‘Slapped cheek’ rash-causing virus on the rise among kids, CDC warns

Abby Parks had by no means heard of parvovirus when she started feeling flu-like signs in late April, adopted by joint ache and a rash. Parks, 27, a particular training instructor in Springfield, Illinois, was about 18 weeks pregnant and had been feeling very sick with a fever for days, however checks for Covid and strep got here again destructive. 

The college nurse, who had been seeing college students with “actually rosy, purple cheeks,” prompt Parks might need the identical an infection.  

“I obtained progressively sicker,” she stated. “I used to be in mattress with a fever for 4 or 5 full days.”

When blood checks given by her OB-GYN got here again constructive for parvovirus B19 in early Could, she was referred to a maternal fetal medication specialist. The physician found the virus had handed to the fetus in utero. The fetus had developed anemia, a really harmful situation. Medical doctors gave the fetus a blood transfusion in utero. 

Instances of parvovirus B19 — extra generally often called Fifth illness or “slapped cheek syndrome” due to the purple rash that covers an contaminated affected person’s face — are rising within the U.S. On Tuesday, the Facilities for Illness Management and Prevention issued an alert to docs to look at for indicators of the extremely contagious seasonal virus. 

A lot of the infections are amongst kids ages 5 to 9, the CDC stated. Since March, parvovirus has been circulating in Europe at unusually excessive charges, in accordance with the European Centre for Illness Prevention and Management. 

Most adults have already had the an infection as children and are nonetheless protected. Nevertheless, the CDC warned that pregnant individuals and folks with sickle cell illness who’ve by no means been uncovered are susceptible to critical sickness.  

Parks’ physician, Kathy Bligard, a Washington College OB-GYN at Barnes Jewish Hospital in St. Louis, stated: “Abby is just not the one affected person whose fetus has wanted a blood transfusion in the previous couple of months for parvovirus. It’s definitely one thing that I used to see perhaps as soon as each different yr and have seen a number of instances in the previous couple of months.”

Bligard stated parvovirus is harmful to pregnant girls as a result of it will probably cross the placenta and infect the fetus and trigger it to be anemic, which may result in fetal loss of life.

Parks has recovered from the virus, however her being pregnant continues to be in danger.

On Wednesday morning, after an ultrasound confirmed the fetus wasn’t receiving sufficient blood from the placenta, Parks was admitted to a hospital in Springfield to take care of the infant.

“I do assume it was lifesaving for the fetus,” Parks stated in regards to the earlier transfusion. “As a result of if that anemia had persevered, with that low blood depend, the infant may have died,” Parks stated in an interview Wednesday from her hospital mattress.

Bligard stated the virus makes it more durable for a fetus to make new purple blood cells. “So as to get oxygen to all the vital organs in our physique, our physique depends on having these purple blood cells. And so it will probably trigger coronary heart failure and even development to loss of life by having low blood counts.”

Though the illness impacts largely kids, when adults do catch it, it will probably trigger extra extreme signs, together with joint ache and anemia, which end result from issues in creating purple blood cells, stated Dr. Vincent Iannelli, a pediatrician within the Dallas space. Low purple blood cell counts could cause being pregnant problems.

Sufferers with sickle cell illness are additionally at excessive threat.

“Over the previous month or two, I believe we’ve been seeing extra instances,” Iannelli stated. Usually Iannelli would see one case of Fifth illness monthly; he stated he’s now seeing one to 2 instances per week, noting that the virus is extra widespread within the spring and summer time.

What are signs of Fifth illness? 

In kids, Fifth illness is usually gentle — its most distinctive signs embody a fever and respiratory signs, adopted by a purple rash on the cheeks, then a “lacy” rash on the remainder of the physique, which can be itchy.

The rash seems towards the top of the an infection and usually disappears in seven to 10 days, however it might final for a number of weeks. Importantly, somebody with Fifth illness is now not contagious as soon as the rash seems. “Sadly, by the point you realize your child has it, they’re not contagious anymore,” Iannelli stated.

The rash can turn out to be extra pronounced in warmth and daylight, nevertheless it would not make the an infection worse, Iannelli stated.

Pregnant girls who expertise signs like joint ache and issues in producing purple blood cells ought to notify their docs instantly, particularly in the event that they know they’ve been in touch with sufferers contaminated with Fifth illness, docs say.

Iannelli doesn’t imagine the rise in instances is trigger for alarm.

“Fortuitously, most pregnant girls had it once they had been children, in order that they’re resistant to it, however each on occasion we do see adults,” he stated. 

In the end, “when you’re wholesome, it’s a gentle illness,” Iannelli stated. “When you have immune system issues or when you’re pregnant, early in your being pregnant it is best to inform your physician. However for everyone else, it’s mainly only a rash.”

He famous that the CDC alert was meant to lift consciousness amongst docs, to not concern the general public.

Why is it referred to as Fifth illness?

Within the early 1900s, docs developed a listing of widespread childhood rashes to assist them be extra exact of their diagnoses. They recognized six main rashes:

• Measles, a extremely contagious virus that may trigger rash, excessive fever and respiratory signs.
• Scarlet fever, a bacterial an infection brought on by group A streptococcus. 
• Rubella, a viral an infection also called German measles. If somebody is uncovered throughout being pregnant, the virus could cause miscarriage or stillbirth. The CDC recommends two doses of the mumps-measles-rubella vaccine for youngsters. 
• Filatov-Dukes, now not thought-about a definite illness. 
• Fifth Illness, or parvovirus B19, also called erythema infectiosum.
• Roseola, a viral an infection often nonetheless referred to as Sixth illness, which might trigger excessive fever and rash. 

There are actually extra acknowledged childhood rashes, akin to chickenpox, so the numbering system isn’t used anymore, apart from Fifth illness.

On the hospital, Parks, now at 30 weeks, is being monitored intently. She desires different pregnant girls to concentrate on the virus and get examined if they’ve been uncovered.

“It has been actually probably the most tough expertise to undergo,” Parks stated. “He wasn’t assured to return by way of the fetal anemia.” 

CORRECTION (August 15, 2024, 11:04 a.m. ET): An earlier model of this text misstated Dr. Kathy Bligard’s affiliation. She is a Washington College OB-GYN at Barnes Jewish Hospital in St. Louis, not Washington College Hospital.