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Viral Infection at Stony Brook University Medical Center Prompts Hundreds of Warning Letters

Aug 6, 2008 | Parker Waichman LLP Over 400 patients recently treated at the Stony Brook University Medical Center have received a letter of caution from the hospital's director of quality control.  It seems two health care providers who work at the Long Island facility were sickened with a viral illness.

A physician, only identified as a medical resident, as well as a nurse both recently came down with a virus named Fifth Disease, which is caused by Human Parvovirus B-19.  The condition's name originates from being the fifth disease in a line of inevitable childhood rash-producing disorders:  Measles, Rubella, Scarlet Fever, and Duke's, which is also referred to as Fourth Disease.

Dr. William H. Greene, chief quality officer for the Stony Brook University Medical Center, located in Stony Brook, New York, said 480 letters were sent to affected patients by overnight mail last Friday.  Potentially affected patients were those who were in the labor and delivery area of the hospital or in the maternal-fetal clinic in the five-week period between June 26 and July 28.  "We're trying to be as cautious and as transparent as possible," Greene said. "The best medicine is communication and information. That's why we're so proactive in trying to let people know, even though we believe the risk of transmission is low."

Most people catch the infection as children, Greene explained, noting that Human Parvovirus B-19 is contagious prior to the appearance of a "slapped face rash," characteristic of Fifth Disease and so named because a bright red rash appears that looks as if the patient was slapped.  A lacy red rash on the trunk and limbs is also common and sometimes the rashes may itch.  Fifth Disease can be accompanied by a low-grade fever, malaise, or the feeling of having a cold a few days prior to the rash, which resolves in about seven to 10 days.  While there have been no other reports of illness, it remains unclear how the two workers became infected.

The hospital set up a hotline for those patients who received letters to discuss Parvovirus B-19 and Fifth disease with a medical professional.  Memos have also been sent to Stony Brook staff members who may have had contact with the two infected providers during the dates.  Dr. Jane Seward, deputy director of viral diseases at the Centers for Disease Control and Prevention (CDC), said Fifth Disease is "not a nationally notifiable disease,” so the government does not keep official tallies. "It's likely many hundreds of thousands of cases occur every year," she said, adding that the infection may be asymptomatic and produce no symptoms.

Seward said Human Parvovirus B-19 is not related to the parvoviruses that affect animals.

Adults with no immunity can be infected with Human Parvovirus B19 and can have no symptoms or can develop the typical rash of Fifth Disease, as well as joint pain or swelling, or both.  Usually, joints on both sides of the body are affected with hand, wrist, and knee joints most affected.  Joint pain and swelling usually resolves in a week or two, but can last several months.

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