Abby Parks had never encountered parvovirus before, so when she began experiencing flu-like symptoms, joint pain, and a rash in late April, she was understandably perplexed. As a 27-year-old special education teacher in Springfield, Illinois, Abby was about 18 weeks pregnant and felt increasingly ill with a persistent fever. Despite undergoing tests for Covid-19 and strep throat, the results came back negative, leaving her without answers.
The school nurse, noticing several students with unusually rosy cheeks, speculated that Abby might have the same infection. “I got progressively sicker,” Abby recalled. “I was in bed with a fever for four or five full days.” When blood tests conducted by her OB-GYN in early May confirmed that she had parvovirus B19, she was promptly referred to a maternal-fetal medicine specialist. It was revealed that the virus had been transmitted to her fetus, causing dangerous anemia. The doctors administered an in utero blood transfusion to the fetus.
Rise in Parvovirus B19 Cases
Increasing Incidence of Fifth Disease
Parvovirus B19, more commonly known as Fifth disease or “slapped cheek syndrome” due to its characteristic red rash, is on the rise in the United States. On Tuesday, the Centers for Disease Control and Prevention (CDC) issued an alert for healthcare providers to be vigilant for this highly contagious seasonal virus. The CDC reported that most infections occur in children aged 5 to 9. Since March, Europe has also seen unusually high rates of parvovirus, as noted by the European Centre for Disease Prevention and Control.
Vulnerable Populations
While most adults have contracted the infection during childhood and remain immune, the CDC cautioned that pregnant women and individuals with sickle cell disease who have never been exposed are at risk of severe illness. Abby’s doctor, Kathy Bligard, an OB-GYN at Washington University Hospital in St. Louis, disclosed that Abby was not the only patient whose fetus required a blood transfusion due to parvovirus. “It’s certainly something that I used to see maybe once every other year and have seen multiple times in the last few months,” Bligard said.
The Impact on Pregnancy
Dangers to Pregnant Women
Parvovirus B19 poses significant risks to pregnant women because it can cross the placenta, infecting the fetus and leading to anemia, which can be fatal. Although Abby has recovered from the virus, her pregnancy remains at risk. On Wednesday morning, an ultrasound revealed that the fetus wasn’t receiving sufficient blood from the placenta, prompting Abby’s hospitalization in Springfield for closer monitoring.
Life-Saving Measures
“The earlier transfusion was lifesaving for the fetus,” Abby emphasized from her hospital bed. “Because if that anemia had persisted with such a low blood count, the baby could have died.” Bligard explained that the virus hinders the fetus’s ability to produce new red blood cells. “In order to get oxygen to all of the important organs in our body, we rely on having those red blood cells. Low blood counts can lead to heart failure or even death.”
Parvovirus in Adults and Children
Symptoms and Risks for Adults
Though Fifth disease primarily affects children, adults can also contract it, often experiencing more severe symptoms such as joint pain and anemia. Dr. Vincent Iannelli, a pediatrician in the Dallas area, highlighted that low red blood cell counts could cause pregnancy complications. Patients with sickle cell disease are particularly vulnerable.
Increasing Cases Among Children
“We’ve been seeing more cases over the past month or two,” Iannelli noted. Typically, he would encounter one case of Fifth disease per month, but now he sees one to two cases per week. The virus is more prevalent in the spring and summer. In children, Fifth disease is usually mild, characterized by fever, respiratory symptoms, and a distinctive red rash on the cheeks, followed by a “lacy” rash on the body, which can be itchy.
Awareness and Precaution
Monitoring Symptoms
Pregnant women experiencing joint pain or difficulties in producing red blood cells should inform their doctors immediately, especially if they’ve been exposed to Fifth disease. Despite the rise in cases, Iannelli doesn’t believe there’s cause for alarm. “Fortunately, most pregnant women had it when they were kids, so they’re immune to it. But every once in a while, we do see adults,” he said.
CDC Alert
The CDC’s alert aims to raise awareness among doctors rather than alarm the public. In the early 1900s, doctors developed a list of common childhood rashes to improve diagnostic accuracy, identifying six major rashes. Although more childhood rashes are recognized today, the numbering system persists only for Fifth disease.
Abby’s Continuing Journey
At 30 weeks pregnant, Abby is being closely monitored in the hospital. She hopes to raise awareness among other pregnant women about the virus and the importance of getting tested if exposed. “It has been truly the most difficult experience to go through,” Abby shared. “He wasn’t guaranteed to come through the fetal anemia.”
FAQs About Parvovirus B19
What is parvovirus B19?
Parvovirus B19, commonly known as Fifth disease, is a contagious virus that causes a distinctive red rash on the face and a “lacy” rash on the body.
Who is at risk of contracting parvovirus B19?
While the virus mainly affects children aged 5 to 9, pregnant women and individuals with sickle cell disease who have never been exposed are at higher risk of severe illness.
How does parvovirus B19 affect pregnant women?
The virus can cross the placenta and infect the fetus, leading to anemia and potentially fatal complications.
What are the symptoms of Fifth disease in children and adults?
Children typically experience mild symptoms, including fever, respiratory issues, and a red rash on the cheeks. Adults may suffer from more severe symptoms such as joint pain and anemia.
How is parvovirus B19 treated?
There is no specific treatment for the virus. In severe cases, such as fetal anemia, blood transfusions may be necessary.
Is there a vaccine for parvovirus B19?
Currently, there is no vaccine available for parvovirus B19.
Conclusion
Parvovirus B19, or Fifth disease, is a contagious virus primarily affecting children but posing significant risks to pregnant women and individuals with pre-existing conditions. Awareness and early detection are crucial, especially for pregnant women who may face severe complications. While most adults are immune, those who aren’t should exercise caution. The CDC’s alert aims to increase vigilance among healthcare providers, ensuring timely intervention and treatment for those affected. Abby Parks’ story underscores the importance of awareness and the life-saving potential of timely medical intervention.
