Fifth Disease: Symptoms, Causes, Treatment

What are the symptoms of fifth disease?

Fifth disease, also known as erythema infectiosum, is a viral illness caused by the parvovirus B19. It’s most common in children, but adults can get it too. Symptoms typically start with mild cold-like symptoms such as a low-grade fever, headache, and mild congestion. After a few days, a distinctive rash appears, which is often described as a “slapped cheek” rash because it gives the appearance of having been slapped on both cheeks.

Other symptoms of fifth disease may include:

1. Red rash on the body: After the slapped cheek rash fades, a red rash may develop on the arms, legs, and torso. This rash can be itchy and may come and go for several weeks.
2. Joint pain and swelling: In some cases, especially in adults, joint pain and swelling may occur, resembling symptoms of arthritis. This tends to improve without treatment but can last for several weeks.
3. Sore throat
4. Fatigue
5. Upset stomach

It’s worth noting that not everyone with fifth disease will experience all of these symptoms, and some people may have very mild symptoms or none at all. In most cases, fifth disease is a mild illness that resolves on its own without complications. However, it can pose a risk to pregnant women and individuals with certain types of anemia or weakened immune systems, so it’s important to seek medical advice if you suspect you or your child has fifth disease.

What are the causes of fifth disease?

Fifth disease is caused by the parvovirus B19. This virus is primarily transmitted from person to person through respiratory secretions, such as saliva, mucus, or sputum, typically when an infected person coughs or sneezes. It can also spread through close personal contact or by sharing utensils or cups with someone who is infected.

Here are some key points about the causes and transmission of fifth disease:

1. Respiratory Transmission: The virus is most commonly spread through respiratory droplets when an infected person coughs or sneezes.
2. Direct Contact: Close personal contact, such as hugging or touching, can also transmit the virus.
3. Blood Transmission: In rare cases, the virus can be spread through blood or blood products.
4. Vertical Transmission: A pregnant woman who is infected with parvovirus B19 can pass the virus to her unborn baby, which can lead to serious complications.

The incubation period for fifth disease is typically 4 to 14 days, but it can be as long as 21 days. People are usually most contagious during the early stages of the illness, before the rash appears. Once the rash appears, the risk of transmission is significantly reduced.

It’s important to note that many people infected with parvovirus B19 do not show symptoms, but they can still spread the virus to others. Practicing good hygiene, such as frequent handwashing and covering the mouth and nose when coughing or sneezing, can help reduce the risk of transmission.

How is the diagnosis of fifth disease made?

The diagnosis of fifth disease, or erythema infectiosum, is usually based on a combination of clinical symptoms and, in some cases, laboratory tests. Here’s how it’s typically done:

1. Clinical Symptoms: The characteristic symptoms of fifth disease, including the “slapped cheek” rash followed by a lacy rash on the body, are often distinctive enough for a healthcare provider to make a diagnosis based on a physical examination alone. A history of exposure to someone with fifth disease may also be considered.
2. Laboratory Tests: In some cases, particularly if the diagnosis is uncertain or if there are complications, a healthcare provider may order laboratory tests to confirm the presence of parvovirus B19. These tests may include:

• Parvovirus B19 IgM Antibody Test: This blood test detects the presence of antibodies that the body produces in response to a recent parvovirus B19 infection. IgM antibodies are typically present during the acute phase of the illness.
• Parvovirus B19 PCR Test: Polymerase chain reaction (PCR) testing can directly detect the genetic material (DNA) of the parvovirus B19 in blood or other bodily fluids. This test is more sensitive and specific than antibody tests and can be useful for confirming active infection.
• Serology: Serological tests can detect both IgM and IgG antibodies to parvovirus B19, which can help determine whether an infection is recent or past.

It’s important to note that laboratory testing is not always necessary, especially if the symptoms are typical and there are no complications. Additionally, fifth disease is usually a mild illness that resolves on its own without specific treatment, so testing may not always be recommended unless there are specific concerns, such as in pregnant women or individuals with certain medical conditions. If you suspect you or your child has fifth disease, it’s best to consult a healthcare provider for an accurate diagnosis and appropriate management.

What is the treatment for fifth disease?

Fifth disease, caused by parvovirus B19, typically resolves on its own without specific treatment. Since it’s a viral infection, antibiotics are not effective against it. The focus of treatment is usually on managing the symptoms and providing comfort. Here are some common approaches to managing fifth disease:

1. Rest: Getting plenty of rest can help the body fight off the infection and recover more quickly. Encourage adequate rest, especially if the person affected is feeling fatigued.
2. Hydration: Drinking plenty of fluids, such as water, herbal tea, or clear broths, helps prevent dehydration, especially if there’s a fever present.
3. Fever Reducers: Over-the-counter pain relievers and fever reducers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help reduce fever and alleviate any discomfort associated with it. However, aspirin should be avoided in children and teenagers with viral infections due to the risk of Reye’s syndrome.
4. Symptomatic Relief: Over-the-counter antihistamines or anti-itch creams can help alleviate itching if the rash is bothersome. Calamine lotion or oatmeal baths may also provide relief.
5. Avoiding Complications: If someone with fifth disease experiences joint pain or swelling, especially in adults, a healthcare provider may recommend over-the-counter pain relievers or anti-inflammatory medications to help manage these symptoms.
6. Isolation: Since fifth disease is contagious, it’s a good idea to keep children home from school or daycare until the rash appears, to prevent the spread of the virus to others.

In most cases, fifth disease is a mild and self-limiting illness that resolves on its own within a few weeks. However, it’s essential to seek medical advice if you or your child experience severe symptoms, complications, or if there are concerns, especially if you’re pregnant or have a weakened immune system. Additionally, if you’re unsure about the diagnosis or management of fifth disease, consulting a healthcare provider is recommended for personalized advice.