Fifth Disease Without the Body Rash?

Updated on February 25, 2009
T.L. asks from San Pedro, CA
18 answers

Okay, I have reason to believe one if not both my children had fifth disease in the past couple weeks. I am pregnant, and it can be a problem to be exposed to this when you are pregnant, because it can be dangerous for the fetus. I am going to call their pediatrician on Monday and see if they can get a blood test next week that would possibly confirm whether they had it or not.
But I am wondering, has anyone ever had a child who was clearly diagnosed with Fifth Disease, but did not get the full body rash? My kids had some of the lesser taletale symptoms like the cold symptoms and tiredness, but only got the slapped cheek rash.
We have also had stomach flu and respiratory influenza hit our home (and their classrooms at school) this past month, what a month! So maybe the symptoms and rashes were due to other viruses, but I have NEVER seen them look like they had slapped cheeks before and I know that IS a telltale sign of Fifth Disease. But I keep reading they are supposed to then get the lacy rash all over their body.

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S.G.

answers from Los Angeles on

My daughter as a toddler had it. I don't recall her even being sick - maybe a fever. And, she didn't have a rash, etc. She had a faint lacelike rash that seemed to fade in and out and only her face. We took her in and they said she had fifth disease. I had never even heard of it at that point.

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C.F.

answers from Los Angeles on

My 6mo daughter was diagnosed w/ 5ths and only had slap face rash, but I got it too and had severe joint pain (I am prone to this due to arthritis) that was so bad I couldn't pick up a tissue let alone my baby. Check w/ your OB re your fetus.

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J.V.

answers from Santa Barbara on

Hi Tara. My son was diagnosed with 5th disease as well when he was a toddler. As I remember he didn't have a rash all over his body either. He wasn't even acting "that sick", but his pediatrician told me he had it...I never had heard of it before.

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S.R.

answers from Los Angeles on

I personally contracted fifth disease at age 11 and only had the face and hands rash

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E.L.

answers from Los Angeles on

Hi Tara,

My daughter has been diagnosed Fifth's disease with only the slap cheek and flu like symptoms appearing. She never had the rash. What I was told by her dr. was that they are contageous before the cheeks turn bright red, during the feverish/achey stage.....hence you don't know they have it until the cheeks turn red and of course by then you've exposed everyone that has been around them. My daughter had it in the spring time 3 years in a row from the age of 6-9 and hasn't had it since. She is now 12. Her cheeks do turn BRIGHT red when she excercises and it looks like slapcheek. I don't know if that's just how she gets or it is a side effect of having fifths disease. I know that it's a virus that stays dorment in the body and can creep up anytime. It's a little uncomfortable, but my daughter never complained about it. Her cheeks were on fire and were a little chapped but it did not keep her from playing.

Please talk to a dr. about your pregnancy, but as far as your kids, they should be just fine. My daughter is perfectly healthy and plays sports and is your typical pre-teen!!! :-)

Good Luck to you and congratulations on baby #3!!!

E.

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B.B.

answers from San Luis Obispo on

sometimes all you have is the slapped cheek. my son had the cheeks, and my daughter the full body rash. your OB will test you for antibodies (70% of adults have already either had it or were exposed and have the antibodies) and if you do, then nothing needs to be done. if not, they'll keep an eye on the baby with extra ultrsounds and blood tests about once a month to see if you develop 5th disease. even if you do develop the disease, the chance of anything happening to the fetus is less than 5%, so try not to stress. chances are you are already immune, most people just get the cold portion of 5th's and never get any rash. my daughter and son just had it at christmas, while i was about 7 months along and i went through all this fun stuff. fortunately i am immune, but its nice to know what you're up against. best wishes.

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J.K.

answers from Los Angeles on

can also be scarlet fever due to the slapped cheeks. I would call your pediatrician.

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J.B.

answers from Los Angeles on

my little one was miss diagnosed with fiths disease. she really had hand foot mouth. i would take your kids in asap to their dr. my daughters dr confirmed my suspicion of hand foot mouth. now my daughter had a horrid diaper rash but also had sores on her feet and hands (none in the mouth). she had the slapped cheek look (which isnt typical of hfmd). theres no medication to help get rid of either sickness you just have to wait it out. good luck!

