March 14, 2005
Common Virus Can Be Tragic for Moms-To-Be
Parvovirus B19 is harmless to all but the fetus, but few moms are warned
HealthDay News -- In 1998, Tammy Delancey was in the sixth month of her second pregnancy when she volunteered for a day at her son's elementary school in Zanesville, Ohio.
"I'm pretty sure I got it there," she recalled.
"It" is a largely harmless pathogen called parvovirus B19, passed like the cold or flu from person to person. In Delancey's case, infection triggered symptoms such as aches, fever and sensitivity to light. In children, a distinctive "slapped cheek" rash can appear on the face. However, a large percentage of cases of what's commonly called Fifth's disease show no symptoms at all.
Experts estimate that about 60 percent of Americans have a history of prior infection with the virus, which has no lasting effects in children and adults.
It's a much different story for the fetus, however.
"If a mother gets parvovirus B19 during her pregnancy, and has never had it before, it can have a very serious impact on the fetus," said Dr. Nancy Green, medical director at the March of Dimes. "What happens is that this virus hones in on the fetus' early red blood cells -- a receptor for the virus is specifically expressed on these cells. It knocks out those cells, so the fetus can develop major, even life-threatening anemia, with all sorts of complications," she explained.
One recent study found maternal infection can lead to miscarriage in up to 9 percent of affected pregnancies.
Because symptoms are so similar, many doctors mistake Fifth's disease for the flu, and -- as happens in the case of many women -- Delancey's true diagnosis was delayed.
"They didn't find out I even had Fifth's disease until I went for my regular ultrasound," she said. "By that time, it was already too late."
Delancey, then 30, agreed to multiple fetal blood transfusions in a desperate attempt to save her unborn child, a girl. "They were doing everything they could," she said. In the end, however, the transfusions failed.
Now, seven years later, Delancey and her husband Darron call themselves "crusaders" in getting the word out to women that a "harmless" virus can be a killer for the unborn.
"At the time, I had no idea Fifth's disease was around," Tammy Delancey said. "I want to educate women, I want the school system to tell people, and I think this should be talked about in doctors' offices -- not only at the ob/gyn, but in your child's pediatric office, your regular family doctor's office."
Green agreed that more information would at least tip women off to the notion that parvovirus B19 is out there. Screening "is something to consider," as well, she said.
A simple blood test can tell a woman if she's already been infected in the past. If the test comes up positive, it may reassure a patient that she is now immune, and that exposure to the virus therefore poses no danger to either herself or her fetus.
On the other hand, pregnant women who test negative for prior infection may want to take some simple precautions to protect their pregnancy.
"Infection tends to be more common in women who are with young children -- teachers, day-care workers, etcetera," Green noted. Because there's currently no vaccine against parvovirus B19, "the only thing we can recommend in terms of prevention are the same things we recommend against cold or flu -- frequent hand-washing, no sharing of drinking glasses, things like that," she said.
Women who discover they are at risk may want to make temporary lifestyle changes, said Delancey. She remembers how, after appearing in a local newspaper article on Fifth's disease, "several ladies came up to me and thanked me."
"We had had quite a bad outbreak at the time, and one pregnant woman told me she had called her doctor, and her doctor had had her come in for the test," Delancey said. "She found she hadn't been infected before, so she made the decision to take early maternity leave from work. She now has a beautiful baby girl."
Delancey believes much more must be done to educate doctors, nurses and women about this common danger. She pointed to one recent study that found that just 50 percent of general care practitioners were familiar with Fifth's disease. And Delancey believes an even larger percentage of young women remain in the dark about the virus.
"More women need to hear about this from women's magazines, and in other media," she said. "If people knew what I went through, if I can save another baby, or help someone who's gone through the same experience, that would be great."
"My daughter would be seven years old now," Delancey said. "Anything I can do, I feel as if, in some way, I've been a better mother to her."
For more on Fifth's disease, head to the March of Dimes.