Managing Ringworm During Pregnancy: A Guide to Safe Solutions and Peace of Mind

Ringlet disease, often confused with German measles, occurs mainly in childhood and is often noticed by the fact that the children have intensely red cheeks. The causative agent, parvovirus B19, is unrelated to the rubella virus. Like German measles, ring measles is particularly dangerous if a pregnant woman becomes infected. The unborn child can become anaemic due to the infection (anaemia) from water retention, for example, in the abdomen, or heart failure can occur (so-called hydrops fetalis): the child can die in the womb as a result of the infection. Professor Susanne Modrow, Head of the Parvovirus Consultant Laboratory, Institute for Medical Microbiology and Hygiene at the University of Regensburg, provides information on how joint this event is and what you should know about ringworm when expecting a child.

How common is the disease in adults and pregnant women?

Prof. Modrow: According to a representative study, around 65 per cent of 18 to 19-year-olds have already contracted ringworm, which rises to 80 per cent among those over 70. It can be assumed that about 70 per cent of pregnant women are protected from infection with parvovirus B19 because they have had the infection before.

 

What are the symptoms that tell you that you are infected?

Prof. Modrow: The course of the disease in children and adults is somewhat different. Red cheeks are a prominent symptom in children. This is often the first sign; one to two days later, a garland-shaped rash appears on the arms, legs and trunk, and there is a slight fever, weakness, tiredness and malaise.

Even children can suffer from joint inflammation. However, these are more severe when adults have the disease; the joint pain and swelling can last for weeks to months and, in rare cases, can even lead to rheumatic disease. However, the classic rash is often missing.

What are the effects of ringworm during pregnancy?

Prof. Modrow: That depends crucially on the time of the illness. An infection up to about the eighth week of pregnancy usually leads to a spontaneous miscarriage. Infections in pregnant women between the 8th and 20th week of pregnancy are particularly problematic. The child can then develop hydrops fetalis about four to ten weeks after the mother is infected. About three to nine per cent of the children of mothers who are going through an acute parvovirus infection during this time are affected.

Unlike rubella, there are no congenital disabilities in children: they either die in the womb or are born healthy. Women who fall ill after the 20th week of pregnancy no longer need to fear any risk for their child.

 

Is there a therapy if an unborn child is infected, and how is this diagnosed?

Prof. Modrow: Sometimes, the women find out for themselves that something is wrong because the child is moving less. In most cases, however, a Doppler sonography during prenatal care shows that the child has anaemia. In these cases, a blood test is carried out immediately on the woman (IgM antibodies + viral DNA in the serum) to clarify whether an acute infection is present.

The child’s haemoglobin level is examined. Treatment is immediate blood transfusion through the umbilical vein. With this, the child can be saved; it is born healthy.

What advice can you give a pregnant woman?

Prof. Modrow: First of all, the advice is not to panic if you have been in contact with someone suffering from ringworm – often, by the way, it is your children who bring the disease home with them from kindergarten, for example. However, this should immediately be a reason for a blood test, especially if the contact was in the 8th to 20th week of pregnancy.

Suppose you have a test done before or at the beginning of pregnancy. In that case, you can usually be completely relaxed in these situations because more than two-thirds of pregnant women have already gone through the disease and thus have lifelong immunity. However, health insurers do not pay for the test.

But even if you do not know whether you have had ringworm, there is no reason to panic because well over 90 per cent of acute infections during pregnancy are unproblematic. And in the other cases, there is the possibility of therapy for the unborn child.