Fifth Disease: Get the Facts Causes, Symptoms, & Treatment

Picture of Fifth Disease (Erythema Infectiosum)

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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.

Picture of Fifth Disease

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.

Fifth disease, or erythema infectiosum, is a mildly to moderately contagious viral infection common among school-age children, particularly in the winter and spring.

Though it can resemble other childhood rashes, such as rubella or scarlet fever, fifth disease usually begins with the distinctive, sudden appearance of bright red cheeks that look as though the child has been slapped. The disease is rare in infants and adults.

Picture of erythema-infectiosum

Signs & Symptoms of Fifth Disease

The first symptoms of fifth disease are usually mild and may include

  • fever,
  • runny nose, and
  • headache.

Then you can get a rash on your face and body
After several days, you may get a red rash on your face called “slapped cheek” rash. This rash is the most recognized feature of fifth disease. It is more common in children than adults.

Picture of Fifth Disease

Some people may get a second rash a few days later on their chest, back, buttocks, or arms and legs. The rash may be itchy, especially on the soles of the feet. It can vary in intensity and usually goes away in 7 to 10 days, but it can come and go for several weeks. As it starts to go away, it may look lacy.

You may also have painful or swollen joints
People with fifth disease can also develop pain and swelling in their joints (polyarthropathy syndrome). This is more common in adults, especially women. Some adults with fifth disease may only have painful joints, usually in the hands, feet, or knees, and no other symptoms. The joint pain usually lasts 1 to 3 weeks, but it can last for months or longer. It usually goes away without any long-term problems.

Causes of Fifth Disease

Fifth disease is caused by human parvovirus B19. It often affects preschoolers or school-age children during the spring. The disease spreads through the fluids in the nose and mouth when someone coughs or sneezes.

The disease causes a tell-tale bright-red rash on the checks. The rash also spreads to the body and can cause other symptoms.

You can get fifth disease and not have any symptoms. About 20% of people who get the virus don’t have symptoms.

Is Fifth Disease dangerous during pregnancy?

Rarely, these patients develop erythrocyte aplasia, meaning the bone marrow stops forming a normal number of red blood cells. This complication is rare and usually transient, but can be fatal. Patients who are immunocompromised (by disease or treatment) are at high risk of this complication.

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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. Although no birth defects have been reported as a result of fifth disease, for 2%-10% of B19-infected pregnant women, fifth disease can cause severe anemia and even the death of the unborn fetus (by hydrops fetalis).

Treatment of Fifth Disease

Fifth disease is caused by a virus, so cannot be treated with antibiotics (antibiotics kill bacteria, not viruses). Although antiviral medicines do exist, none are currently available to treat fifth disease. In most cases, this is such a mild illness that no medicine is necessary.

Usually, kids with fifth disease feel fairly well and need little home treatment other than rest. After the fever and mild cold symptoms have passed, there may be little to treat except any discomfort from the rash itself.

If your child has itching from the rash of fifth disease, ask the doctor for advice about relieving discomfort. The doctor may also recommend acetaminophen for fever or joint pain.