IgM is greater than 1.1

My IgM is less than 0.1
My IgG is 5.2 (5x the level to be positive)

With a lot of the viral factors (and I am assuming this would be applicable to any viral), the research work of Dr. Martin Lerner and Dr. Jose Montoya is showing that high titers on IgG is far more important than most doctors realize. When the IgG titer continues to rise, it shows there has beeen ongoing reactivation periods.

For example, based on what I have read, IgM titers may only show active for 2 months or so (depends on the type of infection).

So, if you didn't happen to test during that 2 month period of IgM activation, then you would have no way of knowing (other than symptoms) that you had a reactivation.

Yet, monitoring your IgG panel to see if IgG titers are climbing can tell you a lot. The only cause of rising IgG can be a reactivated infection. With each reactivation period, it signals the body to make increased antibodies in the IgG panel to protect you against future infection.

I couldn't get the link to work in one of the above posts where it said Parvovirus B19 can interfere with western blot results. Thank you to whomever mentioned it though so I can ask my LLMD about it at my next appt.

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Lymetoo
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quote:
Originally posted by AliG:
Research Article

Possible transmission of parvovirus B19 from intravenous immune globulin

Dean D. Erdman 1 *, Barbara C. Anderson 1, Thomas J. Trk 1, Terri H. Finkel 2, Larry J. Anderson 1


Abstract
To look for genetic changes in human parvovirus B19 that might be associated with chronic infection, we sequenced B19 DNA obtained from serum specimens collected over an approximately 1-year period from a patient with systemic vasculitis.

A comparison of the nucleotide sequences of the VP1/VP2 gene from four specimens revealed an abrupt change in the B19 genotype that coincided with initiation of intravenous immune globulin (IVIG) therapy.

We suspect that one or more of the lots of IVIG administered to the patient were contaminated with B19.

If true, this finding suggests that investigators must be careful in linking B19 infection to disease based on detection of B19 DNA in persons who have received multiple unit blood products.

J. Med. Virol. 53:233-236, 1997. Published 1997 Wiley-Liss, Inc.[Note ][This article was prepared by a group consisting of both United States government employees and non-United States government employees, and as such is subject to 17 U.S.C. Sec. 105.] [/qb]

Highlighted for "Raymond"...

hey Raymond... your PM box is full

--------------------
--Lymetutu--
Opinions, not medical advice!

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emla999/Lyme
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For Jam338



http://findarticles.com/p/articles/mi_qa3874/is_/ai_n17183134


http://www.bjbs-online.org/article.asp?id=222

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kelmo
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I got parvovirus back in the mid-90s. I went to see my PCP because I was extremely fatigued (I had just come off a long EBV illness that lasted three years), my joints and bones ached, and I had a weird rash under my skin.

When he mentioned parvo, I that that was rediculous. When it came up positive, I was contacted by a lab in CA that wanted to pay me $500 for a pint of my blood for research and control.

When I went to have it drawn, they said I was too anemic. Parvovirus attacks the bone marrow and stops blood production.

I can see how someone can die from it. I was pretty sick.

The next week, my daughter came down with Fifths Disease, which is the childhood version of parvo.

It did resolve on it's own, and it re-ignited my EBV.

The next year, I came down with a SERIOUS double pneumonia.

My LLMD now thinks I've been infected for a very long time with the soup we now know as the Lyme family.

Kelmo

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AliG
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Sheeesh Kelmo! [Eek!] [group hug]

I'm guessing this would be another one of the darn viruses, that our immune system is expected to keep under control, that start acting up again when Lyme & the tick-borne co-infections take down our immune systems.

I would guess that, whether you've gotten it from a tick-bite or contracted it previously, it could still be a complication when we're trying to overcome this mess.

Have you had any antiviral treatments at all?

Was that double-pneumonia from Mycoplasma?

[Frown]

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Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner.

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gemofnj
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How do they treat Parovirus?
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AliG
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I just realized something....

Are they relying on SEROLOGY to determine that neither of those two cases also had Lyme Disease? [bonk]

I would imagine that there was a reason that it was suspected in both cases. I wish they would have stated whether a tick-bite was involved.

--------------------
Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner.

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ByronSBell 2007
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My LLMD has been testing all of her patients for parvo virus for quite a while and most patients here at the lyme clinic have it, including myself.
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Keebler
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-

Woof! Woof!

Thanks for all this information.


-

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kelmo
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I don't think my LLMD is very active in treating the viruses. He did recommend Transfer Factor to me.

I think this is something I'll just have to figure out how to live with.

I'm hoping that taking care of the bacteria will give my body the opportunity to build the immune system so that my body can kick the viruses.

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AliG
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Human Parvovirus B19 Infection - Autoimmune Disease Trigger
excerpt:
quote:
In chronic infection, Human Parvovirus B19 can infect the brain. Because of its ability to induce autoimmunity, this virus is suspected of triggering co-morbid bipolar and autoimmune thyroid disorders in females and schizophrenia and autoimmune thyroid disorders in males.
I've been looking for Tx & it seems mostly just symptomatic Tx has been used.

