Fifth disease and pregnancy


  • Fifth disease is a common childhood illness. It often starts with cold-like symptoms followed by a rash. 

  • If you’ve had fifth disease, you can’t get it again. If you do get it during pregnancy, it usually doesn’t cause problems. 

  • If you get infected during pregnancy, you can pass it to your baby. This can cause miscarriage or stillbirth, but this is rare. 

  • To help prevent fifth disease infection, wash your hands often with soap and water, especially after being around children.

What is fifth disease?

Fifth disease (also called erythema infectiosum) is a common childhood illness. In children, it starts with cold-like symptoms followed by a rash. It’s called fifth disease because many years ago, it appeared fifth in a list of common skin rashes in children. If you have fifth disease as a child, you can’t get it again. 

If you get infected with fifth disease during pregnancy, it usually doesn’t cause problems. You can pass it to your baby during pregnancy, which can cause miscarriage and stillbirth. But this is rare. About half of all pregnant women are immune to fifth disease because they had it in the past.

What causes fifth disease?

A virus called parvovirus B19 causes fifth disease. Fifth disease spreads easily, like a cold. You can get it through hand-to-hand contact with an infected person or through fluids from the nose, mouth and throat that spread through an infected person’s cough or sneeze. Fifth disease also can spread through blood, which is why you can pass it to your baby during pregnancy. Fifth disease outbreaks are most common during the winter and spring among children, but anyone can get infected at any time of the year.

What problems can fifth disease cause in pregnancy?

Fifth disease usually doesn’t cause problems for pregnant women and their babies, but it can affect the way the body makes red blood cells. Red blood cells carry oxygen throughout the body. You may have complications from fifth disease if you have:

  • Sickle cell anemia. Sickle cell anemia is the most common form of sickle cell disease (also called SCD). SCD is a condition in which the red blood cells in your body are shaped like a sickle (like the letter C). In a healthy person, red blood cells are round and flexible. They flow easily in the blood. A person with SCD has red blood cells that are stiff and can block blood flow. This can cause pain, infections, organ damage and stroke.
  • A weak immune system due to cancer (like leukemia blood cancer) or HIV infection. HIV stands for human immunodeficiency virus. It’s a virus that attacks the body’s immune system. Over time, HIV can destroy the cells in the immune system so that it can’t protect the body. When this happens, HIV can lead to AIDS (acquired immune deficiency syndrome).

If you get infected with fifth disease during pregnancy, the virus can make it hard for your baby to make red blood cells. Rarely, this can lead to a severe anemia that can cause: 

  • Hydrops fetalis. This is -a buildup of fluid in your baby’s body. Hydrops can cause heart failure and death.
  • Miscarriage. This is when a baby dies in the womb before 20 weeks of pregnancy.
  • Stillbirth. This is when is when a baby dies in the womb after 20 weeks of pregnancy.

These kinds of serious problems happen in less than 1 in 20 (5 percent) of women who become infected during pregnancy. They usually happen during the first half of pregnancy. 

Who is at risk of getting fifth disease?

Fifth disease is common in children 5 to 15 years old. People with young children and those who work with children (like child care providers and teachers) are most likely to get infected with fifth disease. If a child in your home has fifth disease, there is a 1 in 2 chance (50 percent) that another family member who hasn’t had the infection will get it. Remember that once you’ve had fifth disease, you can’t get infected again. 

What are the signs and symptoms of fifth disease?

Signs of a condition are things someone else can see or know about you, like you have a rash or you’re coughing. Symptoms are things you feel yourself that others can’t see, like having a sore throat or feeling dizzy. Signs and symptoms of fifth disease usually appear between 4 and 14 days after infection. 

Signs and symptoms of fifth disease are usually mild and may include:

  • Rash on the face, sometimes called a slapped-cheek rash. A rash is most common in children younger than 10. The rash often spreads to the arms, legs and torso. It can last from 1 to 3 weeks. A child with fifth disease is most contagious before the rash appears and isn’t contagious after the rash appears.
  • Fever
  • Runny nose, sore throat and swollen glands
  • Headache
  • Diarrhea
  • Joint pain or swollen joints, especially in older teens and adults. Fifth disease most often affects the hands, wrists, knees and ankles.  
  • Red eyes

About 1 in 5 people (20 percent) who gets infected with fifth disease doesn’t have any signs or symptoms. 

If you think you’ve come in contact with fifth disease or you have signs or symptoms, tell your health care provider right away. If you have a rash, your provider may be able to diagnose fifth disease during a physical exam. If you don’t have a rash, your provider can test your blood for the infection. 

How is fifth disease treated?

Fifth disease is usually mild and goes away on its own. If you’re pregnant and have fifth disease, your health care provider monitors your pregnancy closely to check for problems with your baby. If your baby has fifth disease, chances are the infection will go away on its own. Your provider checks your baby’s health during routine prenatal care checkups.

Your provider may recommend that you have ultrasounds to check your baby’s health. An ultrasound is a prenatal test that uses sound waves and a computer screen to show a picture of your baby inside the womb. If an ultrasound shows that your baby is having problems, your provider may recommend amniocentesis (also called amnio) to confirm the infection. Amniocentesis is a prenatal test that takes amniotic fluid from around your baby in the uterus (also called womb). The fluid is tested to see if your baby has certain health conditions. 

If an ultrasound shows that your baby has hydrops fetalis, your provider may use a procedure called cordocentesis to find out how severe your baby’s anemia is. For this test, your provider inserts a thin needle into an umbilical cord vein to take a small sample of your baby’s blood. If your baby has severe anemia, your provider may be able to treat it by giving her a blood transfusion (new blood) through the umbilical cord. In most cases, the anemia isn’t severe. 

If your baby has hydrops fetalis during the third trimester, you may need to have your labor induced to give birth early for your baby’s health. Inducing labor (also called labor induction) is when your health care provider gives you medicines or uses other methods to start your labor.

How can you protect yourself from fifth disease during pregnancy? 

To protect yourself from fifth disease:

  • Wash your hands often with soap and water, especially after being around children.
  • Carefully throw away tissues used by children and wash your hands right away.
  • Don’t share food and drinks with other people.
  • Avoid close contact with people who are sick.

Last reviewed: December, 2018