Pregnancy and fifth disease

What is 'fifth disease'?
This illness is so called because it is classified as fifth in a list of six diseases that can affect children, manifesting themselves with a raised temperature and a skin rash. Other diseases in the group include measles and rubella, for example.
It is more commonly known (sometimes even to GPs!) as 'slapped cheek', because one of the symptoms is red cheeks, as if the person has been slapped.
It tends mostly to affect toddlers and children up to their early teens, but can be contracted by an adult in close contact with the child (caring for the sick infant, for example).

What are the symptoms of 'fifth disease'?
Sometimes a child will feel generally under the weather, possibly (but not always) have a raised temperature, and have red cheeks. It may seem as if your child has a cold, with a runny nose. As small children often have red cheeks if they have been out in cold weather, or are possibly still teething, this can sometimes go unnoticed.
You are more likely to notice the fine, almost lacy-looking red rash which will spread across your child's tummy, legs and/or arms.
The disease is sometimes so mild you won't realise your child has had it, but in worse cases, you child may need two to five days away from school, resting. When your child is hot, the rash may appear to be more vivid but this will probably fade back again once the child has cooled down. The rash may linger for a week to 21 days. In adults, the rash and feeling generally unwell might be accompanied by aching joints.
Treat any fever with a normal fever-reducing infant suspension (eg Calpol). You may wish to see your GP to confirm diagnosis, but it cannot be treated with antibiotics or antiviral drugs. Of course, if your child suffers from any serious ongoing medical condition, do seek medical advice swiftly to ensure the illness does not provoke complications.

When is fifth disease contagious?
Like so many other diseases of this kind, fifth disease is, unfortunately, most contagious before the tell-tale rash appears. The average duration of incubation is about 16 days but can be as little as four days or as much as four weeks.
Your child is most contagious after contracting the virus and then up to and including the period when he feels unwell, possibly feeling chesty. Once the rash appears he is unlikely to be contagious.
The rash itself is your body's reaction to the disease.
Anyone caring for a child sick with fifth disease will be in close enough contact to contract the illness. Sharing drinking cups, forks etc, or being near when a child coughs or sneezes, or picking up their discarded tissues - all these cause the infection to spread quite easily.
If a child gets it, another child in the home has about a 50 per cent chance of also contracting the disease.
As with many illnesses, it is very rare to get fifth disease again once you have had it, because you develop an immunity to it. Many adults are immune to it without realising because they may have had the disease in a mild form during childhood.

Why should pregnant women avoid fifth disease?
Fifth disease exposure can be of concern, especially if the woman is in the first half of her pregnancy.
This is because the infection has been shown, in rare cases, to slightly increase the incidence of miscarriage. (If this is the case, a future pregnancy will not be at risk for the same reason.)
It is also possible that the infection can cause a form of anaemia in the fetus, which can be fatal.
Most women, by the time they reach adulthood, may well have had fifth disease even without realising it, and will therefore not contract the illness if they are exposed to it. However, following good clean practices when caring for children at all times, and especially when they are feeling poorly, will certainly help.
If you know or suspect you have been exposed to a child with fifth disease, see your GP or consult your obstetrician. They will be able to run blood tests to see if you have the virus, and if neccessary, be able to monitor the health of the fetus.
Even in those women who do contract fifth disease during pregnancy, only about five per cent experience any problems.