I have come across IVIg used for chronic Parvovirus B19 infection.

[ 14. October 2008, 10:57 PM: Message edited by: AliG ]

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Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner.

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AliG
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J Med Virol. 2008 Nov;80(11):2005-11.

Tissue persistence of parvovirus B19 genotypes in asymptomatic persons.

Corcioli F, Zakrzewska K, Rinieri A, Fanci R, Innocenti M, Civinini R, De Giorgi V, Di Lollo S, Azzi A.

Department of Public Health, University of Firenze, Italy.


Parvovirus B19 (B19V) can persist in immunocompetent symptomatic and non-symptomatic individuals, as demonstrated by the finding of viral DNA in different tissues, in absence of viremia and of anti-B19V IgM.

The spread and the nature of this phenomenon have not been clearly determined.

In order to investigate the frequency of persistence and the tissue distribution of the three genotypes of B19V, the viral load of the persistent virus and its expression in the affected tissues, 139 tissue samples and 102 sera from 139 asymptomatic individuals have been analyzed by consensus PCRs and genotype specific PCRs for B19V detection and genotyping.

Viral load was measured by real time PCR and viral mRNAs were detected by RT-PCR.

Altogether, 51% individuals carried B19V DNA, more frequently in solid tissues (65%) than in bone marrow (20%).

Genotype 1 was found in 28% tissue samples, genotype 2 in 68% and genotype 3 in 3% only.

Viral load ranged from less then 10 copies to 7 x 10(4) copies per 10(6) cells, with the exception of two samples of myocardium with about 10(6) copies per 10(6) cells.

mRNA of capsid proteins was present in two bone marrow samples only.

In conclusion, in asymptomatic individuals B19V persistence is more common in solid tissues than in bone marrow, and genotype 2 persists more frequently than genotype 1.

The results suggest that the virus persists without replicating, at sub-immunogenic levels.

2008 Wiley-Liss, Inc.

PMID: 18814251 [PubMed - in process]

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Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner.

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Angelica
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Byron how are you doing and how is your treatment going?
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just don
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VERY interesting topic. Can one who does NOT respond to any teatment be suspect for this??

I KNOW animals carry parvovirus,,,but not sure it is this P-19 version,,how many versions are there?

Maybe merry girl would have valuable info on this,,,as to whether animals have SAME type??

any idea how expensive the test is for this?? Is it something fry labs can or will do??

I was tested for burcellosis once and it said negative,,,didnt know at the time it had to be tested immediately and not 'shelved' for awhile

,,,most small labs here dont even know that I think

Guesing fry labs would be beter at it,,but IF it cant wait,how does one ship??

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just don

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AliG
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B19 is the human strain. I don't believe the animal strain can jump species.

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Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner.

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emla999/Lyme
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Just Don,

I believe that it would be wise to get tested for Parvovirus B19 if you have been diagnosed with Chronic Lyme Disease, particularly if you are not improving on antibiotics. Actually, it would probably be helpful to be tested for other viral infection at the same time, such as EBV, HHV-6,CMV etc..


Thus far the only strain of parvovirus that has been identified to infect humans is the Parvovirus B19 strain. So,you can't catch parvo from your pet.


And to my knowledge the Parvovirus B19 strain only infects humans and doesn't infect other animals. Although, I read somewhere that monkeys may be carriers of the Parvovirus B19 strain. But animals such as dogs,cats,cows,deer etc. do not carry the Parvovirus B19 strain.


Also, I don't believe that the Fry lab tests for Parvovirus B19. Focus Diagnostics is a lab that does test for Parvovirus B19.


http://www.focusdx.com/focus/search/search_results.asp?q=Parvovirus+B19&Enter=Go


There is also a discussion group devoted to the Human Parvovirus B19.


http://groups.msn.com/TheMirandaMissionHumanParvoVirus/general.msnw?action=get_threads&Dir=0&ID_Last=5663

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AliG
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Lots of links on Parvovirus B19

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Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner.

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AliG
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I'm guessing that a tick could not carry Parvovirus B19 if there would be no animal reservoir.

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emla999/Lyme
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According to the link bellow humans are the only known host of the Parvovirus B19 strain.


http://tinyurl.com/4cn3nk


So yes, it would seem unlikely that ticks could transmit the Parvovirus B19 strain to any extent.
I am not sure about mosquitoes though.

[ 14. October 2008, 10:03 PM: Message edited by: emla999/Lyme ]

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Tincup
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Many many moons ago I had myself tested for Parvo B-19 for some reason. Something caught my eye about it in something I read somewhere. Anyhow...

I was positive. I've since encouraged others to be tested and LLMD's to test for it... to be sure the patients were ok and to see if I was the only "unlucky one" who got it along with multiple other co-infections.

I would be VERY cautious about the "misdiagnosis" the author of the abstract mentions. I've seen a number of other pieces of literature on it and in MY opinion...

Docs are missing the Lyme (more often than not due to bad Lyme tests and stupidity)... and catching the Parvo in some folks. These folks are also not tested for other tick borne coinfections.. making me very concerned about any "results" reported in studies like this one.

