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Fifth Disease
Fifth Disease
(Parvovirus) Medical Author: Frederick Hecht, MD, FAAP, FACMG
Medical Editor: William C. Shiel, Jr, MD, FACP, FACR
What is "fifth disease"?
Fifth disease is a temporary illness caused by a virus known as parvovirus B 19. Fifth disease (also known as "erythema infectiosum" and "slap cheek") is so named because in the pre-vaccination era, it was frequently the "fifth disease" that a child would develop. About 50% of adults have been infected with the virus but do not remember having it because it often does not cause symptoms.
What are the symptoms of fifth disease?
Fifth disease generally occurs in children between 5-15 years of age, but can affect any age group, including adults. It most commonly occurs during the winter and spring. The illness begins with a low-grade fever and malaise (a sense of not feeling well). This is followed by a characteristic bright red rash on the cheeks (the so called "slapped cheeks" rash). Finally, a fine, red, lace-like rash can develop over the rest of the body. This rash may last for 5 days to a week and occasionally comes and goes for up to 3 weeks. The other symptoms are usually gone by the time the rash appears.
While the illness is not serious in children, 80% (4 out of 5) of adults with fifth disease can have joint aches and pains. This arthritis is usually temporary, lasting days to weeks, but may become a long-term problem for months. People with arthritis from fifth disease usually have stiffness in the morning, with redness and swelling of the same joints on both sides of the body (a "symmetrical" arthritis). The joints most commonly involved are the knees, fingers, and wrists.
What are the serious complications of fifth disease?
Rarely, patients have difficulties forming a normal number of white and red blood cells as a result of fifth disease. This complication can be fatal, but is exceedingly rare.
Pregnant women (who have not previously had the illness) should avoid contact with patients who have fifth disease. The fifth disease virus can infect the fetus prior to birth. And, while no birth defects have been reported as a result of fifth disease, it can cause the death of the unborn fetus. The risk of fetal death is 5-10% if the mother becomes infected.
What is the treatment for fifth disease?
The treatment is supportive only. Fluids, acetaminophen , and rest are important. Antibiotics are of no use in the treatment of fifth disease since it is a viral illness. In those with persistent arthritis, antiinflammatory medications, such as ibuprofen or naproxen can be used.
How is the virus spread and should I be isolated if I have fifth disease?
The virus of fifth disease is spread mostly by droplets. This means that when an infected person coughs or sneezes, the virus can be spread. However, once the rash is present, the person is usually no longer infectious and need not be isolated. - Fifth disease is caused by a virus.
- Symptoms include low fever, fatigue, a "slapped cheeks rash," joint aches, and a whole-body rash.
- Rarely, fifth disease can have complications.
- Fifth disease can cause a miscarriage .
Last updated on 07/19/2008
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