Fifth Disease??? - Walnut,CA

Hi E.,

One of my areas of expertise is infectious disease, including Parvovirus B19 (Fifth Disease). This is NOT the same variant of Parvovirus that infects dogs and cats, and you can NOT get it from an animal, so don't worry about your pets. Also, there is no vaccine available for this virus.

Please ask your obstetrician to order Parvo B19 IgM and IgG tests immediately. Although your son's symptoms appeared when you're at 20 weeks, he was most infectious about 10 - 14 days before you saw his first symptoms, which puts you about between 18 and 19 weeks. This is still a risk period for complications to the fetus.

Here's how the tests are interpreted. If you have presence of only IgM or of both IgM and IgG to Parvo, you are recently infected. The likelihood is that you will have no symptoms, although some adults can develop a type of transient arthritis from the virus, which usually only lasts a few weeks, but can last for up to a year or more. The risk to your baby, however, is high. Your obstetrician will need to monitor the baby's development closely by ultrasound to make sure that fetal hydrops is not developing. If it does, this indicates that the virus has infected the fetus and is destroying the blood-forming "machinery." The danger of this is that the baby can become anemic and inadequate oxygenation because of this can lead to later learning and developmental disorders. In most cases, hydrops is not severe and the pregnancy can proceed normally to term. If it is severe, a specialist can do an in utero blood transfusion, but this can be a dangerous procedure, because there is risk of fetal hemorrhage and miscarriage.

The good news is, that more than half of all women of childbearing age have already had Parvovirus and are immune. If the test shows only IgG antibodies to the virus, you have nothing to worry about. The obstetrician may still prefer to be cautious and do a couple of extra ultrasounds, in case the IgM window was missed, but if you get the test done now, that's not likely.

Since your son's rash has faded, he's no longer contagious. Your 4 yr old, however, could be in the viral prodrome phase now, and very well could be contagious. While the risk is lower now that you're at 20 weeks, I would still send him off to Grandma's for a week or two if you can bear it.

When you ask the doctor for the Parvo testing, ask him/her to also test for CMV immunity. Most obstetricians are still not aware that this poses a significant risk to pregnant women who are around small children (which you are), and 1 of 150 children are born with congenital CMV which can cause severe birth defects and life-long health problems. The testing is the same for Parvo (IgM and IgG), and the interpretation is the same. You can reduce risk to yourself from both of these viruses by practicing simple precautionary methods, which everyone should do, anyway. Namely, never kiss a small child on the mouth, and wash your hands frequently -- especially after exposure to nasal mucous or oral saliva.

If your doctor wants to learn more about CMV (definitely should, if he/she has not already counseled you), the Association of Public Health Laboratories is hosting a webinar on the subject this Tuesday at 10AM PDT, 1PM EDT. The cost is only $95 ($115 if you want access to the video archive), and can be accessed from https://www.aphlnet.org/eweb/DynamicPage.aspx?webcode=Eve...

If the link doesn't work, go to aphl.org, and scroll down through the professional development area to "education and training." Select "webinars." On this page, there is a link on the right with the training calendar. The CMV webinar is the first item on it's page. I've seen the slides and will be attending this webinar, which looks to have good content.

Good luck! I hope everything turns out OK. There is a high likelihood that everything is fine.

speak to your dermatologist and pediatrician
Fifth's disease can cause SERIOUS problem with the fetus
As much as you miss him, that would be MUCH worse
you should wait until you are entirely in the clear before getting your son
a few weeks of missing him is better than a lifetime of sorrow!

From my understanding I only think you get the rash on one side of your body and it's generally in one location such as the trunk, the waist, etc.
If his rash is gone then he's probably over the worst of it, but it might be good to wait an entire week just to be on the safe side. Fifths disease can cause serious health issues for your fetus.

Call the doc and see how long he's contagious.
Usually it's during the fever stage.

My daughter had it and only got a very faint rash on her face.

My girlfriend's kids just had this and I couldn't visit with her!! Here's what I did. I called my OB. They had me come in that very day and do a simple blood draw to check and see if I was already immune to it. People are the most contagious BEFORE the rash and the incubation period is quite long. I know for me, the best thing to do to ease my mind was go and do the blood draw. i am surprised the pediatrician didn't tell you to do that!
L. (oh yeah, I was immune. It's something like 60% of people already are!)

You've gotten great advice. Please go get tested. I went through the same same thing 3 months ago at 13 weeks pregnant. I'm just surprised his peditrician did tell you to call your obgyn. It is scary not knowing if you have been exposed to this virus in the past. I had to take 2 blood test during a two week period. My first test showed I had a past exposure and. A much recent exposure. My normally ob ordered second test but the high risk doctor I was seeing for genetic testing said it was unnecessary because the past exposure would make the fetus immune to the virus even though I had been exposed. All in all it was all turn out fine. Just remember you have a good chance of already having the virus as a child. Some Childrens symptoms are so mild you don't even know they have it. I know my sons were. I thought his school didn't put sunscreen on him and he had sunburn on his face. Then the next week his legs and arms looked like sunburn and a day following that it looked more like a rash. That was when I thought something else was wrong. He never had a fever.

I just did some research on this, and it seems that by the time the rash appears, they doubt that it is contagious any more. The contagious period is before the rash appears.

But what's wrong with visiting Grandma for a while? At six, your son and you should be able to have a week apart now and then. Otherwise you end up as one of those clingy parents who follows the 18 year old to to college and virtually tries to move into the dorm room! Believe me, it happens! Learn to separate every once in a while. Your son will be fine, and so will you.

