Summary about Disease
Erythema infectiosum, also known as fifth disease or "slapped cheek syndrome," is a mild viral illness, most common in children, caused by parvovirus B19. It is characterized by a distinctive red rash on the cheeks, giving the appearance of having been slapped. While usually harmless, it can pose risks to pregnant women and individuals with certain blood disorders.
Symptoms
The initial symptoms of fifth disease are often mild and flu-like, including:
Fever
Runny nose
Sore throat
Headache
Fatigue These symptoms usually subside before the characteristic rash appears. The rash typically starts as bright red patches on the cheeks ("slapped cheek" appearance). This is often followed by a lacy, slightly raised rash on the trunk, arms, and legs. The rash may be itchy and can come and go, especially with changes in temperature or sunlight exposure. Adults may experience joint pain in addition to, or instead of, the rash.
Causes
Fifth disease is caused by the human parvovirus B19. The virus spreads through respiratory droplets when an infected person coughs or sneezes, similar to a common cold. It can also spread through blood or from a pregnant woman to her fetus.
Medicine Used
There is no specific antiviral medication to treat fifth disease. Treatment focuses on relieving symptoms. Medicines used include:
Pain relievers: Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help reduce fever and relieve aches or joint pain.
Antihistamines: May be used to relieve itching associated with the rash. In rare cases, individuals with weakened immune systems or severe anemia may require intravenous immunoglobulin (IVIG) to help their bodies fight the infection.
Is Communicable
Yes, fifth disease is communicable. The virus is most contagious during the early stages, before the rash appears, when the individual is experiencing flu-like symptoms. Once the rash appears, the person is generally no longer contagious.
Precautions
To prevent the spread of fifth disease:
Good Hygiene: Frequent handwashing with soap and water is essential, especially after coughing or sneezing.
Respiratory Etiquette: Cover your mouth and nose when coughing or sneezing.
Avoid Sharing: Do not share utensils, cups, or other personal items.
Pregnant Women: Pregnant women should inform their healthcare provider if they are exposed to fifth disease, as it can potentially harm the fetus.
Inform Schools/Daycares: If your child is diagnosed, inform their school or daycare so they can monitor for other cases.
How long does an outbreak last?
The incubation period (time between exposure and symptoms) for fifth disease is usually 4 to 14 days, but can be up to 21 days. The illness itself, including the rash, can last from one to three weeks, and sometimes longer. The rash may come and go for several weeks, especially with triggers like heat, sunlight, or exercise.
How is it diagnosed?
Fifth disease is usually diagnosed based on the characteristic "slapped cheek" rash. A doctor can often diagnose the illness with a simple physical exam. If the diagnosis is uncertain or if the individual is at risk for complications (e.g., pregnant women, individuals with blood disorders), a blood test can be performed to detect antibodies to parvovirus B19.
Timeline of Symptoms
Incubation Period (4-14 days, up to 21 days): No symptoms.
Early Symptoms (7-10 days after exposure): Mild flu-like symptoms (fever, runny nose, sore throat, headache, fatigue). These symptoms often resolve before the rash appears.
Rash Stage (Typically follows the flu-like symptoms):
Phase 1: Bright red rash on the cheeks ("slapped cheek" appearance).
Phase 2: Lacy, slightly raised rash on the trunk, arms, and legs.
Phase 3: Rash may fade and reappear over 1-3 weeks, triggered by heat, sunlight, or exercise.
Important Considerations
Pregnancy: Fifth disease can be dangerous for pregnant women as it can cause anemia in the fetus, leading to miscarriage in some cases. Pregnant women exposed to fifth disease should contact their healthcare provider immediately.
Anemia: Individuals with chronic anemia, such as sickle cell anemia, are at risk of developing a severe anemia crisis if infected with parvovirus B19.
Immunocompromised Individuals: People with weakened immune systems (e.g., due to HIV/AIDS, cancer treatment, or organ transplant) may develop chronic parvovirus B19 infection, leading to severe anemia and other complications.
Adults: Adults who contract fifth disease may experience joint pain and swelling that can last for several weeks or months.
Most cases are mild: Fifth disease is usually a mild, self-limiting illness in otherwise healthy children. Treatment is mainly supportive to relieve symptoms.