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N.D.

answers from Reno on

Both my youngest had fifth disease this Christmas! But they both got the body rash. The baby had the rash extreme all over his arms,legs, face, and chest, the older one barely had the body rash. On him his arms just looked kinda red and sunburned, he got it a few days before the baby. The older one was so light with the rash that I doubted we had it, then when the baby got it I was SURE that was what they both had. I was watching for they signs since it was going around daycare, and when the baby got the rash I took them both to the dr. You two may have had a lighter case, or maybe you are correct in thinking that it is all the other linger illnesses. What a month for you all! Have the two been exposed to fifth disease recently? All the kids at the daycare that got the disease did get some kind of rash/redness at least on the arms. Good luck to you! And congrats on the newest addition!

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N.S.

answers from Los Angeles on

Wow, I didn't know that this was still around. When my now 22yr old old 20 yr old were in elementary school they both got Fifth disease, but then it was only on their forearms. That seemed to be the case with the majority of their classmates, too. My oldest also had foot and mouth and scarlet fever. And both boys had chicken pox when I gave birth to my daughter, who then caught it at 2 wks of age. Try to wear a robe or other body covering outerwear that you can take off and wash immediately and wash, wash, wash your hands. I know it is frustrating.

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R.L.

answers from Los Angeles on

Hi Tara,

Sorry -- I'm just catching up after a busy week. Funny -- I just completed an educational slide set for doctors on the TORCH diseases and decided, at the last minute, to include Parvovirus B19, which is the virus that causes Fifth Disease (also known as erythema infectiousa or slapped cheek disease).

The lacy rash that you see with Fifth disease can sometimes be difficult to see on darker skinned complexions, so it is possible to have the disease and not see the rash, except for on the cheeks. About 65% of the population worldwide gets this disease before they're 20, but pregnant women who have not been previously exposed are at increased risk during pregnancy because of immune suppression that accompanies pregnancy (keeps your body from rejecting the baby). In general, though, if this is a standard year for parvo infection, only about 1% of all pregnant women will become infected, which is a pretty low rate. But, if this is an epidemic year (and I don't know if it is), then the risks of becoming infected are 10 times greater. Your risks are increased even more if your children really do have the disease (I don't know the actual numbers, though). Over all, in nonepidemic years, approximately 33 out of every 100,000 pregnancies will result in some problem because of parvo infection. In epidemic years, this number increases to up to 550 out of every 100,000 pregnancies. These are pretty low numbers, so you should get things checked out, but not be freaked out by them, and you should not be freaked out by the information below. It is meant to be purely informative, not scary (although it can sound that way). Just keep in mind that the chances that you and your unborn baby have been infected are small. If you have any doubts or concerns, however, get tested. It's easy, it's cheap, and it's great peace of mind.

In terms of the actual disease, these are the risks to you and your unborn child. While parvo is usually very mild in children, it can cause arthritis-like symptoms in adults, and this can last for several months or even years after the virus has cleared (it can target the synovium - the membrane that covers joints -- and cause an inflammation response). It is NOT actual arthritis, though.

Because parvo primarily acts by interrupting the generation of red blood cells and platelets, it can cause anemia and even anemic crisis in severely immune suppressed individuals (this is not a factor in pregnancy, unless you're already immune suppressed for other reasons, such as have HIV or are on immune suppressants following an organ transplant). This is a rare occurrence.

Parvo in pregnant women is associated with a higher rate of second and third trimester miscarriage and preterm delivery because it can also infect the placenta. The most significant risk from it is fetal anemia that can lead to the development of nonimmune fetal hydrops (fluid build up in the fetus). This can be mild or quite serious. The greatest risks to the fetus occur if the mother is infected before the 20th week of gestation.

So, how to decide to get tested? First: in parvo, the viral prodrome (fever, malaise, loss of appetite) occurs separately from the rash. Fever usually lasts for 3 - 7 days, then subsides and the rash shows up about 7 days later. But, the prodrome can be completely nonsymptomatic, too, as can the rash. If this was the case with your kids and you are less than 20 weeks pregnant, GET TESTED. If you have had symptoms of fever and joint aches, with or without the rash, GET TESTED. It's a simple blood test -- 2 tubes of blood, max. The doctor must test for both parvovirus B19 IgM and IgG, as the pattern of these tests will allow him to decide if you had previous immunity to parvo or if you have had a primary infection, or are susceptible to a primary infection, during pregancy.

Test results: If you are IgM-negative and IgG-negative, you have never had the disease and are at risk of getting it, so you should be closely monitored with blood tests over the next couple of weeks to see if IgM begins to rise. If you are IgM-positive and IgG-negative, or if you are IgM-positive and IgG-positive, you most likely have a primary infection (see the next paragraph). If you are IgM-negative and IgG-positive (and your exposure was very recent, like within the last 2 - 3 months), then you probably had the virus already and do not need to worry, but you might still want to mention the exposure to your obstetrician. S/he might want to order an extra ultrasound, just to be on the safe side.

