This sheet is about having fifth disease during pregnancy or while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider.
What is fifth disease?
Fifth disease (erythema infectiosum) is a viral illness. It is caused by a virus called human parvovirus B19. Fifth disease is more common in children than adults. The illness often starts with mild fever, headache, sore throat, and other flu-like symptoms. Children can also develop a bright red rash on the face that looks like “slapped cheeks”, along with a lacy or bumpy rash on the body, arms, and legs. In adults, joint aches are a common symptom. Rash and joint symptoms can develop several weeks after the infection. Some adults with Fifth disease might not have symptoms. About 2 in 10 adults (20%) to 3 in 10 adults (30%) who get infected with parvovirus B19 will not have symptoms.
How do people get fifth disease?
Fifth disease is very contagious, which means it can easily spread from person to person. It is spread by coughing, sneezing, touching secretions from the nose and mouth of an infected person, and through contact with blood. When an infected person coughs or sneezes, the virus can travel several feet. The time between infection and the development of the illness (incubation period) is usually between 4 and 14 days. People with fifth disease are most likely to spread the disease before their symptoms start. People are less likely to be contagious after the rash occurs. Many people that work with children have antibodies to parvovirus B19. These antibodies can help lower the chance for infection if exposed to parvovirus B19. Everyone can lower their chance of infection by practicing good hygiene such as washing your hands regularly and not sharing eating utensils (spoons/forks) and by not drinking out of the same cups/containers.
How can I find out if I am infected with fifth disease?
Blood tests can show if someone is immune to the virus, if someone is not immune and has never been infected, or if someone has had a recent infection. Once you have had fifth disease, it is rare to be re-infected. Because fifth disease is a mild illness, and most people get infected as children, many adults might not remember if they ever had it. Talk to your healthcare provider if you think you have been exposed to parvovirus B19.
I have fifth disease. Can it make it harder for me to get pregnant?
It is not known if fifth disease can make it harder to get pregnant.
Does having/getting fifth disease increase the chance of miscarriage?
Miscarriage is common and can occur in any pregnancy for many different reasons. Having a parvovirus B19 infection during pregnancy might slightly increase the chance of miscarriage.
Does having/getting fifth disease increase the chance of birth defects?
Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like fifth disease, might increase the chance of birth defects in a pregnancy. It is not known if fifth disease increases the chance of birth defects.
Does having/getting fifth disease in pregnancy increase the chance of other pregnancy-related problems?
It is not known if fifth disease can increase the chance of other pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). Studies show that most women who become infected with fifth disease during pregnancy deliver healthy babies.
If a woman is infected during pregnancy there is up to a 33% (33 out of 100) chance of passing the infection to the fetus. If the infection does pass to the fetus, about 10 out of 100 (10%) could have complications.
Fetal infection with fifth disease can lead to inflammation of the heart muscle (myocarditis). Fetal infection could also damage the bone marrow so that it is harder for the body to make red blood cells (aplastic crisis). Aplastic crisis can lead to anemia, a condition in which the body does not have enough healthy red blood cells. Fetuses with mild anemia generally recover. If the heart damage or anemia is severe, hydrops fetalis (too much fluid in fetal tissues) can occur and could lead to fetal death. Sometimes, the hydrops fetalis goes away without treatment. Rarely, a baby is born unable to make red blood cells and will need blood transfusions. Babies with hydrops might also have breathing problems at birth.
Fetal loss has been reported in a small number of cases. Infection in the first 20 weeks of pregnancy has up to a 10 out of 100 (10%) to 15 out of 100 (15%) chance of fetal loss. This chance gets lower when infection happens after 20 weeks of pregnancy.
There is a reported case of maternal mirror syndrome (MMS) after getting fifth disease during pregnancy. MMS can look like maternal edema (swelling) and placentomegaly (an enlarged placenta). There are additional reports of the placenta becoming infected. The placenta is the organ that develops during pregnancy and works as the blood connection between the woman who is pregnant and the fetus.
Does having/getting fifth disease in pregnancy affect future behavior or learning for the child?
Neurodevelopmental problems have been reported in a small number of infected pregnancies that developed complications.
What screenings or tests are available to see if my pregnancy has any issues?
Prenatal ultrasounds can be used to screen for some issues, such as hydrops fetalis. Ultrasound can also be used to monitor the growth of the pregnancy. An amniocentesis can be done to diagnose fifth disease in the growing fetus. Talk to your healthcare provider about any prenatal screenings or testing that are available to you. There are no tests available during pregnancy that can tell how much effect there could be on future behavior or learning.
Breastfeeding while I have fifth disease:
Women who have fifth disease can usually keep breastfeeding. Talk with your healthcare providers about precautions when handling the baby, such as washing hands before touching and using a face mask. Women who use a breast pump should disinfect all parts of the pump that come into contact with the milk after each use. Antibodies against parvovirus B19 have been found in breast milk. It has been suggested that these antibodies might pass some immunity to the child that is breastfeeding. Be sure to talk to your healthcare provider about all your breastfeeding questions.
If a man has fifth disease, can it affect his fertility or increase the chance of birth defects?
Studies have not been done to see if fifth disease could affect male fertility (ability to get a woman pregnant) or increase the chance of birth defects. Since fifth disease is contagious, it is important to talk to your healthcare provider if your partner or other people living in your home have been diagnosed with this disease. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
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