The parvovirus B19 is not usually tested for in pre-conception or antenatal screenings. It is a very common infection that is found in children and transmitted to adults. The illness is contagious in the week before the rash appears. Parvovirus infection has also been known as fifth disease because, historically, it was one of five common childhood illnesses characterized by a rash.In most children, parvovirus infection is mild and requires little treatment. 593-596. Pregnant women are not routinely screened for past parvovirus B19 infection as there is no vaccine or preventative treatment … 5:32-3. Primate erythroparvovirus 1, generally referred to as B19 virus, parvovirus B19 or sometimes erythrovirus B19, was the first known human virus in the family Parvoviridae, genus Erythroparvovirus; it measures only 23–26 nm in diameter. Clinical aspects of parvovirus B19 infection. The most common clinical encounter with parvovirus B19 is as the causative agent of erythema infectiosum (fifth disease). Vol 2: 65. Drugs, encoded search term (Parvovirus B19 Infection) and Parvovirus B19 Infection, Renal Manifestations of Sickle Cell Disease, Ophthalmologic Manifestations of Sickle Cell Disease (SCD), Neurology Clinical Practice Guidelines - 2020 Year in Review, Oncology and Hematology Clinical Practice Guidelines - 2020 Year in Review, Hospital Medicine Clinical Practice Guidelines - 2020 Year in Review, Report May Inform First Dietary Guidelines for Americans From Birth to 24 Months, Kindergartner in Texas Reportedly Dies From COVID-19, Neonatal Resuscitation Clinical Practice Guidelines (AHA, 2020), A Teenager With Fever Who Can’t Talk After Visiting Mexico. The IgM antibody should eventually clear and convert entirely over to IgG antibody. American Academy of Pediatrics Committee on Infectious Diseases. However, its role in the latter remains not completely understood. [Full Text]. Parvovirus B19 is a non-enveloped, icosahedral virus, containing a single-stranded, linear DNA genome 2). Vol 2: 1840-1847. Transfusion. The IgM antibody test diagnoses acute infection, the IgG antibody test diagnoses exposure in the past. Like COVID-19 or the common cold, parvovirus B19 spreads by way of infected bodily fluids. J Infect Dis. Parvovirus B19 which causes Fifth disease, spreads through respiratory secretions, such as saliva, sputum, or nasal mucus, when an infected person coughs or sneezes. Antibacterial and antiendotoxin treatments. Once you’ve become infected with parvovirus B19, you acquire lifelong immunity. When Should Students Resume Sports After a COVID-19 Diagnosis? Parvovirus infection is a common and highly contagious childhood ailment — sometimes called slapped-cheek disease because of the distinctive face rash that develops. Parvovirus B19 clearance from peripheral blood after acute infection. A linked donor-recipient study to evaluate parvovirus B19 transmission by blood component transfusion. 109 (5):311-323. Mini-outbreaks of parvovirus B19 infection occur about every three to four years. While mucus and saliva are the most common vectors, the virus can also spread through blood. Patient suffering with fever caused due to parvovirus are treated with tylenol and motrin. J Infect Dis. Experimental parvoviral infection in humans. J Obstet Gynaecol Can. This disease despite being produced by a virus, there is no antiviral on the market to eliminate this disease, since it has very mild symptoms and simply disappear. Jrnl Internal Med. In parts of the world with changing seasons, people tend to get infected with parvovirus B19 more often in late winter, spring, and early summer. Fifth disease is usually mild for children and adults who are otherwise healthy. The major clinical manifestations that can occur with parvovirus B19 infection include: Erythema infectiosum. 1975. [Medline]. have an illness that might be caused by parvovirus B19. Also, their babies usually do not have any problems. Young NS, Brown KE. have been exposed to someone with Fifth disease, have an illness that might be caused by parvovirus B19 infection, or. Philadelphia, PA: Lippincott Williams & Wilkins; 2007. 2009 Aug. 14(4):218-21. B19 virus is most known for causing disease in the pediatric population; however, it can also affect adults. Intravenous immunoglobulin (IVIG) is not recommended for transient aplastic crisis. Landry ML. 2006 May. All material on this website is protected by copyright, Copyright © 1994-2021 by WebMD LLC. Case report: aplastic crisis in sickle cell disorders: bone marrow necrosis and human parvovirus infection. 