Compelling Increase in Parvovirus B19 Infections: Analysis of Molecular Diagnostic Trends (2019-2024)

Human parvovirus B19 (B19V) follows a well-documented cyclical epidemiology, with peaks occurring every 3-4 years. However, recent reports indicate an unusual resurgence in B19V infections across multiple countries, prompting increased surveillance. This study analyzed molecular diagnostic assay results from 826 unique-patient samples tested for B19V DNA between 2019 and 2024 at a large Italian tertiary-care hospital, covering pre-, during, and post-COVID-19 years. Overall, 80 of 826 patients (9.7%) tested positive for B19V DNA. A significant increase in positivity was observed in 2024 (23.4%), with a peak in May, representing an eightfold rise compared to 2019-2020. Despite this surge, the distribution of positive cases across population categories remained consistent with previous years, with 32 of 80 (40.0%) positive samples from pregnant women and 27 of 80 (33.8%) from hematology/oncology patients. Among 66 B19V DNA-positive patients with available serology, 4 of 66 (6.1%)-all immunocompromised-lacked detectable IgM/IgG despite high B19V DNA levels (7.8 logIU/mL). These findings highlight the importance of integrating molecular and serological diagnostics, particularly in high-risk populations. Given the potential impact of the COVID-19 pandemic on B19V circulation, continued surveillance is essential to determine whether this resurgence represents a temporary fluctuation or a sustained epidemiological shift.10