Parvovirus Infection, Malaria, and Anemia in the Tropics—a New Hidden Enemy?

Anemia takes an exacting toll on the lives of individuals, particularly children living in tropical areas where malaria is endemic. In such areas, there is general agreement that the major causes of anemia are malaria, iron deficiency, hookworm infection, and the hemoglobinopathies, especially sickle-cell disease. In general, anemia is caused by factors that decrease hemoglobin production and those that lead to increased blood loss. In this respect, iron deficiency represents a major cause of decreased hemoglobin production, whereas worm infection (via fecal blood loss), hemoglobinopathies, and malaria (mainly via hemolysis) relate to blood loss. Parvovirus B19 (B19) infection in humans is unique in that it can specifically and abruptly lead to a transitory cessation of erythropoiesis [1]. Parvovirus has specificity for red blood cell precursors and can totally suppress erythropoiesis for ~37 days. The bone marrow of patients with B19 infection reveals an absence of ma-