Fifth Disease: Common in Kids, Bad for Pregnant Moms

Photo of my daughter laughing with rosy cheeks.

Behold the red glow of Fifth Disease. It is often a mild romp for kids, but can slam adults and fetuses hard.

My wife recently awoke one morning with the mythical rosy glow of pregnancy splashed across her face… and an itchy rash over her torso. Her doctor quickly identified it as Fifth Disease.

Uhh, what?

It’s also called Slapped Cheeks Disease.

Huh?

Fifth Disease is the fifth of six classic childhood rash-producing infections, the others being measles, scarlet fever, rubella, Dukes’ disease and roseola.

My 3-year-old daughter, my wife and I have contracted Fifth Disease. We had never heard of it. Here is what we’ve learned.

[Caution: Do not use this article for diagnosis or treatment. Contact your doctor!]

Fifth Disease is caused by an annoying little bug called Parvovirus B19, and the full disease name is Erythema Infectiosum. Sounds like a Harry Potter spell, doesn’t it?

The good news is that, despite the word “disease,” it is actually a temporary viral infection. It’s usually a mild sickness in kids, much harsher in adults, and in pregnant mothers, such as my wife, it can cause a miscarriage.

Incubation:

The virus is spread through respiratory secretions such as coughing or sneezing. After infection, the virus takes 4 to 14 days, sometimes as many as 20 days, before symptoms appear. First you may experience cold-like symptoms for a few days, then a skin rash hits. Once the rash is present, you aren’t contagious any longer.

In our case, we thought my daughter and wife caught a common cold, then I got it too just because I don’t like being the odd man out. A few days after we were “better,” my wife and I got the real Fifth Disease symptoms. More than a week later, our daughter did too.

Kids:

The long incubation period makes it easy for an outbreak at school to last several months. Our daughter started preschool two weeks ago, and that’s how we figure it came to us.

Warm rosy cheeks are likely, and sometimes symptoms similar to a common cold. My daughter had the rose garden, but no adverse symptoms. A rash on her arms lasted one day, but most rashes in kids last 5 to 10 days.

Rashes can reoccur weeks or months later, caused by a reaction to the antibodies that have been built up in a person.

For all practical purposes, my daughter has been her usual spunky self. As illnesses go, this has been a cakewalk for her.

Adults:

Thirty to fifty percent of US adults have been exposed to the virus in their childhood and are now immune. The virus can hit vulnerable adults hard.

I did not experience a rosy red face. Instead, I was greeted with achy joints, I’m told, similar to full-body arthritis. Standing up in the morning made the bottom of my feet hurt. Oh, and the itching. Arms. Legs. Hands. Feet. The aches lasted five days, but the itching is going on 10 days now. In the early days, scratching produced a lacy rash within minutes. Now the itch is just an annoyance with no unsightly marking. This affects me more psychologically because I’m the type of person who never gets sick, not even headaches. Tylenol? What’s that?

My wife had a rash for four to five days, and a persistent itch that still exists in her hands. She also has pregnancy-related nausea that wipes her out in the afternoons.

Anti-itch creams have helped us with moderate success. Symptoms can last up to a month.

If you read my redwood forest trip article posted on Monday, you may wonder how we went on a mini-vacation on Saturday while sick. My wife and I were over the major symptoms after being sick a week. We were no longer contagious on Saturday and felt up to the trip. Our daughter didn’t reveal her symptoms until Monday morning.

Miscarriage:

This linked chart from the UK Health Protection Agency lays out various risks to an unborn child, with the risk period being the first five months of pregnancy. Here are statistics on the potential for viral transmission to the baby:

  • 0 percent before 4 weeks,
  • 15 percent between 5 and 16 weeks
  • 25 to 70 percent after 16 weeks

My wife is entering her fifth week of pregnancy.

At less than 20 weeks, an infected mother has a 9 percent greater chance of miscarriage than an average mother, which brings the threat to an infected mother to 15 percent.

