Association of human herpesvirus 6 infection with exanthem subitum in Belem, Brazil

Freitas, R. B. de; Linhares, A. C.; Oliveira, C. S.; Gusmão, R. H. P.; Linhares, M. I. S.

doi:10.1590/S0036-46651995000600003

Abstracts

Recent human herpesvirus 6 (HHV-6) infection was detected in cases of exanthem subitum (ES) involving four children, aged 10 to 24 months, between April and August 1994, in Belém, Brazil. By using the indirect immunofluorescence antibody assay (IFA), significant increases (at least eight times) in antibody concentrations were noted from the acute to the convalescent serum samples, with titers ranging from <1:10/1:80 to <1:10/1:640 (patients 3 and 2, respectively). All children had high fever (over 39ºC) for three days, followed by generalized, maculo-papular skin rash. A physical examination of the children also revealed concomitant, cervical lymph node swelling and tonsillar pharyngitis in two of them.

Human herpesvirus 6; Exanthem subitum

Infecção recente por herpesvírus humano tipo 6 (HHV-6) foi detectada em casos de exantema súbito envolvendo quatro crianças com idades de 10 a 24 meses, no período compreendido entre abril e agosto de 1994, em Belém, Brasil. Utilizando-se a técnica da imunofluorescência indireta, aumentos significativos (de pelo menos oito vezes) foram observados nas concentrações de anticorpos das amostras de soro, da fase aguda para as da convalescente, com títulos variando de < 1:10 / 1:80 a < 1:10 / 1:640 (pacientes 3 e 2, respectivamente). Todas as crianças apresentaram febre alta (acima de 39ºC) por três dias, seguida de exantema máculo-papular generalizado. O exame físico realizado nas crianças revelou concomitância de adenomegalia cervical e amigdalite em dois desses indivíduos.

VIROLOGY

Association of human herpesvirus 6 infection with exanthem subitum in Belem, Brazil

Exantema súbito associado a infecção pelo herpesvírus humano tipo 6 em Belém, Brasil

R. B. de Freitas^I; A. C. Linhares^I; C. S. Oliveira^I; R. H. P. Gusmão^I; M. I. S. Linhares^II

^IServiço de Virologia Geral, Instituto Evandro Chagas, Fundação Nacional de Saúde, Ministério da Saúde, Belém, Pará, Brasil

^IIInstituto de Imunopatologia Keizo Asami, Universidade Federal de Pernambuco, Ministério da Educação, Recife, Pernambuco, Brasil

^{Correspondence to} Correspondence to: Dr. Ronaldo B. de Freitas Instituto Evandro Chagas Avenida Almirante Barroso, 492 66090-000, Belém, Pará, Brasil

SUMMARY

Recent human herpesvirus 6 (HHV-6) infection was detected in cases of exanthem subitum (ES) involving four children, aged 10 to 24 months, between April and August 1994, in Belém, Brazil. By using the indirect immunofluorescence antibody assay (IFA), significant increases (at least eight times) in antibody concentrations were noted from the acute to the convalescent serum samples, with titers ranging from <1:10/1:80 to <1:10/1:640 (patients 3 and 2, respectively). All children had high fever (over 39ºC) for three days, followed by generalized, maculo-papular skin rash. A physical examination of the children also revealed concomitant, cervical lymph node swelling and tonsillar pharyngitis in two of them.

Keywords: Human herpesvirus 6; Exanthem subitum.

RESUMO

Infecção recente por herpesvírus humano tipo 6 (HHV-6) foi detectada em casos de exantema súbito envolvendo quatro crianças com idades de 10 a 24 meses, no período compreendido entre abril e agosto de 1994, em Belém, Brasil. Utilizando-se a técnica da imunofluorescência indireta, aumentos significativos (de pelo menos oito vezes) foram observados nas concentrações de anticorpos das amostras de soro, da fase aguda para as da convalescente, com títulos variando de < 1:10 / 1:80 a < 1:10 / 1:640 (pacientes 3 e 2, respectivamente). Todas as crianças apresentaram febre alta (acima de 39ºC) por três dias, seguida de exantema máculo-papular generalizado. O exame físico realizado nas crianças revelou concomitância de adenomegalia cervical e amigdalite em dois desses indivíduos.

