Slapped cheek infection

I have come in contact with a child with slapped cheek infection. Should I be worried?

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Erythema infectiosum is also known as ‘slapped cheek disease‘ or ‘fifth disease‘ and is a common childhood viral infection caused by human parvovirus B19.

Fifty to sixty percent of women are immune to the virus by the time they reach childbearing age. Occasionally, an unborn baby of a non-immune mother can develop problems if infected before the 20th week of pregnancy.

What are the symptoms?

Most cases experience no symptoms at all. Children can have a mild illness with little or no fever but a striking redness of the cheeks (hence ‘slapped cheek disease’). Sometime the rash will extend over the bridge of the nose or around the mouth and occasionally to the rest of the body, with the upper arms and legs being the most common locations. The rash usually lasts a couple of days and may itch.

Patients are usually no longer infectious once the rash has appeared. The incubation period of the infection is one to two weeks.

Parvovirus infection is spread by through coughing, sneezing or touching something that has been coughed or sneezed on. About 50% of non-immune people will become infected if there is a case in their household, less if the case is at school or child care.

How can it affect my baby?

The risk to unborn babies is low. Spread from mother to baby can only occur if the mother is not immune. Even if the mother is affected only one-third of babies will develop the infection (generally about a month after the mother’s illness).

Infection during the first 20 weeks of pregnancy can rarely cause a form of anaemia in the baby. In many cases this resolves by itself but in some instances it may require treatment. Very rarely it can be fatal. Parvovirus infection does not cause congenital abnormalities but is infrequently associated with miscarriage

Testing for Parvovirus B19 during pregnancy

A blood test for parvovirus B19 can show if you:

  •  are immune and have no recent sign of infection (Parvovirus IgG positive and  IgM) negative),
  • are not immune and have never been infected (Parvovirus IgG negative and IgM negative), or
  • have had a recent infection (Parvovirus IgG positive and IgM positive).
How can I protect myself and my baby?

Washing hands before eating or touching your face can help prevent infection. Avoid sharing cutlery, cups and plates.

What action should I take if I think I have been exposed?

I you believe you have been in contact with a case of parvovirus infection I or you local doctor can arrange a blood test to check. There is no risk to you or you baby if you already have immunity.

If active infection is diagnosed, ultrasounds can be done every one to two weeks to monitor the health of the baby. In the unlikely event that there are signs your baby is having difficulty with severe anemia a blood transfusion while the baby is still in the womb may be considered.

Posted by Dr Gary Sykes on -

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