Slapped cheek disease

Our resident doctor answers your health questions


‘My daughter’s nursery has reported a case of slapped cheek virus. It sounds awful, plus I am eight weeks pregnant and have heard this illness can cause miscarriage. What is the risk to me and my daughter, and how should I proceed?’ Sam, The Lakes

Dr Zainab Malik, Consultant Paediatrician – American Board Certified in Pediatric Infectious Diseases at City Hospital, says:

‘Slapped cheek’, also known as Fifth Disease or Erythema Infectiousum, is caused by a virus called ‘parvovirus B19’. The typical ‘slapped cheek’ appearance of the rash is usually preceded by mild fever and achiness. The rash on the face is intensely red, and actually looks as though the child has been slapped in the face.

Some children develop a lacy-appearing, slightly itchy rash on the rest of their body as well, which can fluctuate in intensity and come and go for weeks. The most infectious phase of this illness is the period immediately preceding the rash: children are not considered contagious once they develop the rash on their face or body.

Fifth disease is highly contagious, and is spread through respiratory droplets from coughs or sneezes, or from saliva. Children are most likely to catch it in late winter or early spring from other children in nursery or daycare settings. Symptoms of parvovirus infection in teenagers and adults tend to be more severe than in children.

As a parent, it’s not an infection to worry about, since it is one of those typically common childhood infections that the vast majority of kids pick up. Usually, the incubation period of parvovirus can be as long as 14 days from the time of exposure, and during that period, your child might not show any symptoms at all. Usually, children who are coming down with slapped cheek tend to suffer from pretty non-specific ailments, like a runny nose, a slight cough or a fever that goes up and down. They might also feel tired and unwell – but nothing that would actually indicate they are suffering from the virus until the actual rash becomes apparent.

Once the rash appears, although the child will feel better and no longer be contagious, but they could feel pretty uncomfortable. The rash on the body is itchy, and certain things like exposure to sunshine, heat, soap and warm water can make it flare up again. The best action is to treat it topically with calamine lotion and offer an antihistamine to help prevent the itching, especially at night. Keeping the skin moisturized also helps decrease the irritation.

Be aware that the rash could be with your child for some time, and can take weeks or months to completely resolve. Since this infection is caused by a virus, antibiotics have no role in treatment, and unnecessary antibiotics should be avoided in children.

Most adults have been exposed to parvovirus in childhood, and have immunity against developing the disease. However, if you are pregnant and don’t have immunity, there can be some risk to the unborn baby in the first 20 weeks of pregnancy. For pregnant women who don’t have immunity against parvovirus, there is a two to six percent risk of miscarriage after exposure to this virus.

Slapped cheek can potentially cause anaemia in the foetus, too, so if you think you’ve never had the virus, you should ask your doctor to test your immunity. If you discover you don’t have immunity, don’t panic. Your doctor will probably advise monitoring your pregnancy closely, and doing regular scans to ensure the baby’s growth is progressing normally. Statistically, the chances of your baby being fine are well in your favour.

For more information, contact Dr Zainab Malik at City Hospital (04 435 9999).

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