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Fifth Disease

Fifth disease

Overview of fifth disease

Key points

  1. An airborne virus called parvovirus B19 causes fifth disease. It’s commonly passed around in elementary schools during the winter and spring.
  2. It typically causes a red rash on children’s arms, legs, and cheeks. In adults, the main symptom is joint pain, usually in the wrists, ankles, and knees.
  3. It’s common and mild in most children, but it can be more severe and potentially dangerous for pregnant women and those with compromised immune systems.

A virus causes fifth disease. It often results in a red rash on the arms, legs, and cheeks. For this reason, it’s also known as “slapped cheek disease.” It’s fairly common and mild in most children, but it can be more severe for pregnant women or anyone with a compromised immune system.

Most doctors advise their patients to wait out the symptoms because currently there’s no medication that will shorten the course of the disease. However, if you have a weakened immune system, your doctor may need to closely monitor you until the symptoms disappear.

What causes fifth disease?

Parvovirus B19 causes fifth disease. The virus tends to spread through saliva and respiratory secretions among children who are in elementary school. It’s most prevalent in the winter and spring, but it can spread at any time and among people of any age.

Many adults have antibodies that prevent them from developing fifth disease because of previous exposure during childhood. However, when people do become infected as adults, the symptoms can be severe. If you get fifth disease while pregnant, there are serious risks, including life-threatening anemia, for your unborn baby.

For children with healthy immune systems, fifth disease is a common, mild illness that rarely presents lasting consequences.

What are the symptoms of fifth disease?

The initial symptoms of fifth disease are very general. They often include:

  • headache
  • fatigue
  • low-grade fever
  • sore throat
  • nausea

After a few days of having these symptoms, most young people develop a red rash that first appears on the cheeks. The rash often spreads to the arms, legs, and trunk of the body within a few days. The rash may last for weeks, but usually by the time you see it you’re no longer contagious.

The rash is more likely to appear in children than in adults with fifth disease. In fact, the main symptom adults usually experience is joint pain. The joint pain can last for several weeks and is usually most prominent in the wrists, ankles, and knees.

How is fifth disease diagnosed?

Often, doctors can make the diagnosis just by looking at your skin rash. Your doctor may test you for specific antibodies if you’re likely to face serious consequences from fifth disease. This is especially the case if you’re pregnant or if you have a compromised immune system.

How is fifth disease treated?

For most healthy people, no treatment is necessary. If your joints hurt or you have a headache or fever, you may be advised to take acetaminophen (Tylenol) as needed to relieve these symptoms. Otherwise, you’ll need to wait for your body to fight off the virus, which usually takes one to three weeks.

You can help the process along by drinking a lot of fluids and getting extra rest. Children can often return to school once the red rash appears since they’re no longer contagious.

What can be expected in the long term?

For most healthy patients, fifth disease has no long-term consequences. However, if your immune system is weakened due to AIDS, chemotherapy for cancer, or other conditions, you’ll likely need to be under a doctor’s care as your body attempts to fight off fifth disease.

In particular, you’ll likely need medical attention if you have any type of anemia. This is because fifth disease can stop your body from producing red blood cells, which can reduce the amount of oxygen that your tissue gets. This is especially likely in people with sickle cell anemia. If you have sickle cell anemia, you should see a doctor right away after being exposed to fifth disease.

Fifth disease can harm your unborn baby, so it can be dangerous to develop the condition if you’re pregnant. Fifth disease can also lead to anemia in your unborn child, which can be life-threatening for them. If necessary, your doctor may offer you a blood transfusion to help protect your unborn child.

How can fifth disease be prevented?

Since fifth disease usually spreads from one person to another through airborne secretions, you should try to minimize contact with people who are sneezing, coughing, or blowing their noses. Washing your hands frequently can also help reduce the chances of contracting fifth disease. For a person with an intact immune system, once you’ve contracted this virus, you are considered immune for life.

You asked, we answered

  • My child was recently diagnosed with fifth disease. How long should I keep her out of school to prevent it from spreading to the other children?
  • According to the CDC, people with parvovirus B19, which causes fifth disease, usually develop symptoms between four and 14 days after being infected. Initially, children may have a fever, malaise, or cold symptoms before the rash breaks out, and the rash can last for seven to 10 days. Children are most likely to spread the virus early in the disease before the rash even develops. Then, unless your child has immune problems, they are probably no longer infectious and can go back to school.

    - Jeanne Morrison, PhD, MSN

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