Fifth disease natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Natural History,Complications and Prognosis
Fifth disease is usually a mild illness that resolves on its own among children and adults who are otherwise healthy. Joint pain and swelling in adults usually resolve without long-term disability.
Parvovirus B19 infection may cause a serious illness in persons with sickle-cell disease or similar types of chronic hemolytic anemia. In such persons, parvovirus B19 can cause an acute, severe anemia. The ill person may be pale, weak, and tired, and should see his or her physician for treatment. (The typical rash of fifth disease is rarely seen in these persons.) Once the infection is controlled, the anemia resolves. Furthermore, persons who have problems with their immune systems may also develop a chronic anemia with parvovirus B19 infection that requires medical treatment. People who have leukemia or cancer, who are born with immune deficiencies, who have received an organ transplant, or who have human immunodeficiency virus (HIV) infection are at risk for serious illness due to parvovirus B19 infection.
Occasionally, serious complications may develop from parvovirus B19 infection during pregnancy. Infection in the first trimester has been linked to hydrops fetalis, causing spontaneous abortion.
For details on pregnancy complications, please see the CDC information sheet entitled, "Parvovirus B19 Infection and Pregnancy."
I've recently been exposed to a child with fifth disease. How will this affect my pregnancy?
Usually, there is no serious complication for a pregnant woman or her baby because of exposure to a person with fifth disease. About 50% of women are already immune to parvovirus B19, and these women and their babies are protected from infection and illness. Even if a woman is susceptible and gets infected with parvovirus B19, she usually experiences only a mild illness. Likewise, her unborn baby usually does not have any problems attributable to parvovirus B19 infection.
Sometimes, however, parvovirus B19 infection will cause the unborn baby to have severe anemia and the woman may have a miscarriage. This occurs in less than 5% of all pregnant women who are infected with parvovirus B19 and occurs more commonly during the first half of pregnancy. There is no evidence that parvovirus B19 infection causes birth defects or mental retardation.