S. Toji

Hi E.,
Maybe you don't need anymore responses... but wanted to add - I went through the same thing. I happened to have bronchitus at the same time & my husband insisted I stay with his Mom for the week. I reluctantly went... turned out to be the absolute best thing for me. Caught up on sleep & days flew by - gave my son & Dad time to bond.

Some of the responses sound a little scary so I just wanted to tell you that Fifth "disease" sounds scary but it's really NOT for your child. It's one of many viruses, bugs that are kids experience & that many of us experienced as kids or adults (adults don't get the rash). It's more about taking the most cautious action for the baby you're carrying. It may give you peace of mind to get the blood test to find out if you are already immune. I'm surprised your pediatrician didn't tell you to do this immediately. That's what I did but the results didn't come back until after the contagious period was over so I still left the house for 5 days. But finding out I was immune was a relief & no further worrying about it. Glad your son is feeling better!

Check with another doctor it has always been my understanding that you are contagious with fifth's disease before you have a rash. Also you could ask your parents if you had it when you were a child if you have you should be immune to it.
"Prevention
There is no vaccine for fifth disease, and no real way to prevent spreading the virus. Isolating someone with a fifth disease rash won't prevent spread of the infection because the person usually isn't contagious by that time.

Practicing good hygiene, especially frequent hand washing, is always a good idea since it can help prevent the spread of many infections."

Fifth disease is more deadly than lysteria -the whole sandwich meat thing. I'd be on the phone with by OB to get the straight scoop on the safest thing to do. I'd also call the pediatrician for good measure. Sorry to hear you guys have to go through this!! Big Hug!!

I don't think it has anything to do with your hormones, you miss your son rightfully so. I would check with your OB I thought the first trimester is when fifths disease was most dangerous for pregnant mammas. I also thought there was a simple blood test to put your mind at ease. Like any virus some children get it worse then others, but I would still air on the side of caution and not take any chances. Try to think of this as special time with grandma and a little vacation for you so you don't feel so sad. The benedryl could have prevented the rash from coming out full blown so the worst could be over, but most virus usually run a course of a week so check with your OB first. Good luck!!

You've gotten some good advice. If you need some support the only person I know is http://themeanestmom.blogspot.com she got it while pregnant could probably give you some good places to turn for emotional advice.

Talk to your doctors not a bunch of strangers good luck A. mother of 4 and 7 grandchildren no hills

My youngest just got over Fifth's Disease. According to Web MD once they have the rash they are no longer contagious. You all have already been exposed, so it's not necessary for him to be away from home. Fifths Disease can cause problems with the fetus, but the chance is very rare. If your other son gets it, well, he gets it. Sadly, there's not much you can do about it. It's a virus. I was totally freaked out when the doctor said that's what my daughter had. He explained that it's just a virus. I can be very painful for kids, but it's normally controlled with Ibuprofen or Acetometaphine. Good luck you your guy! I hope no one else gets it, but if they do, just make sure to have the Benadryl and the pain medicines on hand. Lots of popsicles and cold drinks too.

Here's the Web MD link.
http://children.webmd.com/tc/fifth-disease-topic-overview

Call your OB. My son was exposed to 5th's when I was pregnant with my daughter. I called my dr, and they did a blood draw on me. They said most people get 5ths as children and dont even know it. It ended up I was exposed, but it was as easy to find out as a simple blood test.

talk to the dr, his and ur ob! i work with a woman who is a teacher of 2 year old. she was pregnant and one of her students caught this and then she caught it. She had a miscarriage and her OB said it was caused by Fifth's disease. This sickness is no joke. please take all necessary precautions.

The blood test is called 'titers' which checks the levels of antibodies to a specific disease. You do not want any vaccines of ANY kind while you are pregnant - if you want the reasons why you can email me.

Why not do preventable things like taking Vitamin D3 of which you can take up to 10,000 mg a day to help prevent or lessen the effects of getting sick - get out in the sunshine for 10 to 20 minutes a day. It is especially important to be taking Omega 3s in the form of DHA (lower amounts of EPA though as this can thin your blood a little too much).

btw - Tylenol tells the immune system to go on vacation for up to 22 days every time you take it. It depletes the production of Glutathione. We've used Motrin and it even worked better for my kids.

This is something that was in my email this morning on Vitamin D3
"A new study finds that women who develop a severe form of pregnancy-related high blood pressure tend to have lower blood levels of vitamin D. The condition is known as early-onset severe preeclampsia, and it contributes to about 15 percent of preterm births in the U.S. each year.

Researchers found that vitamin D levels were generally low among 50 women with early severe preeclampsia. Their average vitamin D level in the former group was a very low 18 nanograms per milliliter."
http://articles.mercola.com/sites/articles/archive/2010/0...

Call your doctor. It's better to be safe than sorry. Unless you want you and your other son to get sick, I would keep your feelings in perspective. There are a lot worse things that children could get. Just imagine if he had cancer and the chemo prevented you from being around him at all because you're pregnant. I say this because my nephew has leukemia. You are lucky you have someone like your mom to help and that this process will take you only a few days. I hope your son feels better soon.

Talk to your ob/gyn or midwife. Most women have been exposed to 5th disease in their childhood so they have an immunity to it that will protect their baby. Because most of the critical development for your baby has already occurred, your baby should be fine. Talk to your birth provider, though. It shouldn't be necessary to stay away from your son. He's probably not contagious anymore. He also might not get a worse rash.Some kids don't get a rash at all, but just get red cheeks. Check with your pediatrician about bringing him home again. God bless you!