What is Fifth Disease?

How to Treat Fifth Disease

You get a call from school. “Your child has fifth disease, please come pick her up.” As you rush to school in a panic, you picture your child lying on a couch in the nurse’s office, lethargic, high fever, moaning. “What is fifth disease anyway,” you ask yourself. “Is it serious?” You arrive at the school and rush in to the office, only to find your child sitting at a table, happily drawing a picture with a big smile on her face. This is a very common scenario.

Here is Dr. Sears’ guide to this very harmless, and very common childhood illness.

It is a harmless viral illness caused by Parvovirus. It is so called because it was the fifth fever and rash illness identified (along with chickenpox, measles, etc.). It is also called “slapped cheek disease” because of its major distinguishing characteristic – bright red cheeks that look like the child has been slapped. It can also infect adults.

What does fifth disease look like?

Bright red cheeks with pale skin around the mouth.
A red lacy or bumpy rash can occur on the chest, abdomen and back, which can then spread to the extremities. It can be itchy.
This face and body rash can fluctuate from better to worse with temperature and weather changes. Sunlight exposure can make the rash flare up.
This rash can sometimes come and go for several months.
Fever is present in 25% of cases.
Mild cold symptoms may occur.
Some people will experience headache, body aches and muscle aches.
Some cases will have general aches and fever which resolve, then have the rash break out 1 – 3 weeks later.
Some children will only have a rash, with no other symptoms or fever.
Adults, especially women, may experience joint pain and swelling.
Some cases can come and then resolve without anyone even detecting it.

Is it contagious and how do I catch it?

It is most contagious the day before the rash starts, the day before any fever starts and for as long as any fever is present. Once the fever is gone for 24 hours your child is no longer contagious, even though the rash will continue for a few days to a few months. If your child does not have a fever, then she is no longer contagious the day after the rash starts.

The virus is transmitted from a cough, runny nose or saliva. Only humans are affected. It’s not caught from animals.

The incubation period (the time from when you are exposed to the time you will become sick) is 4 – 14 days, sometimes as long as 21 days.

I am pregnant. Can this infection harm the fetus?

If a pregnant woman is exposed to this illness for the first time in her life, and she comes down with the symptoms of the illness, then there is a very small risk of a miscarriage. This risk is much greater during the first half of pregnancy. However, the good news is that the vast majority of adults have acquired this infection at some point during their lives and are therefore immune to it. A pregnant woman who is exposed to this illness can speak with her OB about testing for it.

Is there a test for it?

Yes, there is a blood test, but it is rarely used in children since it is not very important to know for certain if your child has fifth disease. The test can be done for pregnant women to see if she is immune to or has been recently infected with the virus.

Is there any treatment?

No. Simply treat any symptoms that are bothering your child. If your child is uncomfortable from itching, use Benadryl liquid. This may make your child drowsy, but it can really help the itching.

Is there any immediate harm from it?

For normal healthy adults and children, fifth disease is self-limiting and will resolve with no problems, except for a few adults (mostly women) who may have some uncomfortable join pains and swelling for several weeks.

There is one situation to be aware of. If you or your child has sickle cell anemia or any other hemolytic anemia, or has an immune deficiency disorder, this virus can cause a severe, life-threatening sudden anemia. If your child has this risk, and has been exposed to fifth disease, see your doctor.