Some of the studies also reported the people were exposed to ticks, then got Parvo... but they played down that theory.

In some studies I've noted in the past people were treated for Parvo and Lyme (the standard 3 weeks antibiotics for Lyme) and went on to have lifelong problems with arthritis, fatigue, etc. (Lyme symptoms)... with a number of them becoming totally disabled from the infections.

The Parvo was being blamed for their misery ... but no one treated the Lyme any further. I think they still had Lyme and or unknown coinfections. Some patients also had positive Lyme tests years later and they were written off as being "false positive" due to prior exposure.

It is also my opinion that it is passed by ticks and other vectors.

This theory that it can't be sustained in other hosts, in MY opinion, is hooey. Especially since the IDSA ducks (some of ours) are involved in a lot of the "theories" out there. And others simply feed off those basic bad "facts" to do their studies and make their conclusions.

They said Lyme couldn't be in any other hosts for the longest time.. and Babesiosis, etc.. and that these diseases couldn't be transmitted from vectors to humans... and certain species couldn't be carried, transmitted or couldn't infect other animals or humans other than the ones THEY said.... which denied many people the proper diagnosis and treatment.

Just my 2 cents.

[Big Grin]

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just don
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I read alot of the links and info supplied here. I am SOOO releived,,,most of them said easy to treat or NO treatment neededd cause it goes away on its own,,,take something for the headache,like tylenol or something.

OH goodie,,sounds easy to ME!!! [Eek!] [dizzy]

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JRWagner
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Ali...up late doing research again I see!!!THANK YOU!!!!

Wow...interesting stuff for sure, as I have auto-immune indicators in my CSF, as you might know.

Now to get tested...but what is the best treatment?

Timaca, could you ask Dr. Montoya what he thinks?

Peace, love and Wellness,
JRW

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emla999/Lyme
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Regarding Parvovirus B19.


"In conclusion, a syndrome characterized by fatigue, arthralgia, sore throat, unrefreshing sleep, new headache, pos-texertional malaise, increased tendency to sweat, dizzy spells, and blurred vision may occur following B19 infection and may persist for several years."


The quote from above was from this study:


http://www.cfsrf.com/pdf/j-rh.pdf


Symptoms may persist for several years!!!!

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AliG
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It would seem to me that. if your immune system is taxed by Lyme Disease Complex (aka-AIDS-Lite)This could be something that WOULD reqiure some form of Tx.

I think it's really messed up that the Tx they recommend is IVIg and there was a study showing that someone actually contracted it FROM IVIg. [Eek!]

If it would take IVIg to fight it off, are you OK if you have positive Ig for it?

emedicine- Parvovirus B19

Medical Care

* Acetaminophen or ibuprofen is effective for treating fever. Fever does not always require treatment with antipyretics; however, consider antipyretics if a patient appears clinically uncomfortable.

* Resolution of infection depends on the presence of immunoglobulins against B19V.

No definitive evidence that cell-mediated immunity is a necessary part of the immune response has been reported.

IVIG may have a role in treating chronic parvovirus infection.

* Patients in aplastic crisis require packed RBC transfusions.

* In patients receiving immunosuppressive agents, temporarily decreasing the dose of immunosuppressive agents usually enables the immune system to produce sufficient IgG to eradicate the infection and confer lifelong protection.

In some individuals with human immunodeficiency virus (HIV) infection, highly active antiretroviral therapy restores immune function, enabling resolution of chronic parvovirus B19 (B19V) infection.

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emla999/Lyme
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I just realized that Parvovirus B19 is also known as Erythrovirus B19.


http://www.google.com/search?num=100&hl=en&lr=&as_qdr=all&q=%22erythrovirus+B19%22&btnG=Search

Now I have some new words to search on Google!!!

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AliG
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Oh great!!!(not)

Does that mean that a positive serology for Parvovirus B19 could be Baculovirus?

Now what the heck is Baculovirus?

J Med Virol. 2002 Feb;66(2):246-52.

Baculovirus expression of erythrovirus V9 capsids and screening by ELISA: serologic cross-reactivity with erythrovirus B19.


Heegaard ED, Qvortrup K, Christensen J.

Department of Clinical Microbiology, University State Hospital, Rigshospitalet, Denmark. [email protected]

Diagnosis of erythrovirus B19 (B19) relies on serology and the detection of viral DNA.

Recently, a distinct erythrovirus isolate termed V9, markedly different from erythrovirus B19 (> 11% nucleotide disparity), was isolated.

Standard B19 PCR assays were inconclusive and serologic tests failed to categorize V9 as an acute B19-like infection.

Sequencing, combined with PCR studies, have since demonstrated the need for specific and differentiated techniques when examining samples for possible B19 or V9 viremia.

The antigenic properties of the V9 capsid proteins have not been characterized previously. To address this question, V9 VP1 and VP2 open reading frames were cloned and expressed in insect cells using a baculovirus vector.