If testing shows that you DO have a primary infection, then your pregnancy will be termed high risk. The doctor will need to follow the progress of your fetus closely by weekly ultrasound. He will be looking for the development of fetal hydrops. S/he should also be measuring the flow of blood in your baby's brain, which will indicate if the baby is developing anemia before signs of hydrops develop. If the baby becomes severely anemic and/or hydrops does develop and you are still early in your pregnancy, it may be recommended that you have an intrauterine blood transfusion. There are risks with this, but in general the results are very good and the likelihood is high that you will deliver a healthy baby at term. If hydrops develops close to term, the doctor may instead suggest early induction or a C-section.

There are a few papers suggesting that there can be minor nervous system developmental problems in babies exposed to parvo in the womb, especially those infected severely enough to require transfusion. There's a bit of debate about this, but if it turns out that your baby was infected, just know that it is a possibility and that you should keep a watch on his or her development through early school age (who doesn't, anyway?!). While there may be no obvious devlopmental problems early on, there is still some conjecture that they won't show up until later as learning disabilities. I always figure that it's best not to worry too much, but it is better to forewarned to be adequately forearmed!

I hope everything turns out to be just find.

R.

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L.V.

answers from Los Angeles on

I was a teacher, and when I was pregnant, 3 of my students had Fifth disease. Two of the kids only had the slapped cheeks look. I went to have a blood test to see if I'd already had Fifth disease (because then I would be immune). So, maybe instead of getting blood tests for your kids, you should have one done on yourself. Then, if you had the disease as a child, your mind will be at ease. But, if you didn't actually get the rash/disease yourself, you are probably past the problem anyway. Your baby would only be exposed through your sickness, not your kids'.

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T.C.

answers from Los Angeles on

You might want to just get a blood test for yourself because it's not dangerous for your kids to have it. Also, if you get tested then you don't have to worry about your kids going through the pain of both getting tested. If you get tested and it shows that you have already had it (which most people already have) then everything is fine. We went through this too and the first time we tested our son, while I was pregnant, it came up that he'd never had it. Well, then he got exposed to it and that time we tested me and it showed I'd already had it! If we had done this the first time around I wouldn't have stressed out so much during my pregnancy with my daughter! Good luck!

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B.R.

answers from San Diego on

My doc said about 50% of cases never even get the rash so no one knows they even had 5th disease. They also said that most people have had it in their lifetime and not to stress too much about it unless you start to show symptoms. The only way for it to harm the fetus is if you get it, and once you have been exposed it is a wait and see game. I would try not to stress about it, let your OB know you have been exposed and then if you show cold like symptoms call your OB again.

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B.V.

answers from Los Angeles on

We this "scare" a while back and children and grandchidren were up set. It was just a scare and a doctor friend put a lot of time looking into it. Just let your doctor know what is happening. It is sort of an urban myth so don't get all up set.
B. v. O.

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B.L.

answers from Los Angeles on

I was exposed to fifth's disease while pregnant with my oldest child. I was a teacher in a preschool where it was making the rounds. I was the only teacher for summer session, so we had to shut down the preschool until my OB GYN was satisfied that I was not susceptible. I don't remember ANY of the kids getting the full body rash, they all got ths slapped cheecks rash, but maybe only one had the body rash. So to answer your question, yes, it is possible to have it without the body rash. The OB had me take a test which determined that I was immune to it, then we started the school back up. I don't remember what the test was, it was 20 years ago. B.

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M.S.

answers from Los Angeles on

Hi tara,fifth disease is called slapped cheek syndrom because most kids have red cheeks than body rash.this infection caused by parvovirus B19 and its very contagious.there is no vaccine or medication available to prevent or treat maternal fifth disease but fetal complications can be circumvented by prompt diagnosis and management.on monday visit your ob doctor instead of calling your pediatrician and he will be able to do a blood test to determine if you are immune or you currently have the infection also in our practice I refer my patients to perinatolgist without delay for serial ultrsound and close monitoring.you really do not need to worry or stress yourself as 50% of general populations are immune and even if you have never had the infection in past serious complications such as sever fetal anemia is very rare at least I have not seen one in many years of practice in this field.by the way you have not mentioned what is your gestional age/EDC,good luck and please don't hesitate to ask questions and keep me posted.

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E.T.

answers from San Diego on

My kids had the cheeks and cold and our dr said it was 5ths so good luck!!!

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