Fifth Disease and Pregnancy

What is Fifth Disease? Fifth Disease is a mild rash illness caused by human parvovirus B19 that occurs most commonly in children but can infect adults as well.

What are the signs and symptoms of fifth disease?

It can take anywhere from 4 to 20 days from the time the virus gets into the body before symptoms start to show. Some people who are infected with fifth disease do not show any symptoms. For most people, fifth disease begins as a mild illness with muscle aches, headache, tiredness and sometimes a fever. A rash can appear 7 to 10 days later.

• Often children with fifth disease will develop a "slapped-cheek" rash on the face and a lacy red itchy rash on the trunk and limbs. Fifth disease does not cause serious illness in most people and the rash resolves in 7 to 10 days.
• Adults can develop a rash and/or joint pain and swelling. The joint pain and swelling usually resolve.

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How is Fifth Disease spread?

The virus is found in the secretions of the nose and mouth. It is spread person to person by direct contact with these fluids, for example when sneezing and coughing or by touching a used facial tissue or sharing cups and utensils.

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When is it contagious?

A person infected with parvovirus B19 is contagious to others before the rash appears. By the time the rash appears the person is no longer contagious.

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Fifth Disease and Pregnancy: The Risk

Sometimes Fifth Disease during pregnancy may lead to complications. Women who have had Fifth Disease in the past will have antibodies to protect them from getting Fifth Disease again. These women do not need to be concerned about it during pregnancy. About 50 percent of pregnant women are immune to Fifth Disease.

There is some risk to the developing baby if a pregnant woman who has never had fifth disease is exposed during pregnancy. In very rare cases the virus can affect the unborn baby’s ability to make red blood cells, sometimes leading to a dangerous form of anemia. The risk is lower for exposures in the second half of pregnancy than in the first half.

A blood test can be done to see if you are immune to the virus that causes Fifth Disease. If you are pregnant and think you may have been exposed to Fifth Disease, consult your doctor.

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Treatment

• There are no drugs to treat Fifth Disease.
• If a pregnant woman becomes infected, the doctor will continue to monitor the pregnancy for signs of problems. If your doctor sees signs that your unborn baby is developing complications, your doctor will determine the appropriate course of action.

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Prevention

The women at highest risk of exposure to Fifth Disease are mothers with young children and those who work as teachers and childcare providers.

• Excluding people with Fifth Disease from work, childcare or schools is not likely to prevent the spread, since sick people are contagious before they develop the rash.
• The Centers for Disease Control and Prevention does not recommend that pregnant women be routinely excluded from a workplace where a Fifth Disease outbreak is occurring.

To reduce the risk of infection as a pregnant woman you should:

Wash Your Hands

• Frequent hand washing is recommended to decrease the chance of becoming infected.
• The six steps to good hand washing are:

1. Wet hands with warm running water
2. Put liquid soap on hands
3. Lather hands and scrub for 20 seconds
4. Rinse under running water
5. Dry your hands with paper towels
6. Use the towel to turn off the taps

• If your hands are not visibly dirty, an alcohol-based hand rub can be added to your hand washing routine:

1. Apply the hand rub to your hands. Use an amount about the size of a dime.
2. Rub your hands together until the hand rub is gone. Hands will feel dry in about 15 seconds.

Do not share eating utensils

• Since Fifth Disease is spread through secretions of the mouth or nose it is important not to share any eating utensils or cups with others.

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