Large quantities of purified recombinant V9 capsid protein were produced and electron micrographs revealed self-assembly of V9 VP1/VP2 and VP2 capsids into empty icosahedral erythrovirus-like particles with a diameter of approximately 23 nm.

Screening of a panel of 270 clinical samples for the presence of V9 IgM and IgG antibodies in ELISA showed 100% serologic cross-reactivity between B19 and V9 when comparing V9 VP2 capsids to a commercial B19 VP2 assay.

This suggests that both a V9 and a B19 antibody response may be diagnosed equally well by ELISA using either V9 or B19 recombinant capsids as antigen source.

Retrospectively, translation of the V9 sequence indicates that despite a significant genetic variation on the DNA level, the majority of the discrepant DNA sequence represents silent mutations leading to an amino acid sequence very similar to the known B19 strains (96-97% homology).

Copyright 2002 Wiley-Liss, Inc.

PMID: 11782935 [PubMed - indexed for MEDLINE]

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AliG
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[Eek!]


"Genetically Modified (GM) Baculovirus Vectors to Control Insect Pests and for Gene Therapy"

Joe Cummins


Baculovirus can infect the human liver and is being used for commercial insect control?!!! [Eek!]

THAT does NOT sound good! [shake]

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emla999/Lyme
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J.Clin Rheumatol 2001 Oct;7(5):350-3; discussion 353.

Coexistent Lyme disease and parvovirus infection in a child.


Fisher JR, Ostrov BE.


Penn State University College of Medicine, Rheumatology and Pediatric Rheumatology, Hershey, PA 17033, USA.


Infectious diseases commonly cause illnesses that mimic rheumatic diseases. Both Lyme disease and Parvovirus B19 infections produce arthritis, rashes, and a systemic illness that may be thought to represent a chronic rheumatic disease. In the case presented, a child with both infections simultaneously exhibited arthralgias, aseptic meningitis, and a facial rash.


The features of Lyme disease and Parvovirus B19 infection that may mimic systemic lupus erythematosus include a facial rash, often in a malar distribution, hematologic abnormalities, arthritis, neurologic disorders, and autoantibody positivity.


Given the proper season and geographical location, one must consider the possibility of co-infection with these two organisms, especially in those with atypical rheumatic complaints.


PMID: 17039169 [PubMed]

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AliG
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WOW - great find emla999!

That was from 2001. I wonder how that poor child is doing now. [Frown]

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emla999/Lyme
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I don't know how that child is doing now. I sure wish I knew though.


I wonder how many other people are co-infected with both Lyme Disease and parvovirus B19?


Personally, I am beginning to believe that there may be several people that are concurrently infected with both parvovirus B19 and Lyme Disease.

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AliG
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It looks like they may be able to get some serious research done on this now.

J Virol. 2008 March; 82(5): 2470-2476.
Published online 2007 December 26. doi: 10.1128/JVI.02247-07.

PMCID: PMC2258946
Copyright 2008, American Society for Microbiology


Ex Vivo-Generated CD36+ Erythroid Progenitors Are Highly Permissive to Human Parvovirus B19 Replication


Susan Wong, Ning Zhi,* Claudia Filippone, Keyvan Keyvanfar, Sachiko Kajigaya, Kevin E. Brown, and Neal S. Young
Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland

Abstract

The pathogenic parvovirus B19 (B19V) has an extreme tropism for human erythroid progenitor cells.

In vitro, only a few erythroid leukemic cell lines (JK-1 and KU812Ep6) or megakaryoblastoid cell lines (UT7/Epo and UT7/Epo-S1) with erythroid characteristics support B19V replication, but these cells are only semipermissive.

By using recent advances in generating large numbers of human erythroid progenitor cells (EPCs) ex vivo from hematopoietic stem cells (HSCs), we produced a pure population of CD36+ EPCs expanded and differentiated from CD34+ HSCs and assessed the CD36+ EPCs for their permissiveness to B19V infection.

Over more than 3 weeks, cells grown in serum-free medium expanded more than 800,000-fold, and 87 to 96% of the CD36+ EPCs were positive for globoside, the cellular receptor for B19V.

Immunofluorescence (IF) staining showed that about 77% of the CD36+ EPCs were positive for B19V infection, while about 9% of UT7/Epo-S1 cells were B19V positive.

Viral DNA detected by real-time PCR increased by more than 3 logs in CD36+ EPCs; the increase was 1 log in UT7/Epo-S1 cells.

Due to the extensive permissivity of CD36+ EPCs, we significantly improved the sensitivity of detection of infectious B19V by real-time reverse transcription-PCR and IF staining 100- and 1,000-fold, respectively, which is greater than the sensitivity of UT7/Epo-S1 cell-based methods.

This is the first description of an ex vivo method to produce large numbers of EPCs that are highly permissive to B19V infection and replication, offering a cellular system that mimics in vivo infection with this pathogenic human virus.

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sammy
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I didn't notice this in any of the articles but did you all know that Parvovirus B19 is more commonly called Fith Disease?

We've all probably had it at some point. It is an extremely common childhood illness, most characteristic symptom is the "slapped- face" rash.