In that same period, there is a 3 percent chance of hydrops fetalis, of which about 50 percent of affected babies die. Hydrops is an edema (swelling) in the baby from excess fluid in tissue where it shouldn’t be.

What Next:

Our first hurdle is to not be in the 15 percent of situations where the baby gets infected. The second hurdle is not to be in the 3 percent that gets hydrops. If a miscarriage occurs, it would likely happen 4 to 6 weeks after exposure.

Because we’re in the fifth week of pregnancy and a fetus is not viable before 24 weeks, we have no intervention options for hydrops. Older babies can sometimes receive intrauterine blood transfusions.

Our next action is to get an ultrasound 4 weeks from now (roughly 4 weeks since my wife’s date of infection) to look for early signs of hydrops. This should be done with a “level 2″ ultrasound, requiring us to travel five hours to UCSF Medical Center.

If everything is OK, then we turn our worry to the larger unknown prospect that a viral infection early in pregnancy may cause some abnormality discovered at birth, or perhaps years from now.

One medical journal I read (JOGNN, #7 in the links found below) indicated there are generally no long-term problems. However, there have been some reported instances on a case-by-case basis of growth restriction (born small), liver problems, persistent anemia or heart muscle injury. I chalk it up to a big “they don’t know, needs more research” response.

I was fairly nervous about having our first daughter come out whole and perfect even though I had no real reasons to be concerned. I expect we’ll be in for a roller coaster ride with our second kid even though the statistical risk for us is small.

More Resources:

  1. Parvovirus B19 Infections
  2. Characteristics of parvovirus b19 infections in the UK
  3. Rashes in pregnancy – Health Protection Agency guidelines
  4. Fetal infection with Parvovirus B19 may cause neurodevelopmental delays (requires login, try BugMeNot)
  5. Clinical description of a baby developing water on the brain from Parvovirus B19
  6. Flow chart: Management of confirmed parvovirus B19 infection in pregnancy
  7. Parvovirus B19 in Pregnancy (requires purchase), from the Journal of Obstetric, Gynecologic and Neonatal Nursing by Deborah McCarter-Spaulding, RNC, MS, IBCLC. January/February 2002 article, Volume 31, No. 1

[Disclaimer: This article is my untrained interpretation of web pages I've read. I'm a writer, not a doctor. Please consult your care provider for up-to-date medical analysis and direction.]

Update: Our 12th week ultrasound was good, and my boy was born in March 2008 with no complications! Any further updates can be read in my Second Baby index, with the oldest entries at the bottom.

Comments

34 Responses to “Fifth Disease: Common in Kids, Bad for Pregnant Moms”

  1. Divrchk says:

    This is so scary. I hope that everything works out for you and your family.

    July 25th, 2007 at 5:17 am

  2. Marianne says:

    It’s worth remembering that risk increases gradually…risk doesn’t jump from 0% to 15% overnight just because the pregnancy reaches day 35. The 15% figure was obtained by lumping together data for pregnancies between 5 and 16 weeks. We simply don’t have enough data to provide figures for each individual week.

    The upshot is that your risk at 4-going-on-5 weeks is far closer to 0% than 15%. It would be fair to describe your risk as extremely low.

    Although I understand why you find this situation worrying, I hope that you’ll be able to enjoy the pregnancy without the “roller coaster ride” you’re anticipating.

    July 25th, 2007 at 7:07 am

  3. Monique says:

    I’m so sorry your entire family has it, it makes it hard to take care of one another when you all get it at once. I had this years ago when i taught and i was home with a fever for 7 days. It was not fun. Hope you have a much quicker recovery!

    July 25th, 2007 at 7:16 am

  4. Jim says:

    Hang in there, AJ. I’m sure everything will turn out all right and you guys are taking all the needed precautionary steps.

    It’s odd, this sounds a lot like Roseola, which ran through my son’s baby group. I checked wikipedia and one of its other names is “Sixth Disease.” Odd.

