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Fifth disease

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Sharmin:
Andy,

My daughter has a friend staying over - when her mom dropped her of she told us that her daughter carpooled with a girl the week of Feb 23 - 27th who had fifth disease.  My daughter's friend has not shown any of the symptoms of the illness - and she will be sleeping over tonight.  What are the risks to little A from my daughter having this friend over? 

Thank you very kindly,

Sharmin

Sharmin:
Little A had IVIG Wednesday morning - can this provide some protection for him from the disease?  I am thinking that the risk of him becoming infected is very very low - but in case there were to be any exposure. 

Is there anything that I should watch for?  He still has a few lingering symptoms from the recent cold that he had, so I won't know if he gets a new cold. 

Sharmin

Andy Battaglia:
Sharmin,

Little A should not be exposed to fifth disease. In most people it is no problem but with anemias it can cause a serious problem.

http://www.cdc.gov/NCIDOD/DVRD/revb/respiratory/parvo_b19.htm


--- Quote ---
Fifth disease is usually a mild illness that resolves on its own among children and adults who are otherwise healthy. Joint pain and swelling in adults usually resolve without long-term disability.

Parvovirus B19 infection may cause a serious illness in persons with sickle-cell disease or similar types of chronic anemia. In such persons, parvovirus B19 can cause an acute, severe anemia. The ill person may be pale, weak, and tired, and should see his or her physician for treatment. (The typical rash of fifth disease is rarely seen in these persons.) Once the infection is controlled, the anemia resolves. Furthermore, persons who have problems with their immune systems may also develop a chronic anemia with parvovirus B19 infection that requires medical treatment.
--- End quote ---

I would suggest keeping him away from the sleepover girls. If your daughter is exposed, he will also need to avoid her until it clears up.


--- Quote ---Is fifth disease contagious?     
Yes. A person infected with parvovirus B19 is contagious during the early part of the illness, before the rash appears. By the time a child has the characteristic "slapped cheek" rash of fifth disease, for example, he or she is probably no longer contagious and may return to school or child care center. This contagious period is different than that for many other rash illnesses, such as measles, for which the child is contagious while he or she has the rash.

Parvovirus B19 has been found in the respiratory secretions (e.g., saliva, sputum, or nasal mucus) of infected persons before the onset of 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 drinking cups or utensils. In a household, as many as 50% of susceptible persons exposed to a family member who has fifth disease may become infected. During school outbreaks, 10% to 60% of students may get fifth disease.
--- End quote ---

Altough IVIG does at least in theory give protection against many illnesses because it is the antibodies of thousands of people, in light of little A's ongoing battles, it is best if he is not exposed.

Andy Battaglia:
I want to also point out what it says about the contagious period. It is contagious only during the early part of the illness and usually before the rash appears.

Sharmin:
Thank you Andy,

I will do my best to keep him away from the her.  Gosh, there is always something to worry about! 

The mom of the girl who is sleeping over is certain that her daughter does not have it because she has not had any symptoms since she  carpooled with the girl having fifth disease 8 or 9 days ago - but you never know she could still be carrying it.  I think that I will call little A's pediatrician as well to let him know. 

Thanks again Andy,  I am pretty nervous now...

Sharmin

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