Fifth Disease and Pregnancy: Symptoms, Treatment, and Effects on the Fetus

Adults aren’t usually affected by Fifth disease, but might become affected because they come into contact with children who are more susceptible and are infected. What is the Fifth disease during pregnancy like and what kind of risk can it pose to your fetus?

What is Fifth disease (Slapped cheek disease)?

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Firstly, the rather baffling name “Fifth disease” is actually derived from the fact that this disease is the 5th disease on a list of 6 childhood rash-forming illnesses. Scientifically known as erythema infectiosum, the fifth disease is also called the “slapped cheek” disease because it makes infected patients look like they have been slapped. It is caused by the parvovirus B19. Children aged 4 to 10 are the most susceptible to this disease, and getting infected once lowers immunity, causing patients to become infected over and over again.

A pregnant woman can also catch the Fifth disease. Although the Fifth disease isn’t a particularly dangerous disease, there is still a need to be cautious since it can lead to pregnancy complications and, in serious cases, a miscarriage.

Fifth disease symptoms during pregnancy

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The main symptoms of Fifth disease are fever, fatigue, pain in the joints, and rash on one’s cheeks, arms, thighs and over the body. However, some adults have no rash at all. The redness of the rash on one’s cheeks generally fades after 10 days of medication. The incubation period, which refers to the time lapse between infection and signs of the disease appearing, can be about 4 to 14 days long.

An infected person is most contagious before the rashes appear. Once the rashes start appearing, the person doesn’t spread the disease to people around. The symptoms of the Fifth disease resemble the symptoms of a flu, so it’s hard to tell that one has been infected. When the rashes appear and the cause of it is diagnosed to be the Fifth disease, it’s very likely that most of the people around have already been infected.

It’s said that about 75% of adults have the immunity to fight the Fifth disease but when the infection rate is especially high, there is a 50% risk of transmission among the family members should one member become infected.

Effects of Fifth disease during pregnancy on fetus

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When pregnant moms get infected with the Fifth disease, this might cause pregnancy complications. When parvovirus B19 is present in the body, the
erythroblast precursors which form the red blood platelets are infected (and, therefore, is termed erythema infectiosum). This means that the infected pregnant woman isn’t able to produce red blood cells and when the vessels to the placenta are infected, this could significantly reduce the number of red blood cells going to the fetus.

As a result, the fetus might become anemic and if the fetus’ condition worsens, this can lead to hydrops fetalis (excess accumulation of fluid) and fetal death. Research puts the number of fetal deaths as a result of Parvovirus B19 infection at 3000 annually and suggests that this rate is similar to that of North America’s.1

Effects on fetus before Week 21

Catching Fifth disease before Week 21 of pregnancy puts the fetus at high risk of pregnancy complications. If you have a child and he or she is down with the Fifth disease, you might want to highlight this to your practitioner. As the signs and symptoms of the Fifth disease are very much like flu symptoms, get yourself checked using a blood test to confirm if you’ve been infected as well.

Treatment and prevention tips for Fifth disease pregnancy

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As of now, there isn’t any medicine or vaccine available that is listed as a cure for Fifth disease. There is but little choice but to take medicine to counter the symptoms present and allow the body to recover naturally on its own. Since there are no medicines or vaccines that specifically target the Fifth disease, what you can do is to pay attention to oral hygiene – wear a mask when you don’t feel well and wash your hands frequently and thoroughly. Fetuses affected by the Fifth disease are usually diagnosed as having hydrops fetalis in Weeks 18 to 29, so be more careful during that period of time!

When you find out you’re pregnant, get yourself screened for immunity to the Parvovirus B19. If you’ve already been exposed to it before (this makes you immune to it), you will have the immunoglobulin M antibody (IgM) or the immunoglobulin G (IgG) in you. If neither is present, you are at risk of picking up an infection.

Expectant moms who are infected should be screened once a week for 10 weeks so that their practitioners can monitor their conditions. Ask your practitioner for a serological screening (blood test to test for infections) should you suspect that you’ve been exposed to the Fifth disease. If there is a vertical infection from mother to fetus and the fetus has hydrops fetalis, the mother can choose to induce labor early so that the fetus can be treated as soon as possible.

Early prevention is way better than cure

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The Fifth disease is an infection that can become a pregnancy complication and put the fetus in danger. Make sure you reduce the risk of you catching the Fifth disease at all times by keeping yourself clean – use mouthwash, wash your hands, and if you have a child, make sure that they have good hygiene habits. This will significantly lower your risk of catching the Fifth disease. Remember that in this case, there is no specific cure, so preventing is a better way of protecting yourself and your fetus!