Erythema Infectiosum Fifth Disease

Fifth disease is a viral infection caused by parvovirus B19. It usually causesa rash and symptoms of mild illness.

What is going on in the body?

Fifth disease is caused by human parvovirus B19. It usually occurs in thespring in schoolage children, preschoolers, or adolescents. Fifth disease isspread through respiratory secretions. Symptoms appear 4 to 14 days after exposure.

What are the causes and risks of the infection?

Fifth disease is generally seen in children in day care, preschool, elementary school,and high school. Adults who are not immune to the parvovirus B19 can alsodevelop fifth disease. It is spread from person to person by respiratorysecretions. Coughing and sneezing spread the disease.

What are the signs and symptoms of the infection?

Fifth disease in children generally follows a certain pattern. While rash isthe most striking symptom of fifth disease, the child may have the followingsymptoms several days before the rash appears:

A child with fifth disease generally has a bright-red rash on thecheeks that gives a “slapped cheek” appearance. This may be followed by a pink,lacy rash on the arms, legs, and trunk. The rash generally causes nodiscomfort but may be mildly itchy.

An adult with fifth disease may have no symptoms at all or may have thetypical rash. The person may also have joint pain and swelling.

How is the infection diagnosed?

The diagnosis of fifth disease is made on the basis of a medical history and physicalexamination. When an exact diagnosis is important, the healthcare provider canorder an antibody titerblood test.

What can be done to prevent the infection?

Fifth disease is a very contagious viral disease. There is no vaccine or other way toprevent it. General precautions include washing the hands thoroughly and avoiding therespiratory secretions of others.

What are the long-term effects of the infection?

There are few long-term effects in most individuals affected with fifthdisease. It is a benign viral infection. Complete recovery is expected.

What are the risks to others?

Fifth disease is passed from person to person by respiratory secretions spreadby coughing, sneezing, or intimate contact. In most individuals, the illnessis mild and causes no significant problems. However, people with anemia or immune system disordersareat risk for an episode of acute, severe anemia if they have fifth disease.

If fifth disease is passed from a pregnant woman to her fetus, the baby maydevelop severe anemia,orshortage of red blood cells, and widespread swelling. This condition, known ashydrops fetalis, can cause stillbirth.

What are the treatments for the infection?

Fifth disease usually resolves on its own without treatment. Fever or joint pain may be relieved with over-the-counterpain medications such asacetaminophen. Aspirin should never be given to children, since it increasesthe risk of Reye’s syndrome. Cool baths or compresses may helprelieve itching from the rash.

What are the side effects of the treatments?

Medications used to relieve pain or fever may cause stomach upset or allergic reactions.

What happens after treatment for the infection?

The rash associated with fifth disease usually fades in one to two weeks.However, the rash may reappear following exposure to sunlight, heat, exercise,or stress. This does notmean that the illness has returned.

How is the infection monitored?

Any new or worsening symptoms should be reported to the healthcare provider.