Pregnancy and Fifth Disease
Mommies-to-be: learn about an infection that could hurt your unborn baby
As any Kindergarten teacher can attest, a day at work involves being exposed to perfect little petri dishes (students) who are blissfully unaware that they are sharing a multitude of germs and bacteria: Little hands reach out regularly to be held, frequently after rubbing their mouths and noses. Faces often deliver clouds of germs following sneezes, sniffles, and coughs.
During the fall of 2008, Eileen Jenks, an early childhood educator at a private school in Orlando, Florida, was excited to learn that she was expecting a baby. As the school year progressed and Eileen entered her second trimester of pregnancy, she noticed that several students in her class had mild flu-like symptoms, including low-grade fevers, headaches, and sore throats. Although their symptoms soon subsided, a few days later these students developed a bright red rash on their faces. The children were sent home with requests that parents seek an appointment with their doctor. Within 24 hours, Eileen was alarmed to learn that the children with the rash had been diagnosed with Fifth disease, an infection that can cause problems to a fetus, particularly if exposed during the first trimester of pregnancy. Some fetuses may develop severe, possibly life-threatening, anemia.
Fifth Disease – the facts
Easily recognizable for the distinctive ‘slapped cheek’ red rash that appears on the faces of infected children, Fifth disease is an infection caused by the Parvovirus B19 and according to Catherine L. Lamprecht, MD, Chief of the Division of Pediatric Infectious Diseases at Nemours Children’s Clinic in Orlando is most likely spread through respiratory secretions. Other signs and symptoms of this infection may resemble those listed above and typically present themselves between 4 to 14 days after exposure. Joint pain and swelling, two symptoms commonly found in afflicted adults, usually resolve in a week or two, but in some cases, last several months.
“Although teachers and preschool workers are at a slightly increased risk for infection compared with the general population, mothers of children infected with the virus are at the greatest risk,” says Lamprecht. For pregnant women who are infected with the disease, the virus can pass through the placenta to the unborn baby, and while fetal infection is rare, the virus can increase a developing baby’s risk for certain complications, including:
- Miscarriage
- Stillbirth
- Severe fetal anemia
The March of Dimes explains that about 1 in 400 women in the United States contracts Fifth disease during pregnancy. Fifty percent of pregnant women already carry immunity thanks to having previously had the illness. However, just as many women are not sure they’ve ever had the illness, thus making their immunity status unknown.
Get Tested
Most obstetricians and fetal medicine specialists agree that it is vital for women to find out their immunity status, especially prior to conception. Although there is currently no vaccine available to prevent infection, your immunity to the virus can be determined by a simple blood test which checks for the presence of specific antibodies that the body produces in response to Fifth disease. If the blood test reveals that an expectant woman is immune to the virus, then there is nothing to be concerned about. If the test reveals that she is not immune and not infected, then a mom-to-be needs to take steps to avoid further exposure.
In Eileen’s case, she was instructed by her doctor to have the blood test and she was concerned to learn that she was not immune to the virus.
Some obstetricians/primary care providers may treat it as a low-risk condition and continue to provide routine prenatal care. Others, however, may increase the amount of prenatal check-ups and perform blood tests and ultrasound examinations in order to monitor the health of the unborn baby.
How to avoid infection during pregnancy
As a practical and effective means to reduce the spread of the virus, the Centers for Disease Control and Prevention (CDC) recommend frequent hand washing. The CDC does not recommend that pregnant women be excluded from a workplace where a Fifth disease outbreak is occurring, but rather, the organization considers that the decision to avoid a workplace where there are confirmed cases of the virus is a personal decision for an expectant women to make, after she discusses the situation with her family, physician, and employer.
Immediately after learning her test results, Eileen was placed on medical leave until the outbreak in the school subsided. “I felt I had to take a leave of absence until the two week mark of a disease free school environment,” she recalls. “I was unable to teach for over five weeks.”
Eileen considers herself extremely lucky. In August of 2009, she delivered a healthy baby boy. “I could not have been happier with the care and advice that my doctors gave me, in addition to the support I received at my school,” Eileen says. Although the overall risk is low, she urges pregnant women everywhere to be aware of the possibility of serious complications and risks that infection with the virus can have to their unborn babies.