Fifth Disease

Written by Autumn Rivers and Winnie Yu | Published on July 25, 2012
Medically Reviewed by George Krucik, MD

Fifth disease


Fifth disease is caused by a virus that often results in a red rash on the arms, legs, and cheeks. For this reason, it is also known as “slapped cheek disease.” It is 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 is no medication that will shorten the course of the disease. However, patients with weakened immune systems may need to be monitored until the symptoms disappear.

What Causes Fifth Disease?

Fifth disease is caused by a virus, called parvovirus B19, which tends to spread among children in elementary school. It is 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 individuals do become infected as adults, the symptoms can be severe. When pregnant women get fifth disease, there are serious risks for the 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 first symptoms of fifth disease are very general. They often include the following:

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

After a few days of suffering with these symptoms, most young patients 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 are 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 diagnose you just by looking at your skin rash. If you are likely to face serious consequences from fifth disease, such as if you are pregnant or have a compromised immune system, your doctor may test you for specific antibodies.

How Is Fifth Disease Treated?

For most healthy patients, 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 will just 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 are 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 will likely need to be under a doctor’s care as your body attempts to fight off fifth disease.

In particular, if you have any type of anemia you will likely need medical attention. 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 patients with sickle cell anemia, who are urged to see a doctor right away after being exposed to fifth disease.

An additional complication is that fifth disease can harm unborn babies, so it is dangerous for pregnant women to develop the condition. Fifth disease can also lead to anemia in fetuses, potentially causing fetal death. 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. Once you have contracted this virus, though, you are considered immune for life.

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