Full text available only in PDF format.

Texto completo disponível apenas em PDF.

ACKNOWLEDGEMENTS

We thank Drs. Elisabete C. O. Santos, Amélia P. A. Travassos da Rosa and Sebastião Aldo Valente for performing the rubella/measles, arbovirus and toxoplasmosis diagnoses, respectively. Thanks are also due to Dr. Ralph Lainson for kindly reviewing the manuscript.

Recebido para publicação em 24/05/1995.

Aceito para publicação em 08/08/1995.

1. ABLASHI, D.V.; JOSEPHS, S.F.; BUCHBINDER, A. et al. - Human B-lymphotropic virus (human herpes virus-6). J. virol. Meth., 21: 29-48, 1988.
2. DOBEDAT, S. & KAPPAGODA, N. - Hepatitis due to human herpesvirus-6. Lancet, 2: 1463-1464, 1989.
3. FREITAS, R.B.; LINHARES, M.I.S. & LINHARES, A.C. - Prevalence of human herpesvirus 6 antibody among isolated Amazonian, Amerindian communities in Brazil. Trans. roy. Soc. trop. Med. Hyg., 88: 167-169, 1994.
4. HOFFMAN, A.; KIR, N.E.; KUERTEN, A. et al. - Active human herpesvirus-6 (HHV-6) infection associated with Kikuchi-Fujimoto disease and systemic lupus erythematosus (SLE). In Vivo, 5: 265-270, 1991.
5. KONDO, K.; NAGAFUJI, H.; HATA, A.; TOMORI, C. & YAMANISHI, K. - Association of human herpesvirus 6 infection of the central nervous system with recurrence of febrile convulsion. J. infect. Dis., 167: 1197-1200, 1993.
6. LEACH, C.T.; SUMAYA, C.V. & BROWN, N.A. - Human herpesvirus - 6: clinical implications of a recently discovered, ubiquitous agent. J. Pediat., 121: 173-181, 1992.
7. LINHARES, M.I.S.; EIZURU, Y.; TATENO, S. & MINAMISHIMA, Y. - Seroprevalence of human herpesvirus-6 infection in Brazilian and Japanese populations in the Northeast of Brazil. Microbiol. Immunol., 35: 1023-1027, 1991.
8. LINNAVUORI, K.; PELTOLA, H. & TAPANI, H. - Serology versus clinical signs or symptoms and main laboratory findings in the diagnosis of exanthem subitum (roseola infantum). Pediatrics, 89: 103-106, 1992.
9. MORRIS, D.J.; LITTLER, E.; JORDAN, D. & ARRAND, J.R. - Antibody responses to human herpesvirus 6 and other herpesviruses. Lancet, 2: 1425-1426, 1988.
10. OKADA, K.; UEDA, K.; KUSUHARA, K. et al. - Exanthem subitum and human herpesvirus 6 infection: clinical observations in fifty-seven cases. Pediat. infect. Dis. J., 12: 204-208, 1993.
11. PRUKSANANONDA, P.; HALL, C.B.; INSEL, R.A. et al. - Primary human herpesvirus 6 infection in young children. New Engl. J. Med., 326: 1445-1450, 1992.
12. SALAHUDDIN, S.Z.; ABLASHI, D.V.; MARKHAM, P.D. et al. - Isolation of a new virus, HBLV, in patients with lymphoproliferative disorders. Science, 234: 596-601, 1986.
13. UEDA, K.; KUSUHARA, K.; HIROSE, M. et al. - Exanthem subitum and antibody to human herpesvirus-6. J. infect. Dis., 159: 750-752, 1989.
14. YAMANISHI, K.; SHIRAKI, K.; KONDO, T. et al. - Identification of human herpesvirus-6 as a causal agent for exanthem subitum. Lancet, 1: 1065-1067, 1988.
15. YOSHIYAMA, H.; SUZUKI, E.; YOSHIDA, T.; KAJII, T. & YAMAMOTO, N. - Role of human herpesvirus 6 infection in infants with exanthem subitum. Pediat. infect. Dis. J., 9: 71-74, 1990.