    July 25th, 2007 at 7:29 am

  5. brettdl says:

    Huh, I never heard of the disease. Best wishes to your family.

    July 25th, 2007 at 7:34 am

  6. Dani says:

    Good luck. Remember that 15% is not really that high when you think about it. Better to think that you have an 85% chance that everything will be fine. As someone who had an incredibly bumpy pregnancy and birth experience, my advice is to focus on the positive statistics and just hope for the best. It’s all you can do. Surround yourself with supportive people and know that you are not alone. Good luck!

    July 25th, 2007 at 7:52 am

  7. meta-dad says:

    Thanks for the “heads-up.” Honestly, this is the best kind of posts you can find on parenting blogs, “sharing the love” kind of thing, you know.

    July 25th, 2007 at 10:43 am

  8. Chief Family Officer says:

    Oh, I am so very sorry to learn that you all got it. And I can only imagine how difficult the next few weeks will be, and even then I’m sure you won’t be able to breathe easy until your child is born and you know for sure that all is well. Please give your wife a hug from me – it’s awful not having control over your body and being unable to stop something that’s going on inside, and especially being bonded to the baby and yet wanting to hold back. My thoughts and prayers are with you.

    P.S. She should of course check with her ob, but Unisom sleep tabs (Doxylamine Succinate 25 mg) were the only way I could endure the nausea.

    July 25th, 2007 at 7:42 pm

  9. AJ says:

    Thank you everyone for your thoughts.

    July 26th, 2007 at 7:52 am

  10. Priscilla says:

    I’m sorry you all are dealing with this. I had two pregnant friends who were exposed and everything turned out fine. I’ll keep you all in my thoughts!

    July 26th, 2007 at 1:12 pm

  11. Cass says:

    I’m so sorry you are going through this. Please keep us posted. Lots of health vibes being sent to your wife and little baby.

    July 28th, 2007 at 11:46 am

  12. The Domestic Diva says:

    I had fifth’s disease when I was a couple months pregnant. I got it from a child that I was taking care of at the time. My son also got the bug.

    I just had the baby 3 months ago and their were no complications.

    August 11th, 2007 at 4:05 pm

  13. Christy says:

    Omg..I am so sorry for you., And also I hope that everyone things gos and works out for you and your family! I am doing research for this subject for a school report and I came across this. It is so sad! And hope the baby is okay! Bye

    November 29th, 2007 at 2:06 pm

  14. Judy says:

    My grandson has this he is my sons child my daughter is 8 months pregnant She has not been around my grandson for about three or four weeks so she should be ok right
    Judy

    January 20th, 2008 at 1:03 pm

  15. AJ says:

    Judy, I’m not a doctor, so I can’t say. Your daughter should consult her doctor. I included links above to articles I found while researching the issue myself.

    January 20th, 2008 at 1:19 pm

  16. Samantha says:

    I am in a very similar situation right now. At less than 3 weeks pregnant I came down with Fifth Disease. I’m now in the rash stage and very worried and the long term effects. I would love to hear how everything turned out for you. Did your wife have her baby?

    March 13th, 2008 at 9:01 am

  17. Lettie says:

    First of all, I hope that your baby arrived with no complications from the 5th disease.
    Your article has been the best information that I have found thus far in regards to pregnancy and the disease.
    I think that I may be pregnant…only a week or two along. I suspected that I got the disease about a month ago and had all of the typical symptoms with exception to the red cheeks. I woke up this morning and think that the virus has reemerged. I will be consulting with a doctor come Monday but want to thank you for the great article and statistics. They have helped put my mind at ease for the time being.

    March 15th, 2008 at 12:30 pm

  18. Laura says:

    I contracted the parvovirus early in my pregnancy but with a ton of illnesses all at once (it was December) I never thought. My children didn’t get but I, looking back, did. I was mostly without symptoms except the horrible joint pain! I was miserable. I thought it was just my joints loosening for pregnancy (so early?) but what could it be? I have to say I complained a LOT – it was very horrible!

