Another patient presented with small joint arthralgias and diffuse early morning stiffness. His orthopedic surgeon thought he had overused his joints in a bicycle race. The bicyclist's son had bright red cheeks. The arthropathy is generally short lived, but may last for months, and may possibly be associated with chronic arthritis. Symptoms generally respond to nonsteroidal anti-inflammatory drugs, but occasionally steroids are necessary for pain relief.
Respiratory secretions are the major source of infection.
This obviously makes infection control difficult. Excluding symptomatic children from school or child care is probably of no benefit. Most problematic is that infection during pregnancy may cause hydrops fetalis and fetal death, caused by a cytotoxic effect of the virus on fetal red cells. Congenital anomalies associated with B-19 have not been reported. All information is general in nature and is not intended to be used as a substitute for appropriate professional advice.