1988. [Medline]. Bredl S, Plentz A, Wenzel JJ, Pfister H, Möst J, Modrow S. False-negative serology in patients with acute parvovirus B19 infection. One type, parvovirus B19, infects only humans. Please confirm that you would like to log out of Medscape. Kimberlin DW, Brady M, Jackson SA, Long SS, eds. Human, Canine, and Feline Parvovirus. [Medline]. People who are at risk of severe parvovirus complications might benefit from blood tests that can help determine if they're immune to parvovirus or if they've recently become infected. [Medline]. But this is not common. Hematologic and hematopoietic consequences of B19 parvovirus infection. [Medline]. Parvo treatment vary, depending on the severity. 2(8247):595-7. Birth Defects Res. But parvovirus B19 can cause different signs and symptoms, depending on your age and overall health. 2018 Nov. 58 (11):2617-2626. In some individuals with human immunodeficiency virus (HIV) infection, highly active antiretroviral therapy restores immune function, enabling resolution of chronic parvovirus B19 infection. [Medline]. Though aspirin is approved for use in children older than age 3, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. Blood. 2015 Red Book: Report of the Committee on Infectious Diseases. About half of adults are immune to parvovirus infection, most likely because of a previous, unnoticed childhood infection. Douvoyiannis M, Litman N, Goldman DL. Elk Grove Village, IL: American Academy of Peiatrics; 2015. Classically, primary PVB19 infection, which occurs most commonly in children, manifests as erythema infectiosum [3]. Parvovirus B19 infects only humans, sometimes called “Fifth disease”, “erythema infectiosum” or “slapped-cheek disease” because of the distinctive face rash that develops 1). Fever does not always require treatment with antipyretics; however, consider antipyretics if a patient appears clinically uncomfortable. 4 (3):1-13. Patients with classic erythema infectiosum are no longer contagious after the rash has appeared. 1995. Mini-outbreaks of parvovirus B19 infection occur about every 3 to 4 years. Thus, children with a classic parvovirus B19 rash may return to school or daycare 3). 38:81. Image courtesy of CDC. 2009. 1985. Since parvovirus B19 only infects humans, a person cannot get the virus from a dog or cat. Acetaminophen (Tylenol, others) may help to relieve temperatures of more than 102 °F (39 °C) or minor aches and pains. Brown KE. Broliden K, Tolfvenstam T, Norbeck O. This is not a routine test but can be performed in special circumstances. Infections with parvovirus B19 tend to occur more often in the late winter, spring, and early summer. Elk Grove Village, IL: American Academy of Peiatrics; 2015. Feigin RD, Cherry JD, Demmler-Harrison GJ, Kaplan SL, eds. 30th ed. By age 30, about 60% of adults develop seropositivity from 5-10% in children aged 2-5 years. It usually goes away without any long-term problems. Intravenous immunoglobulin (IVIG) has been used with good results for patients suffering pure red cell aplasia 5). 7. Clin Infect Dis. The Human Parvovirus B19 is not the same Parvovirus that vets may be concerned about in pets, especially dogs, and it cannot be passed from humans to animals or vice versa. People who have complications from fifth disease should see their healthcare provider for medical treatment. Joseph Domachowske, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American Society for Microbiology, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta KappaDisclosure: Received research grant from: Pfizer;GlaxoSmithKline;AstraZeneca;Merck;American Academy of Pediatrics, Novavax, Regeneron, Diassess, Actelion
Received income in an amount equal to or greater than $250 from: Sanofi Pasteur. People with Fifth disease can also develop pain and swelling in their joints. It happens less than 5% of the time among all pregnant women with parvovirus B19 infection, and it happens more commonly during the first half of pregnancy. Patients in aplastic crisis require packed red blood cell transfusions 7). The rash may be itchy, especially on the soles of the feet. There is no vaccine or medicine that can prevent parvovirus B19 infection. Young NS. Papular-purpuric "gloves and socks" syndrome: polymerase chain reaction demonstration of parvovirus B19 DNA in cutaneous lesions and sera. You do not have to go for expensive medical treatment for parvo. Prompt treatment was started because of the high level of certainty of viral-associated hemophagocytic lymphohistiocytosis, and the patient was successfully treated with prednisolone administration. This disease is usually not a problem for pregnant women and their babies. 