Sir.—Human parvovirus (B19) is now known to be the causative agent of erythema infectiosum (EI) or "fifth disease." Erythema infectiosum is characterized by a distinctive facial rash, giving a "slapped cheek" appearance. Although fever, a generalized lacy rash, minor gastrointestinal or respiratory symptoms, or arthralgias may be noted, most children have mild disease.1 Erythema infectiosum occurs in epidemics, most often in late winter or spring, and outbreaks of EI in elementary or junior high schools are frequent. Inevitably, pregnant mothers or teachers of infected children will be exposed to parvovirus.
Patient Report.—A 35-year-old healthy woman, gravida 3, para 3, became pregnant in March 1989 and had an uneventful first trimester. At 10 weeks of gestation, an outbreak of EI that centered in the elementary schools occurred in her community. All three of the patient's children developed a mild febrile illness with the characteristic facial rash. At 11