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Fifth disease

Fifth disease is caused by a virus that leads to a rash on the cheeks, arms, and legs.

Alternative Names

Parvovirus B19; Erythema infectiosum; Slapped cheek rash

Causes

Fifth disease is caused by human parvovirus B19. It often affects preschoolers or school-age children during the spring. The disease spreads through the fluids in the nose and mouth when someone coughs or sneezes.

The disease causes a tell-tale bright-red rash on the checks. The rash also spreads to the body and can cause other symptoms.

You can get fifth disease and not have any symptoms. About 20% of people who get the virus don't have symptoms.

Symptoms

Early symptoms of fifth disease include:

  • Fever
  • Headache
  • Runny nose

This is followed by a rash on the face and body:

  • The tell-tale sign of this illness is bright-red cheeks. This is often called a "slapped-cheek" rash.
  • The rash appears on the arms and legs and middle of the body, and it may itch.
  • The rash comes and goes and usually disappears in about 2 weeks. It fades from the center outwards, so it looks lacy.

Some people also have joint pain and swelling. This more commonly occurs in adult women.

Exams and Tests

Your doctor will examine the rash. Usually this is enough to diagnose the disease.

Your doctor can also do blood tests to look for signs of the virus, although it's usually not needed.

The doctor may choose to do a blood test in certain situations, such as for pregnant women or people with anemia.

Treatment

There's no treatment for fifth disease. The virus will clear up on its own in a couple of weeks. If your child has joint pain or itchy rash, talk with your child's doctor about ways to ease symptoms. Acetaminophen (such as Tylenol) for children can help relieve joint pain.

Outlook (Prognosis)

Most children and adults have only mild symptoms and recover completely.

Possible Complications

Fifth disease usually doesn't cause complications in most people.

If you are pregnant and think you may have been exposed to someone with the virus, tell your health care provider. Usually there's no problem. Most pregnant women are immune to the virus. Your doctor can test you to see if you are immune.

Women who are not immune usually only have mild symptoms. However, the virus can cause anemia in an unborn baby and even cause miscarriage. This is uncommon and occurs only in a small percentage of women, usually in the first half of pregnancy.

There's also a higher risk of complications in people with:

  • A weak immune system, such as from cancer, leukemia, or HIV infection
  • Certain blood problems such as sickle cell anemia

Fifth disease can cause severe anemia , which will need medical treatment.

When to Contact a Medical Professional

You should call your health care provider if:

  • Your child has symptoms of fifth disease
  • You are pregnant and think you may have been exposed to the virus or you have a rash

References

Koch WC. Parvovirus B19. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 243.

Updated: 8/22/2013

Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.


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