    Then, the second week of January I got an ultrasound. I think all the illness had scared my doctor. The baby dated right – just past 9 weeks – but he had a reasonably large cystic hygroma with signs of hydrops. A week later our little man had died. (9 weeks 6 days)

    It has been 3 months. I asked my Dr. if it could have been parvovirus B19 and he said no but then again what would he say? I had no idea I had symptoms of it. But today both my kids finally got Fifths and while researching a few things I realized that I am sure this killed my little boy.

    I wish doctor’s would warn mothers to be very careful in those first couple months, especially around other children who are exposed to many kids. I don’t know if I could have changed it but I would give anything to still be pregnant right now. it hurts to know that an otherwise healthy pregnancy was ended by that.

    I hope your situation turned out well. The reality is someone always has to be in the % that the outcome is not good. Maybe if I hadn’t been so sick so much…

    This is a serious problem though and I wish doctors were more aware to warn their patients. I guess the good side is that once you have had it you are immune and it will not recur.

    April 14th, 2008 at 7:39 pm

  19. kim says:

    I am a week away from my due date. I just found out that a little girl at our daycare has fifth’s diease should I be worried.

    April 22nd, 2008 at 6:52 am

  20. Rebekah says:

    I had symptoms of fifth’s disease (achy joints) from week 9 and a half to 10 and a half of pregnancy. I had no idea the reason for my achy joints at the time. A week later I learned of a child at the daycare where I work having been diagnosed with Fifth Disease. I got tested immediately and was positive for the virus. I was tested again two weeks later, still high numbers, leading to an ultrasound at 15 weeks. The baby didn’t have a heartbeat, and was measured to be 11 weeks old, with fluid around the skull, indicative of parvo.
    I am interested, AJ, how your wife’s pregnancy went following from what I have read?
    Also, Laura, your posting was on the day of my ultrasound, two weeks ago. I can very much relate with much that you have said. We are grieving together. I am wondering if you, or anyone, knows anything about future pregnancy after a miscarriage of this sort? How long does it take for the virus to completely leave your body? How long should one wait before trying to conceive again?

    April 28th, 2008 at 11:33 am

  21. AJ says:

    Rebekah, good point. I’ve appended an update with three links at the end of the article. Short answer: everything went well and the baby was born in March 2008.

    April 28th, 2008 at 11:44 am

  22. Amanda Edwards says:

    I had the fifths disease when I was in my first trimester. I was a very rare case where not only did I have the rash it then affected my joints. After that my bone marrow stopped producing red blood cells which sent me into a downward spiral. I developed an extreme amount of fluid around my heart and lungs. In order to fix that I received a blood transfusion. I ended up having a healthy baby boy after having a series of ultra sounds looking for heart complications of the fetus. Now though I’m beginning to wonder the effects it is having on my son. He is 4 now and has had a series of developmental delays and now today was told he has a heart murmur and we need to see a pediatric cardiologist. Think there may be some longtime complications that they don’t know about.

    September 11th, 2008 at 3:19 pm

  23. Jen says:

    I just found out I have fifths disease and I am 5 weeks pregnant, I am freaking out, we just had to terminate a pregnancy at 5 months due to severe defects and now here we are again!

    September 30th, 2008 at 2:19 pm

  24. Tissa says:

    Glad to hear that your story came out well. I caught fifth disease in 2001 at around 13 weeks pregnant, and fell into the worst of worst scenarios. My baby died in-utero around 15 weeks of hydrops fetalis.

    I know this is not the usual outcome from exposure to fifth disease, but it is proof that the threat is real.

    November 7th, 2008 at 9:13 am

  25. Jess says:

    My heart breaks for all of you who have lost your babies to this. I just found out that the school I sub at has 5th disease running rampant. I’m hoping for the best, and waiting for my doc to call me back. I’m 8 weeks pregnant on our first baby that we’ve been trying for for quite a while.
    AJ, congrats on your baby!
    My prayers go out to you all….

