Fifth Disease

What is fifth disease?

From: MedlinePlus, National Library of Medicine

Fifth disease, also called erythema infectiosum, is a viral infection caused by parvovirus B19. This virus only infects people; it's not the same type of parvovirus that dogs and cats can get.

Fifth disease mostly affects children. It often causes a bright red rash on their cheeks (sometimes called a "slapped cheek" rash).

In the United States, parvovirus B19 infections are more common in late winter, spring, and early summer. There are usually minor outbreaks of fifth disease about every 3 to 4 years.

What causes fifth disease?

From: MedlinePlus, National Library of Medicine

Parvovirus B19, which causes fifth disease, can spread from person to person:

• Through respiratory droplets, such as saliva (spit), sputum, or nasal mucus. The droplets can spread when: Someone who has the virus coughs and sneezes You touch an item that has the virus on it
• Through blood or blood products
• From a pregnant parent to the baby during pregnancy

You are most contagious early in your infection, when you usually only have a fever or cold-like symptoms. You are not likely to be contagious after you get later symptoms such as a rash and joint pain.

What are the symptoms of fifth disease?

From: MedlinePlus, National Library of Medicine

About 2 out of 10 people who get a B19 parvovirus infection will have no symptoms.

But most people will get the symptoms of fifth disease, which are usually mild and can include:

The "slapped cheek" rash is more common in children. They usually get the rash a few days after they first have other symptoms. The rash can then spread to the arms, legs, chest, back, and buttocks.

Adults who get fifth disease might also have joint pain and swelling (called polyarthropathy syndrome).

Sometimes the infection can cause serious health complications affecting the nerves, joints, or blood system. This is more likely to happen if you are pregnant, have a blood disorder such as anemia, or a weakened immune system.

Because of these risks to you and some possible risks to your baby, contact your health care provider if you are pregnant and:

• Fever
• Headache
• Cough
• Sore throat
• Rashes
• Joint pain
• You show signs of fifth disease (or a "slapped cheek" rash)
• You may have been exposed to someone who has the infection

How is fifth disease diagnosed?

From: MedlinePlus, National Library of Medicine

There is no routine lab test to diagnose fifth disease. Providers can often diagnose fifth disease just by seeing the "slapped cheek" rash and rashes on the body.

There is testing to show whether or not you have protection (immunity) against the B19 parvovirus or if you have had a recent infection. This test is usually not needed, but your provider may order the test if you are pregnant or at higher risk for complications of the disease.

What are the treatments for fifth disease?

From: MedlinePlus, National Library of Medicine

There is no specific treatment for fifth disease. It is usually mild and goes away on its own.

To feel better, get plenty of rest. Taking acetaminophen can help with the fever and pain. Do not give aspirin to children, because it may cause Reye syndrome. This is a rare, serious illness that can affect the brain and liver.

Can fifth disease be prevented?

From: MedlinePlus, National Library of Medicine

There is no vaccine to prevent fifth disease. But you can help protect yourself and others by:

• Washing your hands often with soap and water
• Covering your mouth and nose when you cough or sneeze
• Avoiding touching your eyes, nose, and mouth with unwashed hands
• Avoiding close contact with people who are sick
• Staying home when you are sick

Most people become immune to the virus after having it once.

Which doctor should you see?

The suggested department for discussing Fifth Disease is Infectious Diseases, with a general physician / infectious disease specialist as the relevant type of clinician. General physician / Family Medicine; paediatrician for children. Referral depends on symptoms.

This is an editorial referral starting point. The appropriate clinic depends on the person’s age, symptoms, previous diagnosis and local services. The first clinician can decide whether another specialty or a team is needed; a department label does not confirm the diagnosis.

How to prepare for an assessment

Bring a short timeline of the main symptoms: when they first appeared, whether they are constant or episodic, what seems to change them, and how they affect daily activities. Include previous reports, discharge summaries, current medicines and supplements, allergies, and any relevant family history. A dated record is more useful than trying to match every feature in an online article.

Ask the clinician what is already established and what remains uncertain. If a test is suggested, ask what question it answers, what its limitations are and how the result would change the next step. The information here is not an instruction to arrange every possible test. In children, bring growth, developmental and school information if it is relevant to the concern.

• Which exposure or organism is suspected, and what evidence would confirm it?
• Are precautions, vaccination or advice for close contacts relevant to this infection?
• What should happen if symptoms worsen or do not improve as expected?

Treatment discussions and follow-up

Where the source describes treatments, these are an overview of possible care, not a prescription for an individual. Ask which option applies to the confirmed diagnosis, what benefit is expected, what adverse effects to watch for and how progress will be assessed. Availability, approvals and local practice can differ from the country described in the source.

Before leaving the appointment, clarify the next review date, who will communicate results, and whom to contact if the situation changes. Discuss difficulties with sleep, work, school, mobility, eating or emotional wellbeing when these are relevant. Practical support may require coordination between the treating clinician and other services.

The collected references do not establish a complete prevention or long-term outlook section for this entry. Missing information should not be interpreted as proof that prevention is impossible or that a particular outcome is inevitable. Ask what is known for the exact subtype, stage and personal circumstances, and which uncertainties remain.

When to seek emergency help

Severe breathing difficulty, collapse, new stroke-like symptoms, a seizure that is prolonged or repeated without recovery, uncontrolled major bleeding, or an immediate risk of self-harm require emergency help. In India, call 112 or reach the nearest emergency department. This is a general, non-exhaustive warning list; it is not a condition-specific triage tool.