Fifth Disease and Pregnancy

Pregnant women who spend much time around children may be at risk of developing the fifth disease, which is caused by a parvovirus. Knowing the signs and risk factors of this disease is important for babies’ health.

What Is The Fifth Disease?
The fifth disease is a minor rash caused by parvovirus B19, which prevents new red blood cells from being made. This is usually not a problem in healthy adults because they have enough red blood cells until they recover. However, in pregnant women, this can cause complications for their unborn children. About one in 400 of pregnant women in the United States, or 0.25 percent, get the fifth disease each year.
The disease got its name years ago when it was fifth on a list of six childhood diseases, such as measles and scarlet fever, that cause a rash. It is also known as the slapped-cheek disease because it can turn cheeks bright red, as though the person has been slapped.

One of the main symptoms of the fifth disease is the appearance of bright red cheeks. However, in adults, the rash may be very mild or absent entirely. People with the fifth disease might have cold-like symptoms, such as a fever, headache, or runny nose.
They may also develop a slight rash on their bodies after one to three days. This rash may be lacy and can worsen with exposure to sunlight, heat, or cold. After the rash has appeared, they are no longer contagious. Some people also experience joint pain, especially in smaller joints, such as the wrists and ankles.
It is also possible that no symptoms appear at all. Pregnant women should still let their doctors know if they think they have been exposed, so the doctor can run a blood test to confirm if they have it.

The Risk to Unborn Babies
About half of pregnant women are already immune to the B19 parvovirus, and there is only a small chance of getting it even if they are not immune. There is an even smaller chance that the parvovirus passes to the baby.
However, the fifth disease can still pose a risk for the unborn baby because it can pass through the placenta to the child. If a pregnant woman gets the disease in the first half of her pregnancy, the baby is at risk of developing severe anemia because he or she will not be able to make enough red blood cells. However, this happens less than 5 percent of the time in pregnant women who have been exposed to B19 parvovirus. Pregnant women may also be at a 10 percent risk of miscarrying if they became infected before 20 weeks’ gestation.
In rare cases, severe anemia caused by the fifth disease can lead to fetal hydrops, a life-threatening condition for the baby where fluid builds up around the baby’s tissues and vital organs. This problem can be detected by the additional ultrasounds and blood tests, which a doctor will recommend to women who have been exposed to fifth disease.
Getting the fifth disease during pregnancy will most likely not result in defects or developmental problems for the baby after birth.

There is no treatment for the fifth disease because it is caused by a parvovirus. However, for women who think they have been exposed to the disease, a health care provider may want to monitor the baby more closely with additional blood tests and ultrasounds. In one common ultrasound test, Doppler sonography, the doctor checks the baby’s blood flow and look for signs of anemia.
If the baby develops fetal hydrops, the doctor may be able to use a needle to remove excess fluid from the baby’s organs and tissues.
If a pregnant woman was exposed to B19 parvovirus several months ago and her baby is still doing well, the baby will most likely not suffer any complications. If the baby has not shown symptoms by that point, he or she likely will not have a parvovirus-related problem later.
Those who have already had the disease are safe because people cannot have it twice. A simple blood test can determine whether someone is immune and if someone has recently been infected with the parvovirus.

Since the fifth disease cannot be treated, women should do their best to avoid getting it. Like most parvoviruses, B19 parvovirus is spread through the air via coughing, sneezing, and sharing cups and utensils.
Those who are not immune to the fifth disease and have not had it should use extra caution because they are most at risk for catching it. Pregnant women who know people with B19 parvovirus may want to consider staying away from them. If their workplace or another frequently visited area has an outbreak of the fifth disease, they should take extra care to wash their hands often.
Pregnant women who have older children, especially between the ages of 5 and 15, should be cautious if the children spend much time with other children. The parvovirus has an incubation period of four to 14 days, but it can sometimes be as long as 21 days. During this time, which is when the infected are most contagious, they will not know who has the disease until they have already caught it.
Proper hygiene can keep people safe from many illnesses, and B19 parvovirus is no exception. When pregnant women are around children or are out in public, they should remember to wash their hands frequently. They should always wash their hands before eating or touching their nose, eyes, or mouth. Avoiding sharing utensils, cups, and plates with children also is a wise idea.

Pregnant women most likely do not have to worry about the fifth disease, even if they spend much time with children. However, pregnant women should still want to use caution. If they do get exposed to the parvovirus, they can discuss options with their health care provider and have the best chances of delivering a healthy baby.

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