Dr.Daniel Hakimi | OB/GYN & Infertility Specialist | Services Of Northern NJ » From the Doctor’s Desk

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From the Doctor’s Desk

From The doctor’s Desk.

Recently we have had a few pregnant women inquring about the outbreak of  Fifth disease in their children’s classes.  I would like to share a little information with our valued patients.

Fifth disease is a mild rash illness caused by parvovirus B19. This disease is also called erythema infectiosum. It is more common in children than adults. A person usually gets sick within 4 to 14 days (sometimes up to 20 days) after getting infected with parvovirus B19. About 20% of children and adults who get infected with this virus will not have any symptoms. The first symptoms of fifth disease are usually mild and nonspecific. The first symptoms of fifth disease are usually fever, runny nose, and headache.  You may then experience after several days a rash on your face and body.  This is called “slapped cheek” rash. This rash is the most recognized feature of fifth disease. It is more common in children than adults. Some people may get a second rash a few days later on their chest, back, buttocks, or arms and legs. The rash may be itchy, especially on the soles of the feet. The rash can vary in intensity and may come and go for several weeks. It usually goes away in 7 to 10 days, but it can last several weeks. As the rash starts to go away, it may look lacy.  People with fifth disease can also develop pain and swelling in their joints (polyarthropathy syndrome). This is more common in adults, especially women. Some adults with fifth disease may only have painful joints, usually in the hands, feet, or knees, but no other symptoms. The joint pain usually lasts 1 to 3 weeks, but it can last for months or longer. It usually goes away without any long-term problems. 

Transmission: Parvovirus B19 spreads through respiratory secretions (such as saliva, sputum, or nasal mucus) when an infected person coughs or sneezes. You are most contagious when it seems like you have “just a cold” and before you get the rash or joint pain and swelling. After you get the rash, you are probably not contagious. So, it is usually safe for you to go back to work or for your child to go back to school or a child care center. The contagious period for fifth disease is different from many other rash illnesses. For example, people with measles can spread the measles virus when they have the rash. However, people with fifth disease who weakened immune systems may be contagious for a longer amount of time. Parvovirus B19 can also spread through blood or blood products. A pregnant woman who is infected with parvovirus B19 can pass the virus to her baby. 

About 50% of pregnant women are immune to parvovirus B19. So, these women and their babies are usually protected from getting the virus and fifth disease. Pregnant women who are not immune usually do not have serious complications after they are exposed to others with fifth disease. They usually have only mild illness. Also, their babies usually do not have any problems. However, sometimes a baby will develop severe anemia, and the woman may have a miscarriage. But, this is not common. It happens in less than 5% of all pregnant women with parvovirus B19 infection and more commonly during the first half of pregnancy. Pregnant women who are not immune and are not currently infected with parvovirus B19 may want to stay away from people with fifth disease.  

A blood test for parvovirus B19 can show if you are immune to this virus and have no recent sign of infection, or are not immune and have never been infected, or have had a recent infection. There is no single recommended way to monitor pregnant women with parvovirus B19 infection. In ost cases we require  may recommend additional prenatal visits, blood tests, and ultrasounds.

Fifth Disease Outbreaks in the Workplace & Pregnancy

Pregnant women may choose to continue going to their workplace if there is an outbreak of fifth disease happening. However, if you are not immune to parvovirus B19 and are not currently infected, you may want to stay away from people with fifth disease while you are pregnant.  All healthcare providers and patients should follow strict infection control practices to prevent the parvovirus B19 from spreading.

 

Sincerely,

Dr. Daniel Hakimi

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