Q&A: What to know about the CDC alert for 'slapped cheek' virus
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Key takeaways:
- The CDC alerted health care providers of a recent increase in parvovirus B19 activity.
- Pregnant women and immunocompromised people are most at risk for complications from the “slapped cheek” virus.
The CDC issued an advisory on Aug. 13 alerting health care providers and public health officials about the elevated activity of parvovirus B19 in the United States.
The proportion of people of all ages who had IgM antibodies indicating a recent infection tripled from less than 3% in 2022 to 2024 to 10% in June 2024, according to the alert. Among children aged 5 to 9 years, the proportion with IgM antibodies increased from 15% in 2022 to 2024 to 40% in June 2024.
In June 2024, 19.9% of pooled plasma samples tested positive for parvovirus B19 DNA, compared with 1.5% in December 2023.
Parvovirus B19, which often presents with a rash resembling a slapped cheek, is a highly contagious virus that spreads through respiratory droplets, according to the CDC. The alert states that people who come into close contact with children have a high risk for infection, but about half of adults have antibodies by age 20 years and more than 70% have antibodies by age 40 years, which means most adults are unlikely to be reinfected.
Healio spoke with Aaron E. Glatt, MD, MACP, FIDSA, FSHEA, chair of the department of medicine, chief of infectious diseases and hospital epidemiologist at Mount Sinai South Nassau and professor of medicine at the Icahn School of Medicine at Mount Sinai, about what providers should know concerning the latest uptick in parvovirus cases.
Healio: How serious is parvovirus?
Glatt: Fortunately for most people, it is not serious. This is a very common childhood infection that most people get. It causes mild illness, flu-like symptoms. Children get the classic “slapped cheek” type of a rash, which looks bad, but they get over it. Adults may experience some joint pain.
However, for a small segment of the population, especially pregnant women and immunocompromised people, it can be far more serious. A lot of pregnant women already had it, so hopefully they won’t get it again. For the vast majority of people, the virus will not impact the pregnancy. But it can cause a miscarriage or impact the baby.
Healio: What should providers be looking for?
Glatt: If you are a pediatrician, you probably have seen thousands of cases like this over your career, because probably every kid in your practice has gotten it at some point in time.
Where it is a problem is if mom is also pregnant. If she brings in the 3-year-old with the virus and she is also pregnant, that is a concern. Mom should certainly not be around people who are sick who are not in her immediate family. She should be careful around other little kids. When the pediatrician says, “This child should not be around pregnant women,” take that very seriously.
Healio: What should providers do if they suspect their patient has the virus?
Glatt: I think the critical thing is to try to prevent the spread as much as possible. If you are sick, you should not be around other people. Take it seriously. Wash your hands a lot. Clean areas where you may have contaminated. But with almost all of the respiratory viruses, there is an excellent chance that if you are exposed, you are probably going to get infected one way or the other. There is not that much you can do other than being cautious and practicing good hand hygiene.
Healio: Is it possible the COVID-19 prevention protocols had an effect on transmission of parvovirus B19?
Glatt: If this had been last year, I would have definitely said yes. Now I am not sure. It certainly is likely that not as many people got it during the height of COVID-19. This is a once-in-a-lifetime type of acquisition; it is not like flu, which you can get multiple times. You usually get parvovirus B19 once. So, it is possible that a child who would have caught it when they were 1 year or 2 years old did not, and now they are getting it at 2 years or 3 years. Therefore, it is possible that there are people who did not get it during that time, and maybe that is why we are seeing more cases than usual. But it is hard to prove.
Reference:
- CDC. Increase in human parvovirus B19 activity in the United States. https://emergency.cdc.gov/han/2024/han00514.asp. Published Aug. 13, 2024. Accessed Aug. 20, 2024.
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