So it makes me wonder, do people who test pos. for it get reinfected later in life (after becoming immune compromised by lyme and co)? Or does the virus reactivate kinda like chronic EBV or shingles?

Interesting.

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johnnyb
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This is actually one virus the ducks DID test me for!

Thanks for the post, Ali.

- J

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AliG
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It's also contagious, through bodily fluids, before it's symptomatic.

children can pass it too each other before anyone seems sick.

Parents can then catch it, while caring for those children before they even appear ill.


I was tested for it too & nothing showed up.

Do I remember anything about subclinical levels of virus or latency in here? I'll have to re-read because my memory is not being nice to me rightt now. [Roll Eyes]

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boscosmom
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well, i am so worried now...i just looked at some tests and i had a positive IGG parvo...5.1

i thought my positve on 31 and 41 IGG and IFA positve ment i had lyme now maybe it means parvo...i am scared and worried all over again.

christine

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emla999/Lyme
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It seems to me that Parvovirus B19 and Lyme Disease cause very similar symptoms in people.


Here is another study showing the relationship between Parvovirus B19 and Chronic Fatigue Syndrome.


http://tinyurl.com/5qjmol


http://www.ncbi.nlm.nih.gov/pubmed/12715326


I also found it interesting that the patients in that study were experiencing the list of symptoms down bellow for many months or years prior to treatment with IVIG.


But after treating the Parvovirus B19 infection with IVIG their symptoms improved significantly.


chronic fatigue
deterioration in memory and concentration
sore throat
painful aching muscles
new headaches
difficulty sleeping
unrefreshing sleep
postexertional malaise
an increased tendency to sweat
dizzy spells
blurred vision
sensation of heat in the soles of her feet and hot
dry eyes


Is it just me or is that list of Parvovirus B19 symptoms very similar to the symptoms caused by Lyme Disease?

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AliG
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Boscosmom- [group hug]

From the link Dr C's Western Blot Explanation, by Lymetoo, at the top of "Medical Questions":

quote:
Surveillance criteria exclude some of the classic hallmark antibodies, such as the 31 kDa band (outer surface protein A or ospA) and the 34 kDa band (outer surface protein B or ospB).

In fact, the 31 kDa band is so tightly associated with Lyme borreliosis that a vaccine was made from that outer surface protein.

In other words, I believe that criteria that exclude the ospA (31 kDa) band should not be used to tell a patient they do not have Lyme borreliosis.

Band 31 is considered to be Bb specific, so possibly both?

This could be good, (I would think) as emla's posted study shows IVIG can be helpful for Parvo.

Perhaps, if some of the symptoms you are experiencing are due to Parvo infection, you might actually benefit from some IVIG. No?

I would think this could be good news for people who have both. [Smile]


Thanks for posting that info emla! [group hug]

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swedish lyme sufferer
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Does the virus cause neurological problems?

Dizziness/muscle twitching/Paresthesia?

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emla999/Lyme
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Swedish Lyme Sufferer,

Yes, Parvovirus B19 can cause neurological symptoms such as dizziness/muscle twitching/paresthesia(numbness and tingling).


Parvovirus B19 can also cause other neurological symptoms such as vision problems, poor memory or the inability to concentrate.


Parvovirus B19 infection as the cause of muscle twitching.


http://tinyurl.com/69t9ck


Parvovirus B19 infection as the cause of paresthesia (numbness and tingling).


http://www.ncbi.nlm.nih.gov/pubmed/2153742


That study showed that 50% of the patients with serologically confirmed Parvovirus B19 infection experienced neurological symptoms such as tingling and numbness in fingers and toes; and mild slowing of nerve conduction velocities.


The Parvovirus B19 patients in the study bellow complained with dizziness. After they were treated with IVIG their symptoms improved significantly.


http://tinyurl.com/5qjmol


The neurological manifestations caused by Parvovirus B19 are just beginning to be recognized.


http://www.ncbi.nlm.nih.gov/pubmed/12740833

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emla999/Lyme
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More studies. Unfortunately, they don't show the abstracts.


MISDIAGNOSIS OF PARVOVIRUS B19 INFECTION AS LYME DISEASE : A SERIES OF PATIENTS WITH FALSELY POSITIVE LYME SEROLOGY


http://cat.inist.fr/?aModele=afficheN&cpsidt=10044373

Parvovirus arthritis mistaken for Lyme
arthritis.


http://www.ncbi.nlm.nih.gov/pubmed/1404110

It's to bad they didn't show the abstracts of those studies. [Frown]

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emla999/Lyme
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Females appear to be particularly vulnerable to the negative effects of a Parvovirus B19 infection.


http://tinyurl.com/69w28k


According to that article, there is a gender difference when it comes to how severely a person's symptoms will be when infected with Parvovirus B19.


So,Parvovirus B19 may cause more severe symptoms in females than it does in males.

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Tincup
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Adding this to the collection.

http://www.cfsrf.com/pdf/j-rh.pdf


Thanks everyone! Already used some of this to help someone!