2002 droxia-hydrea-hydroxyurea-342100 You may also have painful or swollen joints. There is no vaccine or medicine that can prevent parvovirus B19 infection. Once the rash appears, the person with the illness is no longer considered contagious and doesn’t need to be isolated. However, the overall risk of fetal loss while pregnant is 2% to 6% 4). Use caution when giving aspirin to children or teenagers. 2018 Jul 4. 48(12):1713-23. Management and outcome of pregnancies with parvovirus B19 infection over seven years in a tertiary fetal medicine unit. 114(17):3677-83. 1087-1091. Yes, human to human: Parvovirus b19 is a causative organism of fifth disease in children. Parvovirus B19. Local outbreaks of human parvovirus infection tend to be cyclical. 25(4):373-8. Neurologic manifestations associated with parvovirus B19 infection. [Medline]. [8] IVIG is not recommended for TAC. Outbreaks of the infection are common in preschool and young school aged children. Williams Obstetrics. Mendelson E, Aboudy Y, Smetana Z, Tepperberg M, Grossman Z. It is more common in children than adults. Parvovirus B19 infection can cause serious complications for people with anemia, a condition in which red blood cells, which carry oxygen to all the parts of your body, are used up faster than your bone marrow can replace them. Anderson LJ, Hurwitz ES. Cherry JD, Schulte DJ. Jrnl Internal Med. 2006. More severe cases could include glucose, tube feeding and as a last resort: blood transfusion. You only need to rehydrate your dog, kill the bacterial and viral infections in him, and replenish the nutrients and electrolytes he … Healthcare providers can often diagnose fifth disease just by seeing “slapped cheek” rash on a patient’s face. The prevalence of parvovirus B19 in developed countries in children younger than five years is 2% to 10%, 40% to 60% in adults older than 20 years, and 85% or more in people 70 years and older. The human parvovirus B19 only infects humans and is different from the parvovirus seen in dogs and cats, so you can’t get the parvovirus B19 infection from a pet or vice versa. [Medline]. 75(3):373-6. Hydrops fetalis is defined as an abnormal collection of fluid in at least two different fetal organ spaces, including ascites, pleural effusion, pericardial effusion, and skin edema. Dollat M, Chaigne B, Cormier G, Costedoat-Chalumeau N, Lifermann F, Deroux A, et al. In some cases, however, infection is associated with sufficiently severe complications that treatment is indicated and may be lifesaving. 593-596. Cossart YE, Field AM, Cant B et al. Treatment for parvovirus B19 The infectious erythema produced by the parvovirus B19 virus is a disease that resolves quickly and without complications. 2005 Feb 22. If the arthritis does not get beeter, other types of arthritis should be considered and the positive test for parvovirus IgM repeated. It can vary in intensity and usually goes away in seven to 10 days, but it can come and go for several weeks. In adults, primary PVB19 infection may manifest as arthropathy [4], and infection during pregnancy can lead to hydrops fetalis [5]. Adults can get infected with parvovirus B19, too. The joint pain usually lasts 1 to 3 weeks, but it can last for months or longer. 1:72. Schneider, E. Human Parvoviruses. Parvovirus B19 (PVB19) is a single-stranded DNA virus that infects the majority of humans [1]. On exam, one will find petechiae and purpura with a sharp demarcation at the wrists and ankles. You can reduce your chance of being infected with parvovirus B19 or infecting others by. Arry Dieudonne, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, Pediatric Infectious Diseases SocietyDisclosure: Nothing to disclose. Crane J, Mundle W, Boucoiran I, Gagnon R, Bujold E, Basso M, et al. Pet dogs and cats can get infected with other parvoviruses that do not infect humans. A standard treatment plan will include fluids, antibiotics, anti-nausea medicines, antacids, probiotics, vitamins, and electrolyte supplement. Vol 2: 1840-1847. Most of the time papular purpuric gloves and socks syndrome resolves on its own without any complications. Some people may get a second rash a few days later on their chest, back, buttocks, or arms and legs. Patients should be monitored for relapsed viremia. Once you recover from fifth disease, you develop immunity that generally protects you from parvovirus B19 infection in the future. Persistence of human parvovirus B 19 in human tissues. Tolfvenstam T, Broliden K. Parvovirus B19 infection. [Medline]. There is no specific antiviral treatment for parvovirus infection. Lindblom A, Heyman M, Gustafsson I, Norbeck O, Kaldensjo T, Vernby A. Parvovirus B19 infection in children with acute lymphoblastic leukemia is associated with cytopenia resulting in prolonged interruptions of chemotherapy. [8, 2, 28, 41]. 