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Slapped Cheek Syndrome

What is “Slapped Cheek Syndrome” ?

Slapped Cheek Syndrome (sometimes called Fifth Disease) is caused by the parvovirus B19 virus. It is a mild rash illness that occurs most commonly in children. The ill child typically has a “slapped cheek” rash on the face and a lacy red rash on the trunk and limbs. Occasionally, the rash may itch. An ill child may feel unwell and have a low grade fever or a “cold” few days before the rash breaks out. The child is usually not very ill, and the rash resolves in 7 to 10 days.

Can adults get parvovirus B19 infection ?
Yes, they can. An adult who is not immune can be infected with parvovirus B19 and either have no symptoms or develop the typical rash of slapped cheek syndrome, joint pain/ swelling or both. They joint pain and swelling usually resolve in a week or two, but may last longer. However, most adults have previously been infected with parvovirus B19 and have developed lifelong immunity to the virus and cannot become infected again.

Is parvovirus B19 infectious ?
Yes. A person infected with parvovirus B19 is infectious during the early part of the illness, before the rash appears. By the time a child has the characteristic “slapped cheek” rash he/she is probably no longer contagious.

How does someone get infected with parvovirus B19 ?
Parvovirus B19 has been found in the respiratory secretions (e.g. saliva, sputum, or nasal mucus) of infected persons before the onset of a rash, when they appear to “just have a cold”. The virus is probably spread from person to person by direct contact with those secretions, such as sharing cutlery, cups, drinks, drinking glasses etc.

Is parvovirus B19 infection serious ?
Parvovirus B19 is usually a mild illness that resolves on its own. Parvovirus B19 infection may cause a serious illness in persons with chronic red blood cell disorders (e.g. sickly cell anaemia or spherocytosis) or a weakened immune system. Rarely, serious complications may develop from parvovirus B19 infection during early pregnancy.

Can parvovirus B19 infection be prevented ?
There is no vaccine or medicine that prevents parvovirus B19 infection. Frequent hand washing is recommended to decrease the chance of becoming infected. People should also avoid sharing cutlery, cups, drinks, drinking glasses etc.

Should children with parvovirus be excluded from school ?
Excluding pupils with slapped cheek syndrome from school is not likely to prevent the spread of the virus. People are infectious before they develop the rash and it becomes clear that they have slapped cheek syndrome. Cases of slapped cheek syndrome in a school most commonly happen when the infection is spreading in the community.

I am pregnant and have been exposed to a child with parvovirus B19. What should I do ?
You should contact your doctor, who may wish to do a blood test. Usually, there is no serious complication for a pregnant woman or her baby if exposed to a person with slapped cheek syndrome. Most 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 develop any problems due to parvovirus B19 infection. However, sometimes parvovirus B19 infection may cause miscarriage or severe anaemia in the unborn baby. There is no evidence that parvovirus B19 infection causes birth defects or developmental delay.

 

Your doctor will be able to answer any further questions that you might have concerning Slapped Cheek Syndrome.

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