Thursday, February 19, 2009

Fifth Disease and Pregnancy

Thanks to a WeeCare mom who suggested this topic of interest to pregnant women.

What it is
Fifth disease is something we don't often hear about, mostly because symptoms are vague, usually quite mild and a doctor may not be consulted as it runs its course. Approximately half of all adults in the U.S. have already had the disease in the past (perhaps without their even knowing it since it is similar to so many other un-named and undiagnosed viruses we deal with in childhood as our bodies build up immunity). The good news is that once we have had it, we have natural immunity and we won't get it again. This is especially good news for pregnant women since the virus, caused by human parvovirus B19 (not the same parvo that affects animals) can possibly cause injury to the developing baby. Even if you get this illness, most babies are fine and suffer no ill effects from it. Only about 10% of infections during pregnancy result in problems to the baby.

When a woman learns she has had an exposure, most health care providers recommend a titer (testing to see if you have immunities already) or a blood test to see if the virus is present. The primary reason for this is because in so many cases she will be reassured that she is already immune. If you have signs of the virus your doctor may monitor you more closely to be sure everything looks OK as your pregnancy progresses but this does not necessarily put you in a high risk classification. There is no drug to treat this.

In children there is usually a mild rash, sometimes appearing like a "slapped cheek" redness or lace-like rash on the trunk and extremities. It fades but may recur for one to three weeks or more. Warmth and sunlight - even bathing - can make it show up again. Before the rash, he or she may have headache, low-grade fever or some generalized malaise - just not feeling like himself or herself, perhaps .

In adults, there is often no rash or at least not a typical rash like the children get. but they may have arthritis-like pain or generalized achiness which can last a few days or linger for months. In at least 25% of those infected, no symptoms are noticed.

There is no vaccine available so natural immunity is our only protection aside from good handwashing practices. This is truly the best defense against fifth disease - all the time; not just when there is an outbreak. This is because the mode of transmission is through contact with respiratory secretions. An infected person can be contagious before he or she has symptoms. If you are regularly washing your hands (especially if you deal with children - teachers, childcare or healthcare workers, etc.) you can usually avoid getting this illness. It might even be a good idea to keep a hand sanitizer handy for use when a sink is not available. If you are pregnant and have a child home sick with this infection, handwashing can still prevent the spread to you. All this time we've been harping on washing hands and it really does make a difference! Teach your children the same good habits so they won't pick up the disease and bring it home to you.

It is also advised to report this disease to the local health department so general precautions in the community, school, etc. can be taken. If there is a large outbreak, pregnant women may personally choose to avoid the environment, but quarantine is not required.

If you would like to read more, click on this post title to be taken to the CDC information page or click here for information from the March of Dimes.

Trivia (how it got its unusual name)
In the early part of the 20th century, several different conditions which had previously all been referred to as "measles" were differentiated and given a number for diagnostic purposes. Measles and scarlet fever were the first two to be separated. Rubella (German measles) was called “third disease”; atypical scarlet fever was “fourth disease”; erythema infectiosum was (and still is) “fifth disease,” and roseola was “sixth disease.” At present, only Fifth Disease continues to be called by this designation.
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