2018 Nov. 52 (5):569-576. Laboratory assessment and diagnosis of congenital viral infections:Rubella, cytomegalovirus (CMV), varicella-zoster virus (VZV),herpes simplex virus (HSV), parvovirus B19 andhuman immunodeficiency virus (HIV). Risk associated with human parvovirus infection. 260:285-304. Drugs, 2010 2004 Feb 5. [Medline]. Glenn Fennelly, MD, MPH Director, Division of Infectious Diseases, Lewis M Fraad Department of Pediatrics, Jacobi Medical Center; Clinical Associate Professor of Pediatrics, Albert Einstein College of Medicine Lancet. It is estimated that around 50% of young men and women have antibodies against B19V, determined via serology tests[1]. In: StatPearls [Internet]. If anything comes to mind when parents hear the word “parvovirus,” it’s usually something to do with dogs or cats. Most babies born to mothers with the infection are born asymptomatic and full term. 1996 Jun. Talk to your healthcare provider. Tschope C, Bock CT, Kasner M, Noutsias M, Westermann D, Schwimmbeck PL. Antibacterial treatment in one experimental study treatment of parvovirus infected dogs, treatment with fluids and antibiotics (procaine penicillin-G 20,000 IU/kg and dihydrostreptomycin 20 mg/kg) improved survival from 10% in untreated dogs to 90%. Patients are no longer infectious after other symptoms resolve (usually by day 7 of illness). Treatment of Parvovirus in Humans Most of the asymptomatic children may not need any treatment for parvovirus infection. You may want to talk to your healthcare provider if you have a weakened immune system, sickle cell disease or a similar long-lasting anemia and you: Your healthcare provider may want to test your blood to see if you have parvovirus B19 infection. [Medline]. Kimberlin DW, Brady M, Jackson SA, Long SS, eds. Pediatric infectious disease specialist or immunologist: Patients with long-term or unusual parvovirus B19 infections can benefit from consultation with a pediatric subspecialist in infectious diseases or immunology. Brown KE. Clin Infect Dis. Semin Hematol. Outcome of fetuses with congenital parvovirus B19 infection: systematic review and meta-analysis. [9]. These patients may benefit from treatment with IVIG. This website also contains material copyrighted by 3rd parties. Bennet JE, Dolin R, Blaser M. Mandell, Douglas and Bennett's Principals and Practice of Infectious Diseases. /viewarticle/942286 Bennet JE, Dolin R, Blaser M. Mandell, Douglas and Bennett’s Principals and Practice of Infectious Diseases. 8th ed. Fifth disease is a mild rash illness caused by parvovirus B19. [Medline]. [Medline]. [9], Patients with aplastic crisis, papular-purpuric "gloves and socks" syndrome (PPGSS), or immunosuppression and chronic parvovirus B19 infection with anemia should be isolated with droplet and standard precautions due to ongoing viremia. Patients with parvo infection recover within few days after the infection without any treatment. 6th ed. Parvovirus B19. Human Parvovirus Infections. Long SS, Pickering LK, Prober CG, eds. 868-892. 2006 Jul 1. In some studies, more than 80% of patients with sickle cell disease in transient aplastic crisis have required transfusion 8). Vol 2: 1902-1920. Parvovirus B19 Infection Treatment & Management. Ornoy A, Ergaz Z. Parvovirus B19 infection during pregnancy and risks to the fetus. (adsbygoogle = window.adsbygoogle || []).push({}); (adsbygoogle = window.adsbygoogle || []).push({ As it starts to go away, it may look lacy. Parvovirus B19. It most commonly occurs in children aged between 3-15 years. 2016 Jun 23. There is no vaccine or medicine that can prevent parvovirus B19 infection. Your healthcare provider may recommend additional prenatal visits, blood tests, and ultrasounds. If a serum anti-B19 IgM antibody is positive, it indicates infection within the previous two to four months. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Medscape Education, From Terminology to Techniques: Gene Therapy for β-Hemoglobinopathies, 2010 1981. }); Parvovirus B19 Fifth disease signs and symptoms, Papular purpuric gloves and socks syndrome, Parvovirus B19 infection during pregnancy, Parvovirus B19 and Fifth Disease. google_ad_client: "ca-pub-9759235379140764", You are most contagious when it seems like you have “just a fever and/or cold” and before you get the rash or joint pain and swelling. Treatment usually involves relieving symptoms, such as fever, itching, and joint pain and swelling. Patients should be monitored for relapsed viremia 6). Parvoviruses have long been known to be significant causes of disease in animals. Resolution of infection depends on the presence of immunoglobulins against parvovirus B19. 