[Big Grin]

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www.MarylandLyme.org
www.LymeDoc.org

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emla999/Lyme
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Here is a link that will take you to a HUGE file about "persistent" Parvovirus B19 infections in humans.


http://diss.kib.ki.se/2006/91-7140-828-2/thesis.pdf

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emla999/Lyme
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A video about Parvovirus B-19 and its association with chronic fatigue and arthritis.


http://www.scivee.tv/node/6645

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AliG
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Do you know....

I just was re-reading the ILADS quidelines & they list Parvovirus B19 as a rule out. [Big Grin]

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1WearyChick
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Long story short, I tested positive for cebv and parvo 15-16 months ago, after being sick for about that long; since that time, 10 months ago I tested positive for lyme. Have not done a lyme treatment but did do 9 months of antiviral valtrex for the ebv (and supposedly parvo)...not sure if it helped or not.....some docs say valtrex helps, some say it hurts more...honestly, I am to the point, I really don't know what or who to believe. But I have some theories..........
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emla999/Lyme
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AliG,

That is interesting about the ILADS acknowledging the fact that Parvovirus B19 can mimic Lyme Disease.

Maybe the ILADS should invite the Dr.Isaac Melamed to speak at their next conference.

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emla999/Lyme
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A little more about Dr. Isaac Melamed.


Dr. Isaac Melamed is a medical doctor that treats patients for persistent or chronic Parvovirus B19 infection.


http://www.1sthealthcenters.com/index.php/1st-Immunology/Treatment-Therapies/Treatment-Therapies.html


If you read through the posts over at the Miranda Discussion(Human Parvo Virus)forum you will see Dr. Melamed's name mentioned alot.


And Dr.Melamed seems to be highly recommended by the people on that forum.


http://tinyurl.com/596xoh


http://tinyurl.com/6hrjdb


So, it would appear that Dr. Melamed has had alot of experience in treating people that have a persistent or chronic Parvovirus B19 infection.

[ 31. October 2008, 02:18 PM: Message edited by: emla999/Lyme ]

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AliG
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quote:
Originally posted by AliG:
[Eek!]


"Genetically Modified (GM) Baculovirus Vectors to Control Insect Pests and for Gene Therapy"

Joe Cummins


Baculovirus can infect the human liver and is being used for commercial insect control?!!! [Eek!]

THAT does NOT sound good! [shake]

I'm just wondering, since Parvovirus B19 = Erythrovirus B19 crossreacts with Baculovirus, could one be infected via the Baculovirus pesticide method & test positive for Parvo B19?

[ 28. October 2008, 05:09 PM: Message edited by: AliG ]

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emla999/Lyme
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I don't know the answer to that question. But it would be interesting to know the answer.


I would assume that most people have not been exposed to the Baculovirus pesticide. So, if you test positive for a Parvovirus B19 infection then it is most likely because you caught it from another person.

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luvs2ride
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Well, this is timely.

Last Thurs evening I had a stressful event and two hrs later I developed a red, itchy rash all over my entire body. It looked like a sunburn rather than hives. I took a hot baking soda bath which stopped the itching. The redness remained for 3 days and I felt sick. No fever. I stopped all meds for fear it was an alergic reaction. I had to take two more baking soda baths then the itching went away too.

My hands and feet began to ache reminiscent of my arthritis. I also developed low back pain which is not something I have ever had before. I found Parvovirus B19 on the internet and diagnosed myself. Like Just Don, I read that there is nothing you can do to treat it as it is a virus and that adults will sometimes develop arthritis in the hands and feet but that it usually goes away within 1 week to several months.

Because I have rheumatoid arthritis as a result of my lyme, I am already on top of ways to stop inflammation. I jumped back on my supplments. Doubled my Vit C and magnesium and drank a fresh carrot,celery,parsley,garlic,ginger juice daily. I also took an herbal colon cleanse to be sure I would have good bowel movements to move this sucker right on out.

Today is Wednesday and I am back to normal. The joint pain in my hands and feet are gone. I believe this "self-diagnosed" parvovirus has been flushed from my system. I will continue the extra precautions for 1 week to be sure.

I don't see my LLMD again until Dec 1 and will tell her about it at that time. Meanwhile, it seems the crisis is behind me and I really attribute my body's ability to fight it off so well to my diet.

Hubby got sick at the same time, but no rash. More sore throat and tired feeling. He did the same things I did and he too is back to normal.

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disturbedme
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Is anyone going to answer the question: If you are IgG positive for Parvo, doesn't that mean past infection and not to worry about it?!? At least for the moment...?

Mine was positive IgG 4.1 or something and my IgM was negative.

But like someone else said, I'd think pretty much everyone would show positivre at some point for parvo since it IS usually caught during childhood for the first time.

Same thing goes for mycoplasma pneu and EBV, etc. Most of the population will show positive for that at some point as well.

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emla999/Lyme
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Disturbedme,


http://content.karger.com/produktedb/produkte.asp?typ=fulltext&file=GOI2007063001053


"Conclusions: Prolonged parvovirus B19 viremia infection can be seen in spite of neutralizing IgG antibodies and in IgM negative patients.


