Appearance, Symptoms, Causes, Treatment, and More
Fifth disease occurs following exposure toparvovirus B19.
The disease is sometimes called slapped-cheek disease because it presents with a bright red facial rash.
Fifth disease is more common in children.
Illustration by Laura Porter for Verywell Health
Fifth disease can sometimes go away on its own, but treatment can manage symptoms and relieve itch.
Illustration by Laura Porter for Verywell Health
What Does Fifth Disease Look Like?
Fifth disease generally starts with symptoms similar tofluor thecommon cold.
Reproduced with permission from © DermNetdermnetnz.org2023.
The rash will appear once these symptoms pass (within a few days).
It generally lasts a few days to two weeks and can be itchy.
It fades from the center outward, resulting in a blotchy appearance.
This photo contains content that some people may find graphic or disturbing.
Reproduced with permission from DermNetdermnetnz.org2023.
But after the rash has cleared, it can reappear if the skin is irritated.
Most adults with fifth disease experience a mild rash, but a rash doesn’t always occur.
And some adults will be asymptomatic (have no symptoms).
During this period, the virus is the most contagious.
The rash will first appear on the face as a raised, bright red patch.
Some children with fifth disease will also experience joint pain and swelling.
It can be dangerous for immunocompromised children because it can trigger severe anemia.
What Is Anemia?
What Causes Fifth Disease?
The parvovirus B19 infection causes fifth disease.
But the disease can spread anytime and affect anyone of any age.
Also, animals cannot acquire parvovirus B19 from humans.
Your pets will not acquire parvovirus from a family member with fifth disease or transmit it to other people.
How Is Fifth Disease Diagnosed?
A healthcare provider can diagnose fifth disease based on the symptoms.
The slapped-cheek rash is a strong indication of the disease.
A blood test can also be done to look for antibodies (immune proteins) to the virus.
How Is Fifth Disease Treated?
For healthy people who develop fifth disease, no treatment is needed.
The condition is self-limiting and will improve with rest and fluid intake.
you could also use anantihistamine medicinelikeBenadryl(diphenhydramine) to manage itch.
In rare cases,intravenous immunoglobulin(IVIG) treatment can be given.
It containsantibodiesthat work against parvovirus B19.
Can Adults Get Fifth Disease?
Most adults have antibodies that prevent them from developing fifth disease.This is often because they were exposed during childhood.
Joint pain and other symptoms in adults usually resolve without any long-term problems.
Joint pain and swelling can be managed withanti-inflammatory drugs, while itch can be treated with an antihistamine.
Once the infection has resolved, the acute anemia will also resolve.Chronic anemiawill need medical treatment, potentially long-term.
The disease is generally mild for most pregnant people.
Symptoms may include joint pain and swelling, and a mild rash.
The fetus is unlikely to be affected, but it is still possible for them to acquire the infection.
When Is Fifth Disease Contagious?
If your child develops a second rash, that rash should go away within a few days.
There are instances in which the rash can come and go several times.
When your child experiences flu-like symptoms, they are contagious and should stay home from school or daycare.
However, once the rash appears, they are no longer contagious and can return if they feel better.
Immunocompromised people should immediately see their healthcare provider if they are exposed to the virus.
A healthcare provider may prescribe additional treatments to prevent disease complications.
A pregnant person exposed to fifth disease should immediately inform their healthcare provider.
Can Fifth Disease Be Prevented?
There is no vaccine available to prevent fifth disease.
Because the disease is spread through respiratory secretions, good hygiene can help prevent the infection.
Roseola (sixth disease)can sometimes be mistaken for fifth disease.
It causes a high fever that can last a few days.
Once the fever passes, a rash will appear across the trunk, extremities, and face.
Roseola also causes symptoms that help set it apart from fifth disease, including eyelid swelling.
Scarlet fever, like fifth disease, causes a red rash.
It results from the same bacteria that causes strep throat.
The scarlet fever rash will start on the face after a day or two of the initial symptoms.
Scarlet fever is treated with antibiotics, which can preventrheumatic feverand other complications.
This is especially important if the child has an itchy rash or severe joint pain.
They can request a blood test and monitor your symptoms if your test comes back positive.
Summary
Fifth disease occurs after exposure to parvovirus B19 and causes a bright red facial rash.
It typically starts with flu-like symptoms, which last a few days before the rash appears.
This is also the most contagious time.
Fifth disease affects more children than adults.
Treatment and monitoring are important for people with weak immune systems and anyone who is pregnant.
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National Heart, Lung, and Blood Institute.What is anemia?
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2022;14(9):e29148.
doi:10.7759/cureus.29148
Centers for Disease Control and Prevention.Fifth disease and pregnancy.
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