Practical Practitioner
By: Pamela Egan, FNP-C CDE
Women can pass Fifth Disease to unborn babies
Dear Pam,
My niece has Fifth’s Disease and stayed with me over the weekend. I am five months pregnant. Should I be concerned?
Fifth disease (erythema infectiosum) is a viral illness caused by parvovirus B19.
It’s especially common in children between the ages of 5 and 15 and usually produces a distinctive red rash on the face, body, arms and legs. Parvovirus B19 is a human virus. It is not the same parvovirus that veterinarians may be concerned about in pets (especially dogs) and cannot be passed from humans to animals or vice versa.
A pregnant woman who has a B19 infection may pass the virus to her unborn child. In most cases this causes no lasting problems for the baby, but, in rare cases, the fetus may develop anemia if the mother is infected during the first trimester.
Parvovirus infection in pregnant women can sometimes cause severe anemia in the fetus. Fetal anemia can cause congestive heart failure, manifested by a severe form of edema-swelling of body tissues due to excessive fluid- called fetal hydrops.
If you have parvovirus infection, you clinician may monitor with ultrasound examinations for possible complications.
The fetal anemia, congestive heart failure and edema can improve over several weeks. The great majority of pregnant women with parvovirus infection have normal, healthy babies, and parvovirus doesn’t increase the risk of birth defects.
Do however, let your obstetrician know if you think you may be infected.
Fifth disease begins with a low-grade fever, headache and mild cold-like symptoms (a stuffy or runny nose). These symptoms pass, and the illness seems to be gone, until a rash appears a few days later. The bright red rash typically begins on the face and gives the child a “slapped-cheek” appearance. Several days later, the rash spreads and red blotches (usually lighter in color) extend down to the trunk, arms and legs. As the centers of the blotches begin to clear, the rash takes on a lacy net-like appearance. Children younger than 10 years of age are most likely to get the rash.
The rash may be reactivated by sunlight, heat, exercise and stress. Other symptoms that sometimes occur with fifth disease include swollen glands, red eyes, sore throat, diarrhea and unusual rashes that look like blisters or bruises.
In some cases, especially in adults and older teens, an attack of fifth disease may be followed by joint swelling or pain. The hands, wrists, knees and ankles are the body joints affected most often by parvovirus infection.
Fifth disease is highly contagious. A person with parvovirus infection is most contagious before the rash appears. It spreads easily from person to person in fluids from the nose, mouth and throat of someone with the infection, especially via large droplets from coughs and sneezes. It can also be spread through shared drinking glasses and utensils.
The majority of children with fifth disease recover with no complications. However, some children who are already anemic can become very sick if their red blood cell production is further affected by the virus. Their red blood cell levels may drop dangerously low, affecting the supply of oxygen to the body’s tissues. They may become very pale and ill-looking, develop a rapid pulse and abnormally fast breathing, have a fever, and be much less active than usual. Blood transfusions and oxygen given in the hospital may be necessary to treat the severe anemia until the child recovers from the parvovirus infection.
There is no vaccine for fifth disease and no real way to prevent the spread of the virus. Isolating someone with a fifth disease rash will not prevent spread of the infection because the person usually is not contagious by that time. Practicing good hygiene, especially frequent hand washing, is always a good idea to help prevent the spread of any infection. About half of adults are immune to parvovirus infection. For your own peace of mind, consider a blood tests that can indicate immunity to parvovirus.
This article was originally published October 28, 2002 in The St. Tammany News.
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