Fifth Disease (page 2)
Fifth disease, which is especially common in kids between the ages of 5 and 15, usually produces a distinctive red rash on the face that makes a child appear to have a "slapped cheek." The rash then spreads to the trunk, arms, and legs.
About Fifth Disease
Fifth disease is actually just a viral illness that most kids recover from quickly and without complications.
Fifth disease (also called erythema infectiosum) is caused by parvovirus B19. A human virus, parvovirus B19 is not the same parvovirus that veterinarians may be concerned about in pets, especially dogs, and it cannot be passed from humans to animals or vice versa.
Studies show that although 40% to 60% of adults worldwide have laboratory evidence of a past parvovirus B19 infection, most can't remember having had symptoms of fifth disease. This leads medical experts to believe that most people with a B19 infection have either very mild symptoms or no symptoms at all.
Fifth disease occurs everywhere in the world. Outbreaks tend to happen in the late winter and early spring, but there can be sporadic cases of the disease throughout the year.
Signs and Symptoms
Fifth disease begins with a low-grade fever, headache, and mild cold-like symptoms (a stuffy or runny nose). These symptoms pass, and the illness seems to be gone until a rash appears a few days later.
The bright red rash usually begins on the face. Several days later, the rash spreads and red blotches (usually lighter in color) extend down to the trunk, arms, and legs. The rash usually spares the palms of the hands and soles of the feet. As the centers of the blotches begin to clear, the rash takes on a lacy net-like appearance. Kids younger than 10 years old are most likely to get the rash.
Older kids and adults sometimes complain that the rash itches, but most kids with a rash do not look sick and no longer have fever. Certain stimuli (including sunlight, heat, exercise, and stress) may reactivate the rash until it completely fades. It may take 1 to 3 weeks for the rash to completely clear, and during that time it may seem to worsen until it finally fades away entirely.
Other symptoms that sometimes occur with fifth disease include swollen glands, red eyes, sore throat, diarrhea, and rarely, rashes that look like blisters or bruises.
In some cases, especially in adults and older teens, an attack of fifth disease may be followed by joint swelling or pain, often in the hands, wrists, knees, or ankles.
A person with parvovirus infection is most contagious before the rash appears — either during the incubation period (the time between infection and the onset of symptoms) or when experiencing only mild respiratory symptoms.
The rash is the result of an immune system reaction that occurs after the infection has passed, so kids usually aren't contagious once it appears.
Parvovirus B19 spreads easily from person to person in fluids from the nose, mouth, and throat of someone with the infection, especially through large droplets from coughs and sneezes.
In households where a child has fifth disease, another family member who hasn't previously had parvovirus B19 has about a 50% chance of also getting the infection. Kids with fifth disease may attend childcare or school, since they are no longer contagious. Once infected with parvovirus B19, a person develops immunity to it and won't usually become infected again.
Parvovirus B19 infection during pregnancy may cause problems for the fetus. Some fetuses may develop severe anemia if the mother is infected while pregnant — especially if the infection occurs during the first half of the pregnancy. In some cases, this anemia is so severe that the fetus doesn't survive. Fortunately, about half of all pregnant women are immune due to a previous infection with parvovirus. Serious problems occur in less than 5% of women who become infected during pregnancy.
There is no vaccine for fifth disease, and no real way to prevent spreading the virus. Isolating someone with a fifth disease rash won't prevent spread of the infection because the person usually isn't contagious by that time.
Practicing good hygiene, especially frequent hand washing, is always a good idea since it can help prevent the spread of many infections.
The incubation period (the time between infection and the onset of symptoms) for fifth disease ranges from 4 to 28 days, with the average being 16 to 17 days.
The rash of fifth disease usually lasts 1 to 3 weeks. In a few cases in older kids and adults, joint swelling and pain because of fifth disease have lasted from several months up to a few years.
Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
© 1995-2009 The Nemours Foundation. All rights reserved.
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