Correspondence to:

Dr. Ronaldo B. de Freitas

Instituto Evandro Chagas

Avenida Almirante Barroso, 492

66090-000, Belém, Pará, Brasil

Publication Dates

Publication in this collection
22 Sept 2006
Date of issue
Dec 1995

History

Accepted
08 Aug 1995
Received
24 May 1995

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ABLASHI, D.V.; JOSEPHS, S.F.; BUCHBINDER, A. et al. - Human B-lymphotropic virus (human herpes virus-6). J. virol. Meth., 21: 29-48, 1988.

[2] 2. DOBEDAT, S. & KAPPAGODA, N. - Hepatitis due to human herpesvirus-6. Lancet, 2: 1463-1464, 1989.

[3] 3. FREITAS, R.B.; LINHARES, M.I.S. & LINHARES, A.C. - Prevalence of human herpesvirus 6 antibody among isolated Amazonian, Amerindian communities in Brazil. Trans. roy. Soc. trop. Med. Hyg., 88: 167-169, 1994.

[4] 4. HOFFMAN, A.; KIR, N.E.; KUERTEN, A. et al. - Active human herpesvirus-6 (HHV-6) infection associated with Kikuchi-Fujimoto disease and systemic lupus erythematosus (SLE). In Vivo, 5: 265-270, 1991.

[5] 5. KONDO, K.; NAGAFUJI, H.; HATA, A.; TOMORI, C. & YAMANISHI, K. - Association of human herpesvirus 6 infection of the central nervous system with recurrence of febrile convulsion. J. infect. Dis., 167: 1197-1200, 1993.

[6] 6. LEACH, C.T.; SUMAYA, C.V. & BROWN, N.A. - Human herpesvirus - 6: clinical implications of a recently discovered, ubiquitous agent. J. Pediat., 121: 173-181, 1992.

[7] 7. LINHARES, M.I.S.; EIZURU, Y.; TATENO, S. & MINAMISHIMA, Y. - Seroprevalence of human herpesvirus-6 infection in Brazilian and Japanese populations in the Northeast of Brazil. Microbiol. Immunol., 35: 1023-1027, 1991.

[8] 8. LINNAVUORI, K.; PELTOLA, H. & TAPANI, H. - Serology versus clinical signs or symptoms and main laboratory findings in the diagnosis of exanthem subitum (roseola infantum). Pediatrics, 89: 103-106, 1992.

[9] 9. MORRIS, D.J.; LITTLER, E.; JORDAN, D. & ARRAND, J.R. - Antibody responses to human herpesvirus 6 and other herpesviruses. Lancet, 2: 1425-1426, 1988.

[10] 10. OKADA, K.; UEDA, K.; KUSUHARA, K. et al. - Exanthem subitum and human herpesvirus 6 infection: clinical observations in fifty-seven cases. Pediat. infect. Dis. J., 12: 204-208, 1993.

[11] 11. PRUKSANANONDA, P.; HALL, C.B.; INSEL, R.A. et al. - Primary human herpesvirus 6 infection in young children. New Engl. J. Med., 326: 1445-1450, 1992.

[12] 12. SALAHUDDIN, S.Z.; ABLASHI, D.V.; MARKHAM, P.D. et al. - Isolation of a new virus, HBLV, in patients with lymphoproliferative disorders. Science, 234: 596-601, 1986.

[13] 13. UEDA, K.; KUSUHARA, K.; HIROSE, M. et al. - Exanthem subitum and antibody to human herpesvirus-6. J. infect. Dis., 159: 750-752, 1989.

[14] 14. YAMANISHI, K.; SHIRAKI, K.; KONDO, T. et al. - Identification of human herpesvirus-6 as a causal agent for exanthem subitum. Lancet, 1: 1065-1067, 1988.

[15] 15. YOSHIYAMA, H.; SUZUKI, E.; YOSHIDA, T.; KAJII, T. & YAMAMOTO, N. - Role of human herpesvirus 6 infection in infants with exanthem subitum. Pediat. infect. Dis. J., 9: 71-74, 1990.