43(3):809-21. Medical Care. 2006 May. It’s impractical and unnecessary to isolate your sick child. After you get the rash you are not likely to be contagious, so then it is usually safe for you or your child to go back to work or school. 43(1):40-8. Luzzi GA, Kurtz JB. This makes sense. [Medline]. Ultrasound Obstet Gynecol. Arry Dieudonne, MD Associate Professor of Pediatrics, Division of Pulmonology, Allergy, Immunology and Infectious Diseases, Rutgers New Jersey Medical School; Clinical Director, Francois-Xavier Bagnold Center for Children, University Hospital Parvovirus B19 can also cause anemia and related complications in: Papular purpuric gloves and socks syndrome usually occurs in young adults but can occur at any age. You can reduce your chance of being infected or infecting others by 1. washing your hands often with soap and water 2. covering your mouth and nose when you cough or sneeze 3. not touching your eyes, nose, or mouth 4. avoiding close contact with people who are sick 5. staying home when you are sickOnce you get the rash, you are probably not contagious. 30th ed. Soderlund-Venermo M, Hokynar K, Nieminen J et al. Some adults with fifth disease may only have painful joints, usually in the hands, feet, or knees, and no other symptoms. However, in some adults, the parvovirus B19 infection can be serious. Few adults with parvovirus infection may suffer with nausea, vomiting and diarrhea. Parvo Treatment parvo in dogs. Patients in aplastic crisis require packed RBC transfusions. Parvovirus B19. 2015 Red Book: Report of the Committee on Infectious Diseases. Human Parvovirus B19. Hirai Y, Takeda Y. Atypical rashes in adult human Parvovirus B19 infection; atypical is typical. Pediatr Infect Dis J. In some individuals with human immunodeficiency virus (HIV) infection, highly active antiretroviral therapy restores immune function, enabling resolution of chronic parvovirus B19 infection 9). Share cases and questions with Physicians on Medscape consult. [9], Pregnant staff should be alerted to the potential risks of parvovirus B19 infection when caring for these patients. In rare cases, some of these symptoms can persist for a long time. Intravenous immunoglobulin (IVIG) has been used with good results for patients suffering pure red cell aplasia (PRCA). Feigin & Cherry's Textbook of Pediatric Infectious Diseases. People with fifth disease who have weakened immune systems may be contagious for a longer amount of time. Parvovirus B19 infection after transplantation: a review of 98 cases. 2007 Feb 1. PVB19 has a propensity to infect erythroid progenitor cells an… In patients receiving immunosuppressive agents, temporarily decreasing the dose of immunosuppressive agents usually enables the immune system to produce sufficient immunoglobulin G (IgG) to eradicate the infection and confer lifelong protection. Fields Virology. Elementary school child with Fifth Disease. Eid AJ, Brown RA, Patel R, Razonable RR. Parvovirus B19 infection can cause painful or swollen joints (polyarthropathy syndrome), which is more common in adults. Failey CK, Smoleniec JS et al. Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug ReferenceDisclosure: Nothing to disclose. Human parvovirus, or parvovirus B19, is a common infectious viral disease that is spread from person to person. Seroepidemiologic studies demonstrate that 60%–90% of adults have antibodies against PVB19 [2]. Clin Infect Dis. They are usually mild or asymptomatic, and do not require treatment. After a person becomes infected with erythema infectiousum, immunity is obtained that protects one from infection in the future. Parvovirus B19 has been linked with various clinical syndromes including neurological manifestations. Polymerase chain reaction (PCR) testing from the serum or tissue can also be used. The symptoms will reduce without any medication. The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous coauthor Dennis Cunningham, MD, to the original writing and development of this article. This disease, also called erythema infectiosum, got its name because it was fifth in a list of historical classifications of common skin rash illnesses in children. Parvovirus B19. Extra-haematological manifestations related to human parvovirus B19 infection: retrospective study in 25 adults. You may get a red rash on your face called “slapped cheek” rash. Although uncommon, this may cause severe anemia that could lead to hydrops fetalis, miscarriage or stillbirth. 