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Slapped Cheek Syndrome

By Bjarne Lühr Hansen PhD, MD and Philipp Skafte-Holm MD, Mentor Institute

When a pregnant woman is infected with slapped cheek syndrome, there is a risk that the foetus may die. Most pregnant women has had slapped cheek syndrome as a child and therefore, there is no risk to their foetus. Your doctor can take a blood sample to determine whether you should take any special precautions when slapped cheek syndrome is rampant.

A virus causes slapped cheek syndrome. Most frequently, it occurs with children who go to school but it can also infect adults. The illness occurs from the late winter months until early summer. It can occur as an epidemic (many cases at once) approximately every 3 years.

The illness has been known for more then 100 years and is very common. Only recently has it become clear that slapped cheek syndrome poses a threat to unborn children with pregnant women. This has created a lot of attention around the illness.

With adults, slapped cheek syndrome starts with discomfort and a feeling of being ill. Later, there is pain and swelling of joints together with a red itchy rash. The look of the rash can vary a lot – all the way from finely dotted to more confluent. It only lasts some days and hereafter disappears on its own even though the pains and the swelling of the joins can, with a few people, last for a couple of months.

If the pregnant woman has not had slapped cheek syndrome (this is true for one in every three pregnant women), she can become infected with the illness. If the pregnant woman contracts slapped cheek syndrome, there is a risk that the foetus may die. In 5 out of 100 cases, where the pregnant woman has slapped cheek syndrome, pregnancy results in the death of the foetus.

It is important to emphasise that there has not been found deformity with newborns even though the mother contracted slapped cheek syndrome during pregnancy.

Only a blood sample can with certainty determine whether the pregnant woman has been infected with slapped cheek syndrome. Two groups of pregnant women should have a blood sample taken with their general practitioner:

  • Those who has been into contact with others who have slapped cheek syndrome.
  • Those who has a rash together with pain and swelling of joints.

By a blood sample it can be determined whether the pregnant woman:

  1. Has previously had slapped cheek syndrome and can therefore not contract the illness again. If that is the case, there is no danger.
  2. Has not previously had slapped cheek syndrome and is therefore able to contract the illness. The pregnant woman should therefore have another blood sample taken after 2 to 3 weeks to see if she has been infected during that time.
  3. Has been infected with slapped cheek syndrome. In that case, the pregnant woman is referred to a hospital.

Contamination

The inflammation is spread through close contact between people, primarily via spit and cough. It takes 1 to 3 weeks from exposure to the illness till it breaks out. Infected people can infect others 1 week before they fall ill. Approximately half of those infected do not fall ill but are still able to infect others. It is therefore very difficult to avoid infection with slapped cheek syndrome.

When can I go to work?
Pregnant women who work with children (e.g. nursery teachers, teachers and child-minders) where incidents of slapped cheek syndrome occur do not gain a lot by staying home from work because you may be unable to detect any carrier. There is therefore no reason to stay at home if you are pregnant even though slapped cheek syndrome may exist in the surroundings.

What can you do?

If you have a fever, you should dress lightly and drink plenty of fluid.

Contact the doctor tomorrow

If you are pregnant and has been into contact with a person who has slapped cheek syndrome. If you are pregnant and has a rash together with swelling and pain in joints.

Contact the doctor immediately

This is never necessary.