Fifth Disease – Information on Fifth Disease

Especially common in kids between the ages of 5 and 15, fifth disease typically produces a distinctive red rash on the face that makes the child appear to have a "slapped cheek." The rash then spreads to the trunk, arms, and legs. Fifth disease is actually just a viral illness that most kids recover from quickly and without complications.

Fifth disease is caused by infection with human parvovirus B19. This virus infects only humans. Pet dogs or cats may be immunized against "parvovirus," but these are animal parvoviruses that do not infect humans. Therefore, a child cannot "catch" parvovirus from a pet dog or cat, and a pet cat or dog cannot catch human parvovirus B19 from an ill child.

The virus is thought to spread via droplets in the air (respiratory secretions transmitted by coughs and sneezes) and blood. Early during the illness, nasal secretions have been shown to contain the viral DNA. Blood has been found to contain viral particles as well as DNA.

The bright red cheeks are a defining symptom of the infection in children (hence the name "slapped cheek disease"). Occasionally the rash will extend over the bridge of the nose or around the mouth. In addition to the red cheeks, children often develop a red, lacy rash on the rest of the body, with the upper arms and legs being the most common locations.

Fifth disease (erythema infectiosum) is a common, usually mild illness spread through the air from an infected person's cough or sneeze. In children, it causes a distinctive “slapped cheek” rash and, less commonly, a low-grade fever, headache, sore throat and joint pain.

Many people with fifths disease show no symptoms at all. Therefore, the only way to definitively diagnose it is to have a test. Approximately 50-60% of adults have had the disease and are immune. However, those who are not immune may be at risk from picking up this infection, particularly healthcare providers, childcare providers and teachers.

While the illness is not serious in children, around 5% of children and around 50% of adults with fifth disease can have joint aches and pains. This arthritis or arthropathy is more common in females than males and is usually temporary, lasting days to weeks, but may become a long-term problem for months. People with arthritis from fifth disease usually have stiffness in the morning, with redness and swelling of the same joints on both sides of the body (a "symmetrical" arthritis). The joints most commonly involved are the knees, fingers, and wrists.

Fifth disease is caused by human parvovirus B19. It often affects preschoolers or school-age children during the spring. The disease is spread by contact with respiratory secretions and usually return for 5 days. However, the rash associated with fifth disease may return for several weeks. Return of the rash may be brought on by sunlight, heat, exercise, fever, or emotional stress.

It is easy to catch fifth disease. Infected people have the virus in their saliva and mucus. You can get it when you come into contact with those fluids. Frequently washing your hands might help prevent getting the virus. Most people become immune to the virus after having it once.

One to two weeks after exposure, some children will experience a low grade fever and tiredness. By the third week, a red rash generally appears on the cheeks giving a slapped face appearance. The rash may then extend to the body and tends to fade and reappear. Sometimes, the rash is lacy in appearance and may be itchy.