Fifth Disease

Fifth disease is a viral infection caused by parvovirus B19. It usually causes a rash and symptoms of mild illness.

What is going on in the body?

Fifth disease is caused by human parvovirus B19. It usually occurs in the spring in schoolage children, preschoolers, or adolescents. Fifth disease is spread through respiratory secretions. Symptoms appear 4 to 14 days after exposure.

What are the causes and risks of the infection?

Fifth disease is generally seen in children in day care, preschool, elementary school, and high school. Adults who are not immune to the parvovirus B19 can also develop fifth disease. It is spread from person to person by respiratory secretions. Coughing and sneezing spread the disease.

What are the signs and symptoms of the infection?

Fifth disease in children generally follows a certain pattern. While rash is the most striking symptom of fifth disease, the child may have the following symptoms several days before the rash appears:

A child with fifth disease generally has a bright-red rash on the cheeks that gives a "slapped cheek" appearance. This may be followed by a pink, lacy rash on the arms, legs, and trunk. The rash generally causes no discomfort but may be mildly itchy.

An adult with fifth disease may have no symptoms at all or may have the typical rash. The person may also have joint pain and swelling.

How is the infection diagnosed?

The diagnosis of fifth disease is made on the basis of a medical history and physical examination. When an exact diagnosis is important, the healthcare provider can order an antibody titer blood test.

What can be done to prevent the infection?

Fifth disease is a very contagious viral disease. There is no vaccine or other way to prevent it. General precautions include washing the hands thoroughly and avoiding the respiratory secretions of others.

What are the long-term effects of the infection?

There are few long-term effects in most individuals affected with fifth disease. It is a benign viral infection. Complete recovery is expected.

What are the risks to others?

Fifth disease is passed from person to person by respiratory secretions spread by coughing, sneezing, or intimate contact. In most individuals, the illness is mild and causes no significant problems. However, people with anemia or immune system disorders are at risk for an episode of acute, severe anemia if they have fifth disease.

If fifth disease is passed from a pregnant woman to her fetus, the baby may develop severe anemia, or shortage of red blood cells, and widespread swelling. This condition, known as hydrops fetalis, can cause stillbirth.

What are the treatments for the infection?

Fifth disease usually resolves on its own without treatment. Fever or joint pain may be relieved with over-the-counter pain medications such as acetaminophen. Aspirin should never be given to children, since it increases the risk of Reye's syndrome. Cool baths or compresses may help relieve itching from the rash.

What are the side effects of the treatments?

Medications used to relieve pain or fever may cause stomach upset or allergic reactions.

What happens after treatment for the infection?

The rash associated with fifth disease usually fades in one to two weeks. However, the rash may reappear following exposure to sunlight, heat, exercise, or stress. This does not mean that the illness has returned.

How is the infection monitored?

Any new or worsening symptoms should be reported to the healthcare provider.

Author:James Broomfield, MD
Date Written:
Editor:Ballenberg, Sally, BS
Edit Date:04/30/01
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:08/09/01