Human Parvovirus B19 in Pregnancy

This guidance was developed by the Society for Maternal-Fetal Medicine Committee on Infectious Diseases and Emerging Threats with the assistance of Naima Joseph, MD, MPH; Brenna Hughes, MD, MSc; Martina Badell, MD; and Russell S. Miller, MD.

 

On August 13, 2024, the Centers for Disease Control and Prevention (CDC) issued a Health Alert Network (HAN) Health Advisory (CDC HAN) to notify healthcare providers, public health authorities, and the public about recent increases in human parvovirus B19 activity in the United States.1

The Society for Maternal-Fetal Medicine (SMFM) continues to monitor the human parvovirus B19 activity closely and will provide updated guidance as necessary. The following are interim clinical considerations.

Introduction

Parvovirus B19 is a seasonal respiratory virus transmitted through respiratory droplets by people with symptomatic or asymptomatic infection.1 Acute parvovirus B19 infection during pregnancy can be associated with adverse fetal outcomes, including severe fetal anemia, nonimmune hydrops, and fetal demise.1 People who are immunocompromised or have certain blood disorders (eg, sickle cell disease) can face serious complications, including transient aplastic crises, encephalitis or other neurologic manifestations, and myocarditis.1,2

Screening, Testing, and Treatment

Although routine screening for parvovirus B19 immunity is not recommended during pregnancy, maternal-fetal medicine subspecialists and other obstetric care clinicians should consider serologic testing in the following situations1,2:

  • Pregnant people who present with symptoms compatible with parvovirus B19 infection (ie, fever, myalgia, malaise, reticular rash, and/or arthralgia following a viral illness);
  • Pregnant people with suspected fetal anemia or nonimmune hydrops; or
  • Asymptomatic pregnant people following confirmed exposure to parvovirus B19.

Immune patients (positive result for immunoglobulin G (IgG) antibody and negative result for immunoglobulin M (IgM) antibody) can be counseled regarding protective immunity and the unlikely risk of adverse fetal outcomes.3 Nonimmune patients (negative results for both IgG and IgM antibodies) can be monitored for symptom development or seroconversion.3 Treatment for acute infection in the pregnant individual is supportive, and management includes monitoring for and treating severe fetal anemia.1,4 Currently, there is no available vaccine to prevent parvovirus B19 infection.1

Prevention

Maternal-fetal medicine subspecialists and other obstetric care clinicians should provide counseling stressing the importance of core prevention strategies4,5 including:

  • Wearing a mask;
  • Handwashing;
  • Cleaning frequently touched surfaces;
  • Limiting physical contact with sick people;
  • Avoiding sharing food and drink, and
  • Covering coughs and sneezes.

For more information, please access the following SMFM and partner resources:

References

  1. Centers for Disease Control and Prevention. Health Alert Network. Increase in Human Parvovirus B19 Activity in the United States. August 13, 2024. https://emergency.cdc.gov/han/2024/han00514.asp. Accessed August 27, 2024.
  2. Centers for Disease Control and Prevention. About Parvovirus B19. August 13, 2024. https://www.cdc.gov/parvovirus-b19/about/index.html. Accessed August 27, 2024.
  3. American College of Obstetricians and Gynecologists. Practice bulletin no. 151: Cytomegalovirus, parvovirus B19, varicella zoster, and toxoplasmosis in pregnancy. Obstet Gynecol. 2015 Jun;125(6):1510-1525. doi: 10.1097/01.AOG.0000466430.19823.53. Erratum in: Obstet Gynecol. 2016 Feb;127(2):405.
  4. Centers for Disease Control and Prevention. Parvovirus B19 in pregnancy. August 13, 2024. https://www.cdc.gov/parvovirus-b19/about/parvovirus-b19-in-pregnancy.html. Accessed August 27, 2024.
  5. Centers for Disease Control and Prevention. Preventing Respiratory Viruses. Core Prevention Strategies. March 1, 2024. https://www.cdc.gov/respiratory-viruses/prevention/index.html. Accessed August 27, 2024.

 

Suggested Citation: Society for Maternal-Fetal Medicine (SMFM). SMFM Update on Parvovirus B19; 2024. Available at: https://www.smfm.org/parvovirus-b19. Retrieved [enter date].