Therefore, the presence of IgG antibodies in the ABSENCE of IgM antibodies should NOT always be interpreted as a past infection.


The infectivity of patients with persistent parvovirus B19 infection requires further studies
"


So, if I understand correctly, having a negative IgM doesn't rule out the possibility that you may have a persistent Parvovirus B19 infection.

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AliG
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Anthony Komaroff MD's lay summary of the Viruses in CFS Conference June 23-24, 2008

I started posting this link & got sidetracked, I don't remember why I was posting it right now. [bonk]

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AliG
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I believe that Dr. Montoya had expressed an opinion on this.

Perhaps it may be in one of Timaca's threads. ???

I'm not sure if it was an elevation of 3-4 times higher on the IgG that he considered to indicate a need for Tx.

[confused]

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AliG
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Some info on testing regarding Virus Induced CNS Dysfunction

TESTING FOR HHV-6 & EBV

Viruses are difficult to detect when they are chronic. It is very difficult to detect chronic infections of HHV-6 and EBV.

One reason is that 90% of us have been exposed to these viruses by early childhood and the viruses remain latent in our cells.

Therefore, in order to differentiate active from latent infection, tests must be done in the serum (the clear liquid portion of the blood) on the theory that in actively replicating virus, viral particles will leave the cell and spill into the plasma.

The problem is that, unlike most viruses, HHV-6 and EBV are very ``cell associated'' which means that the virus rarely leaves the cell.

In fact, with HHV-6, transmission is largely cell-to-cell or directly through the cell walls.

The net result is that it becomes very difficult to detect active infection because there are very few viral particles in the serum.


The other reason chronic infections are difficult to detect is that these viruses (especially HHV-6A) migrate to the central nervous system and other organs and away from the blood.

For example, HHV-6A has been found to persist in the spinal fluid long after it has disappeared from the plasma.


This means that indirect signs of the virus (antibodies to the viral proteins) become more important and antibody assays are more sensitive than molecular assays (PCR) for differentiating latent from active chronic infections.


PCR tests for HHV-6 & EBV. These tests are currently not useful for detecting most cases of Virus Induced CNS Dysfunction.

While PCR tests can easily detect primary HHV-6B roseola infections and acute mononucleosis, they are not sensitive enough to detect chronic, persistent central nervous system infections.

A negative PCR test done in serum or plasma is meaningless because the test itself is hopelessly insensitive.

At the same time, a positive PCR test on whole blood is also meaningless until a threshold is established that can distinguish between healthy controls and patients.

Since 90% of us have latent virus in the cells, a whole blood test will detect latent virus in the cells of healthy controls as well as patients.

Many healthy individuals, especially young adults, have detectable levels of latent virus in their whole blood.


Only a positive test in the plasma or serum is a significant result, although extremely rare.

Not one of Montoya's patients who benefited from antiviral treatment (and were subsequently determined to have active infections) was positive by PCR.

A high positive result for HHV-6 may mean that the patient has chromosomally integrated HHV-6.

This is a rare form of HHV-6 that is inherited and was found in 0.2% of the population in one large study in Japan.


HHV-6 Antibody Tests:


IgG Antibodies.
These antibody levels indicate that a person has had an infection at some point in the past; at high levels they can suggest (but not prove) that the virus is active.

Much more research is needed on this question but in one study of HHV-6 in CFS patients, 89% of the patients with HHV-6 IgG antibody titer of 1:320 and above were found to have active infections by culture (Wagner 1996).

Results vary by laboratory, but at most commercial labs, healthy adults have titers of 1:40 to 1:160.

Sometimes a different ELISA assay is used and the results are reported as an index.

These index scores can also vary by laboratory depending on the manufacturer of the kit.

Young adults may have unusually high antibodies due to reactivation during mononucleosis.


IgM Antibodies.
This is not a very useful test. Although it is worth testing once, this result is rarely positive in patients with chronic viral infections.

Typically IgM titers persist only for a few weeks after the primary infection.

Just because the IgM is normal does not mean that you don't have an active infection; many clinicians are not aware of this fact.




EBV Antibody Tests:

Antibody testing for EBV is more complicated. There are three different types of EBV assays offered at commercial laboratories.

These antigens are the viral capsid antigen (VCA), the early antigen (EA), and the EBV nuclear antigen (EBNA).

In addition, differentiation of immunoglobulin G and M subclasses to the VCA can often be helpful for confirmation.

The optimal combination of EBV serologic testing consists of the antibody titers to all four markers: IgM and IgG to the VCA, antibody to the EA


Viral Capsid Antibodies (VCA).
IgG antibodies to the viral capsid antigen develop 2 to 4 weeks after onset of the initial and then persist for years, at gradually declining levels.

Drs. Montoya and Kogelnik at Stanford have found that patients with elevated antibodies to VCA IgG and HHV-6 antibodies respond to antivirals, and the VCA titers dropped significantly with treatment, suggesting that elevated VCA titers represent active infection.

