FIFTH DISEASE

General Information

DEFINITION--An infectious, mild, viral illness that occurs in localized outbreaks (often during the winter and spring months). The name comes from its position on a list developed in the early 1900s of childhood diseases.

SEX OR AGE MOST AFFECTED--Children and adolescents ages 5-14; rare in infants and adults.

> Widespread rash--

called "slapped cheeks appearance" because it starts as a rash on the cheeks. The rash then spreads to the trunk, buttocks and limbs, usually in a lacy pattern.

• Low-grade fever (sometimes).
• Slight tiredness or fatigue.
• Mild joint pain or swelling (in adults).
• Sometimes no symptoms are apparent (about 20% of patients).

CAUSES--A virus called human parvovirus B-19 spread by airborne particles. The incubation period is 4-14 days. Once the rash appears, the child is no linger infectious.

RISK INCREASES WITH--School and day care attendance.

HOW TO PREVENT--No preventive measures. Outbreaks can last for months, so keeping a child out of a school or day care where the infection has occurred will accomplish little. Infection provides future immunity.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of the symptoms.
• Awareness of an outbreak in the school or community.
• Medical history and physical exam by a doctor (sometimes).

APPROPRIATE HEALTH CARE--Self-care after diagnosis.

POSSIBLE COMPLICATIONS

• None expected in the general population. In rare instances (patients with other disorders such as sickle cell anemia or the immunocompromised), fifth disease can cause a serious anemic reaction.
• In pregnant women there is a small risk of miscarriage if the woman is infected during the first 20 weeks of pregnancy. There is no evidence that fifth disease causes birth defects.

PROBABLE OUTCOME--Complete recovery. The rash usually clears in 10 days to 2 weeks.

How To Treat

GENERAL MEASURES--

• Use cool soaks if the rash itches.
• External factors such as sun exposure, bathing, excitement or exercise can cause the rash to redden or reappear weeks after the initial infection. This is no cause for concern.

MEDICATION--

• There are no medicines for treating fifth disease. You may use acetaminophen for fever. Don't give a child younger than 18 aspirin for fever.
• If the rash itches, use plain calamine lotion.

ACTIVITY--Extra rest during symptomatic period.

DIET--No special diet. Drink plenty of fluids.

Call Your Doctor If

• If you or your child has symptoms of fifth disease and you are concerned.
• Symptoms don't improve or worsen after self-care treatment.
• You are pregnant and have been exposed to fifth disease.