260:285-304. Broliden K, Tolfvenstam T, Norbeck O. Parvovirus B19 is the only virus of the Parvoviridae family that is infectious to humans. You may be at risk for serious complications from fifth disease if you have a weakened immune system caused by leukemia, cancer, organ transplants, or HIV infection. [Medline]. Undefined. 1989. Infections. Humans can contract a human version of parvovirus, but this is a different strain from the one that affects dogs. Pattison JR,Jones SE, Hodgson J et al. 1981 Sep 19. 21(4):421-35. A person usually gets sick with Fifth disease within four to 14 days after getting infected with parvovirus B19. Ergaz Z, Ornoy A. Parvovirus B19 in pregnancy. Bascietto F, Liberati M, Murgano D, Buca D, Iacovelli A, Flacco ME, et al. Lancet. However, in some adults, the infection can … David J Cennimo, MD, FAAP, FACP, AAHIVS Assistant Professor of Medicine and Pediatrics, Adult and Pediatric Infectious Diseases, Rutgers New Jersey Medical School SUMMARY Parvovirus B19 (B19) was discovered in 1974 and is the only member of the family Parvoviridae known to be pathogenic in humans. Pregnant women who are not immune usually have only mild illness if they are exposed to fifth disease. 1988. Hematologist: Patients who present with aplastic crisis require intensive monitoring and RBC transfusions to prevent death and should be evaluated by a hematologist. Despite the inability to propagate the virus in cell cultures, much has been learned about the pathophysiology of this virus, including the identification of the cellular receptor (P antigen), and the control of the virus by the immune system. Pets can be vaccinated to protect them from parvovirus infection. 2006. Children and adults who are otherwise healthy usually recover completely. This is because aspirin has been linked to Reye’s syndrome, a rare but potentially life-threatening condition, in such children. However, sometimes in case of severe itching in soles or joint pain patient may be recommended symptomatic treatment. [Medline]. Parvovirus B19 most commonly causes Fifth disease, a mild rash illness that usually affects children. [9], Maintain precaution for patients with TAC for 7 days or until the reticulocyte count rebounds to at least 2%, whereas those with chronic infection should be isolated for the duration of their stay. Principles and Practice of Pediatric Infectious Diseases. Tamiflu is increasingly being used to combat parvovirus, with encouraging results. [Medline]. Self-care treatment is aimed primarily at relieving signs and symptoms and easing any discomfort. Humans cannot get parvovirus from their dogs, however they can pass parvo from one dog to another on their clothes, shoes or hands. Clinical Review, You are being redirected to Parvovirus infection during pregnancy sometimes affects red blood cells in the fetus. People with severe anemia may need to be hospitalized and receive blood transfusions. Remington JS, Klein JO, Wilson CB, Baker CJ. Reprod Toxicol. [Medline]. Parvovirus B19 infection in some pregnant women can lead to serious health problems for the fetus. were recently infected with parvovirus B19. American Academy of Pediatrics Committee on Infectious Diseases. Hydrops fetalis is not itself a disease, but an ultrasound marker of other fetal complications. 8th ed. 1995. This rash is the most recognized feature of Fifth disease. J Clin Virol. Parvovirus infection: Infection with one of a family of small single-stranded DNA viruses. 1985 Aug. 152(2):257-65. Note the right side of this boy's face displaying signs of erythema infectiosum, or Fifth disease. [Medline]. Mustafa MM, McClain KL. Fetal risk appears greatest during the first half of the pregnancy (before 20 weeks gestation). Philadelphia, PA: Saunders Elsevier; 2009. 21(4):421-35. washing your hands often with soap and water, covering your mouth and nose when you cough or sneeze, avoiding close contact with people who are sick, sickle cell disease or similar types of long-lasting anemia or problems producing red blood cells, or. Other much less common symptoms of parvovirus B19 infection include painful or swollen joints (polyarthropathy syndrome), which is more common in adults, and severe anemia (a condition in which the body doesn’t have enough healthy red blood cells). Semin Fetal Neonatal Med. 2017 Mar 15. [Medline]. Most fetal losses occur in the second trimester. [Medline]. Ferrari B, Díaz MS, López M, Larralde M. 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