This test is not definitive since many healthy adults have relatively high antibodies as well.

A high titer in a 45 year old is far more significant than the same titer in a 20 year old.

IgM antibody tests are not very useful since they are typically found only in primary or initial infections, not chronic or reactivated infection.


Early Antigen (EA) Antibodies. IgG.
The early antigen (EA) antibody appears during active replication phase and generally falls to low levels after 3 to 6 months.

Most healthy adults have very low levels of early antigen; higher levels however can be a sensitive marker of active infection in chronic disease.

There is consensus that a titer of 1:640 is indicative of active disease, and that a titer of less than 1: 80 suggests there is a far smaller chance of an active infection.

Results vary by laboratory and much more testing needs to be done to establish cutoff values, but the early antigen IgG antibody test remains our best clue for active infection.

Again, IgM elevations are typically found only in a primary infection, not a reactivated infection, so the IgM test is usually not very meaningful for chronic infections.


Epstein-Barr Nuclear Antigen Antibodies (EBNA).

Antibody to EBNA is not seen in the acute phase, but slowly appears 2 to 4 months after onset, and persists for life.

Most physicians use of this test is to determine if an EBV infection is the initial infection or a secondary/ reactivated infection.

A low EBNA in the presence of a high VCA titer suggests an immune deficiency.

For reactivated infections, only the absolute level of the IgG titer usually significant.


Interpreting Results from Commercial Laboratories

There are several commercial laboratories that will test for HHV-6 and EBV.

However, not all labs use the same metric.

For example, Focus Diagnostics and Specialty Laboratories use an IFA method with results reported as titers (1:80, 1:160 etc).

Other labs such as Mayo Clinic, Quest and Labcorp use the ELISA method and report with an index.

There is no standard data publicly available that would allow patients to compare IFA and ELISA scores.

The Stanford group currently conducting a trial of Valcyte for these viruses uses Focus Diagnostics as their reference laboratory because they are familiar with their scale and can interpret the results.


The best way to interpret the results from your laboratory is to ask your doctor to find out median and range values at the laboratory for controls or blood donors.

If your result is in the top quartile you are more likely to have an infection, but there is no way to know for certain.

Patients who are immunosuppressed and have a low IgG may show up with low antibody levels in spite of active disease.

If the IgG is low normal or below normal, then the HHV-6 and EBV antibody test results may also be suppressed.

Similarly, some patients with very high IgG may have high EBV and HHV-6 antibody levels that do not indicate active disease.

These considerations need to be evaluated by a knowledgeable physician.



[confused]

[ 30. October 2008, 08:48 PM: Message edited by: AliG ]

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emla999/Lyme
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I got this from the Miranda Mission Human Parvovirus Discussion Group.


http://tinyurl.com/6e6xw3


This person is talking about chronic Parvovirus B19 and treatment with IVIG. Its message #3.


"My experience with IVIG has been very positive so far. The infusion center that I go to does this regularly so they have it down to a science.


Also, after my first IVIG and just before my second the doctors ran blood work again. When I was first diagnosed my PARVO numbers were 6.5 IgM and 6.2 IgG.


Before my second IVIG they took blood work and my PARVO numbers were 3.5 IgM and 5.1 IgG. Still active PARVO but getting better.


Also my PARVO PCR numbers are getting better but I don't have those exact numbers. I also have noticed my symptoms getting better and/or gone.


I still have a chronic fever, mild fatigue, joint aches but not too bad, and ringing ears.


The "jerks" that you looked up for me are significantly less and my hands and feet don't tingle or go numb anymore. My tremors are gone too.


I am functioning at about 70-80% of "normal". I certainly have not gone back the the gym yet or anything but I am participating in life much more."



That person's "Parvo B19" symptoms were; hands and feet tingled and/or numb, tremors, muscle jerking, fatigue, joint aches, ringing ears and chronic fever.


And apparently after that person was diagnosed with PARVO and given IVIG treatments many of those symptoms improved or resolved completely.


I just find all of this to be very interesting.


Chronic Parvovirus B19 can mimic the symptoms of Chronic Lyme Disease. Having a Parvovirus B19 infection can make you test positive for Lyme Disease via the Western Blot test.


Parvovirus B19 can become a chronic infection in some people. And Parvovirus B19 seems to affect women more severely than it does men.


Interesting.

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AliG
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I wonder if Valgancyclovir might work for Parvo?

Science Daily - New Therapy For Chronic Fatigue Syndrome To Be Tested

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emla999/Lyme
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I am not sure if antiviral drugs can help with Parvovirus B19 or not. Based upon what I have read IVIG seems to be the only recommended treatment available for Parvo B19.


I have read that Transfer Factor is helpful in treating viral diseases such as EBV. So, I have been wondering if a Transfer Factor product containing Parvo B19 specific transfer factors would be helpful in treating Parvo B19.

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AliG
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Thanks for that info! I knowingly have EBV. [Roll Eyes] I'll have to check into the Transfer Factor.

An LLMD had recommended it to me & I completely forgot about it. [bonk]

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