Fifth disease, or erythema infectiosum, is caused by a virus called the human parvovirus B19. It most often infects school aged children, and appearing most frequently in the winter and spring. It is also possible for adults to get the virus, and for it to occur anytime during the year.
The name fifth disease was given to the viral infection because it was one of the five most common illnesses of childhood in the past that the main characteristic was a rash. Fifth disease is also called slapped cheek syndrome or disease because of the characteristic rash that appears of the face.
Fifth disease is usually a mild infection. The first signs and symptoms of fifth disease are vague and nonspecific, including:
After several days of the above cold/flu like symptoms the classic “slapped cheek” rash will appear. The rash is bright red, and is found on both cheeks. After about 4 days, the rash will spread to the trunk of the body (chest and abdomen), and then will continue onto the arms, legs and rest of the body. On the body the rash looks pink, with a lacy looking pattern and is slightly raised. Sometimes the rash is itchy, especially once it spreads to the feet. The rash can last several weeks, but most often it lasts about 7 to 10 days.
Parvovirus B19 is easily spread from person to person through respiratory secretions like saliva, sputum, or nasal mucus. It is expelled into the air when an infected person breathes, coughs or sneezes. It can also be spread to nearby surfaces or hand-to-hand contact. A person can spread the infection before they have a rash, and is no longer infectious after the rash appears. At this point your child is able to return to school.
The virus can also be transmitted through blood, or through pregnancy. A pregnant woman can transmit the virus directly to her unborn baby.
When seeing your doctor or nurse practitioner they will examine your child looking for the above signs and symptoms, most importantly the characteristic “slapped cheek” rash on the face. They will perform a physical exam and take a history including information about possible exposure to someone who is infected with the fifth disease. A diagnosis can be determined often just by a clinical exam. The clinical diagnosis can be confirmed by performing a blood test, if necessary, to see if your child has the infection, was recently infected, or if they are immune to parvovirus B19. This test usually takes a couple days before results are confirmed.
Fifth disease is usually a mild infection that resolves on its own with time in an otherwise healthy child or adult. The virus can cause severe complications in people with anemia, leukemia, cancer, HIV, organ transplants, those with weakened immune systems or pregnant women.
If you think your child has fifth disease and has any of the above conditions, or if you are pregnant and think you may have been exposed to fifth disease, see your doctor or nurse practitioner.
Like most viral illness, fifth disease cannot be treated with antibiotics. As a parent you can help to manage your child’s symptoms and keep them comfortable. The following may be helpful for your child:
You can help to prevent the transmission of parvovirus B19 and risk of infecting others by:
– Dr. Christina Cesareo and Dr. G Paul Dempsey
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