Parvovirus B19 infection (Slapped Cheek
Syndrome)
(also called Erythema Infectiosum or fifth
disease)
This illness, is a mild viral
disease mainly occurring during late winter and early spring. It only affects
humans and predominately affects children. About 50 per cent of all adults have
been infected during childhood or adolescence.
Symptoms
The most common illness caused
by parvovirus B19 is a mild rash illness. The infected person typically has a
‘slapped cheek’ rash on the face and an itchy, lace like rash occurring on the
body and limbs, often the infected person has a runny nose and sore throat. The
infected person is usually not very ill and the rash resolves in 7 – 10 days.
Once a person recovers from parvovirus B19, they develop lasting immunity and
are protected against further infection.
An adult who develops
parvovirus B19 may have no symptoms at all, or may develop a rash, joint pain or
swelling or both. The joint symptoms usually resolve in a week or two, but can
last longer.
Parvovirus B19 is usually a
mild illness. It resolves without treatment among children and adults who are
otherwise healthy.
Incubation period
Between 4 to 20 days.
Infectious period
Persons are contagious before
the rash develops and once the rash appears, those who have no underlying immune
deficiency are usually no longer infectious.
Parvovirus B19 and Pregnancy
Usually there is no serious
complication for a pregnant woman or her unborn baby following exposure to a
person with parvovirus B19.
About 50 per cent of women are
already immune to this infection, and these women and their unborn babies are
protected from illness and infection.
Even if a woman is susceptible
and gets infected with parvovirus B19, she usually experiences only a mild
illness.
Likewise, her unborn baby
usually does not have any problems attributable to parvovirus B19 infection.
Sometimes, however, parvovirus
B19 infection will cause the unborn baby to have severe anaemia and the woman
may have a miscarriage. This occurs in less than 5 per cent of all pregnant
women who are infected with parvovirus B19 and occurs more commonly during the
first half of pregnancy.
There is no evidence that
parvovirus B19 infection causes birth defects or mental retardation.
There is no universal
recommended approach to monitor a pregnant woman who has a documented parvovirus
B19 infection. Some doctors treat a parvovirus B19 infection in a pregnant woman
as a low-risk condition and continue to provide routine prenatal care. Other
physicians may increase the frequency of doctors visits and perform blood tests
and ultrasound examinations to monitor the health of the unborn baby. The
benefit of these tests in this situation, however, is not clear.
A blood test for parvovirus
B19 may show that you are immune to parvovirus and do not have the infection,
are not immune and could be infected if exposed, or have had a recent infection.
If the unborn baby appears to
be ill, there are special diagnostic and treatment options available, and your
obstetrician will discuss these options with you and their potential benefits
and the risks.
Controlling the spread of
infection
The virus is spread by contact
with infected respiratory secretions (for example, by coughing), and from mother
to unborn child.
There is no vaccine or
medicine that prevents parvovirus B19 infection.
Frequent, good handwashing
practices, not sharing food, utensils or handkerchiefs will assist in
controlling the spread of this virus.
Surfaces contaminated by
respiratory secretions need to be cleaned thoroughly.
Excluding persons with
parvovirus B19 from work, child care centres, schools, or other settings is not
likely to prevent the spread of parvovirus B19, since ill persons are contagious
before they develop the rash.
Pregnant women should not
routinely be excluded from a workplace where an outbreak of parvovirus B19 is
occurring because of the high prevalence of the infection, the low risk during
pregnancy, and because school or child care centre outbreaks are generally
indicative of other inapparent and unavoidable sources of spread in the wider
community. Pregnant women who are concerned should discuss this further with
their family doctor or obstetrician.
For further information on
this illness, contact the Communicable Diseases Prevention Unit on 1800 671 738.
Adapted from:
Centers for Disease
Control and Prevention: Parvovirus B19 Infection (Fifth Disease) Infection and
Pregnancy. www.cdc.gov/ncidod/diseases/parvovirus/B19&preg.htm
Staying Healthy in Child
Care 3rd edition. December 2003.
http://www.nhmrc.gov.au/publications/synopses/ch40syn.htm