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Common Illnesses: Fifth Disease

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What is Fifth Disease?
Named for the fact that it was historically one of five common childhood illnesses known to produce a rash, Fifth Disease seems like it would be easy to identify. Its red rash typically appears on a child’s cheeks, a distinction that’s given the disease another, more familiar name—“slapped cheek” disease. Like many contagious childhood viruses, however, Fifth Disease (also known as Parvovirus infection) can be a bit sneaky in that it may not cause any symptoms at all. In addition, if the rash does surface, parents might mistake it for another viral illness or an allergic reaction. In most cases, where healthy children (and adults) are concerned, mistaking the disease for another illness isn’t a concern because Fifth Disease is rarely a serious condition. Cause for concern, however, arises when the virus infects pregnant women (read why here), as well as children (and adults) with anemia or a compromised immune system.

What are Fifth Disease symptoms?
While the “slapped cheek” rash is Fifth Disease’s signature symptom, it typically appears several days after your child begins to complain of other symptoms, including a sore throat, slight fever, upset stomach, headache, fatigue, and itching. When the rash surfaces, usually at the end of the illness, it begins on the cheeks but may eventually extend to the arms, trunk, thighs, and buttocks. On these body parts, the rash is usually pink, lacy, and slightly raised. The rash may come and go for up to three weeks, and it may be more noticeable if children are in the sun or exposed to extreme temperatures.

The Center for Disease Control and Prevention reports that about 20 percent of adults and children infected with the parvovirus during outbreaks do not display symptoms. In addition, adults don’t usually develop the rash. Instead, they typically complain of sore joints (hands, wrists, knees, ankles) lasting for days or weeks.

How do children get Fifth Disease?
Caused by the human parvovirus B19, Fifth Disease is highly contagious. Like the common cold and many other viruses, it spreads through contact with respiratory secretions. Once infected, a susceptible person usually develops symptoms within 4–14 days. Children are contagious before the rash appears, meaning they are likely infecting others without knowing they have the disease. Once the rash surfaces, the child is no longer considered contagious.

How is Fifth Disease treated?
As with most viruses, parents of an otherwise healthy child should focus on relieving their child’s symptoms until the parvovirus runs its course. Children showing symptoms should get plenty of rest and drink lots of fluids. Your child’s physician may also recommend acetaminophen or ibuprofen (over-the-counter medications) to ease fever and pain. However, do not give aspirin to children under the age of 12 or to teens under the age of 19 with a viral illness. Research has established a link between the use of aspirin and Reye’s syndrome, a rare but serious illness.

A child with anemia who shows signs of Fifth Disease may need to be hospitalized and receive blood transfusions, while a child with a compromised immune system may receive antibodies (through immune globulin injections) to treat the infection. For more information on Fifth Disease complications, visit the Mayo Clinic’s website.

How can Fifth Disease be prevented?
Frequent handwashing is the best way to reduce your child’s chances of getting Fifth Disease and other childhood viruses. Though there’s no vaccine for Fifth Disease, once you’ve been infected, you become immune to it. In many cases, people are immune to the disease (due to an unknown childhood bout with the illness) but don’t know it. If you or your child is at risk for parvovirus complications, talk to your doctor about blood tests that can help determine if someone is immune to the parvovirus or if he or she has recently become infected.

When should I call a doctor?
Parents should make an appointment with their child’s pediatrician if the child has sickle cell anemia or an impaired immune system and is exhibiting signs of Fifth Disease. Pregnant women exposed to Fifth Disease should contact their health care provider, as the infection can cause complications for the fetus. For more information on Fifth Disease and pregnancy, visit the CDC website.

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