    December 12th, 2008 at 2:00 pm

  26. Kelly says:

    Thanks so much for posting such helpful, information on Fifth’s Disease. We suspect our 4 year old has it right now and I was put to ease by the facts you’ve posted. Thanks again!

    January 16th, 2009 at 2:13 pm

  27. Mame says:

    Our grandaughter was diagnosed with Fifths her mom is 34 wks preganat, Our unborn grandson had previously been diagnosed with C-Camm a condition that creates cysts in his lung. He is at grave risk for hydrops and has been monitored. Now I read Fifths may place him at higher risk. Doctors have done a fifths titre and we are waiting. Anyone have any knowledge or experience of this? Doctors not saying much, perhaps he doesn’t know.

    January 31st, 2009 at 11:37 am

  28. jacqui says:

    my 11year old daughter was told today that she has fifth diease it is something i have never heard of her face was like she had been on holiday with rosy sun burn cheeks and a tempature and itchy

    May 26th, 2009 at 8:06 am

  29. Mary Anne says:

    Thanks for y’all inputs. My 8-year old was diagnosed with it today. She’s had felt nausea a little bit one day & has had rosy cheeks for the last 2 days and we’ve been to Soak City twice this week. We thought it was a heat rash or/and sunburn. Doctor said it would go away by Monday and prescribed nothing.

    July 17th, 2009 at 9:28 pm

  30. Mommy with Parvo says:

    I am 10 weeks pg today. I was exposed to the parvo virus over 2 weeks ago. My 2 children both had it. I had a healthy ultrasound 8 days ago. The doctor called me today informing me I did infact contract the virus, and I would now need to be closely monitored. I am very worried. Please keep me and my baby in your prayers. I am hoping for a healthy baby in Feb!

    July 24th, 2009 at 5:25 pm

  31. Sue says:

    I’m so glad to hear of the healthy & happy outcomes for some; terribly saddened to hear that maternal parvovirus has caused immense grief for others. And for those of you in the throws of worry, keep positive and concentrate on that 90% chance of a happy ending.

    I experienced parvovirus during my 2nd semester and was fortunate enough to have everything turn out okay. Fast forward 13 years, my boy is healthy and all’s well. But I’ve noticed in recent years a few wacky incidences with regard to my health and was wondering if anyone else has had a similar experience. I’ve had some strange bruising responses occasionally, only 1-3x/year or so. And out of the blue, joint pain in both elbows has popped up, reminding me of the symmetrical joint pain I experienced during the active parvo infection all those years ago. I understand this is a commentary mainly for new and youthful parents, but maybe there’s someone else out there beyond their 30s who can shed some light on longterm complications, or not, involving maternal parvovirus/Fifth’s Disease.

    August 8th, 2009 at 7:04 am

  32. Melody says:

    I am 18 and 1/2 weeks prego and just found out my son may have this….i am very concerned please keep me and my baby in your prayers

    February 4th, 2010 at 9:58 am

  33. Beverly says:

    Wow reading all this is making me cry. I am so very sorry for the ladies here who have lost their babies. My heart goes out to you all. I am 20 weeks pregnant. I got sick at about 15 weeks and I tested positive for fifths disease. I have to have a series of ultrasounds for the next six weeks to make sure the baby doesn’t have hydrops. The first ultrasound looked good so far.
    (fingers crossed!) but, every week I’m going to be a nervous wreck that something may be seriously wrong with my baby girl. This is the ONLY website that I’ve come to where I actually heard of other mothers who have had a similar problem. It’s been impossible to find others on the web.

    June 9th, 2010 at 9:13 pm

  34. Beverly says:

    Also, I’d love to talk with anyone who has some information on fifths while pregnant. Maybe you were told something I missed or haven’t heard of yet. Please feel free to email me @ bev1244@comcast.net

    Thanks everyone.

    June 9th, 2010 at 9:36 pm