Outpatient insurance data indicate increased numbers of Parvovirus B19 infections and -associated miscarriages during the 2024 epidemic in the German federal state Saarland

Abstract

Objectives

Parvovirus B19 (B19V) infection usually causes mild diseases such as Erythema infectiosum in immunocompetent individuals. During pregnancy, however, it can lead to fetal anemia, hydrops fetalis or fetal death. To date, neither B19V infections nor attributable complications are notified in Germany. At the beginning of 2024, we observed an increased number of B19V infections in pregnant women at Saarland University Hospital.

Study design and methods

To investigate this further, we analyzed retrospective ICD-10-coded aggregated outpatient health insurance data over the last 10 years in the German federal state Saarland on B19V infections, stratified by sex and age groups, and on B19V infection-associated pregnancies and miscarriages.

Results

The first B19V epidemic after the SARS-CoV-2 pandemic began in the third quarter of 2023, peaked in the first quarter of 2024 and remained stable in the second quarter of 2024. Compared to the last two pre-pandemic B19V epidemics in 2017 and 2018, the number of infections were 14 and 6 times higher respectively. In pregnant women, the number of B19V infections increased 17.5-fold in the first quarter of 2024 and by more than 60 % in the second quarter, which was accompanied by a marked increase in miscarriages.

Conclusions

These are the first objective data documenting an unusually strong B19V epidemic in a German federal state after the SARS-CoV-2 pandemic, with a steep rise of B19V infections in pregnant women and associated miscarriages. The establishment of early warning systems should be considered to prevent dramatic consequences of future B19V epidemics.