Summary about Disease
Third disease, also known as erythema infectiosum or "fifth disease," is a mild, common viral illness primarily affecting children. It's characterized by a distinctive "slapped cheek" rash and is caused by parvovirus B19. Generally, the disease is self-limiting and resolves without serious complications in healthy individuals. While usually mild, it can pose risks to pregnant women and individuals with certain blood disorders or weakened immune systems.
Symptoms
The symptoms of fifth disease typically appear in stages:
Early Symptoms (flu-like): Mild fever, headache, fatigue, runny nose, sore throat. These symptoms may appear 7-10 days after infection.
"Slapped Cheek" Rash: A bright red rash appears on both cheeks, often the most recognizable symptom.
Lacy Rash: 1-4 days after the facial rash, a lacy, maculopapular (slightly raised) rash appears on the trunk, arms, and legs. The rash may be itchy.
Arthritis: Joint pain and swelling, mainly in the wrists, knees, and ankles, are more common in adults, especially women.
Causes
Fifth disease is caused by human parvovirus B19. The virus spreads through respiratory droplets produced when an infected person coughs or sneezes. It can also spread through blood or blood products.
Medicine Used
There is no specific antiviral medication to treat fifth disease. Treatment focuses on relieving symptoms:
Pain Relievers: Over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help reduce fever and relieve joint pain.
Antihistamines: May be used to relieve itching associated with the rash.
Rest and Fluids: Adequate rest and fluid intake are important for recovery.
For Severe Anemia: In rare cases, individuals with underlying blood disorders who develop severe anemia due to parvovirus B19 infection may require blood transfusions or intravenous immunoglobulin (IVIG).
Is Communicable
Yes, fifth disease is communicable. It's most contagious during the early stages of the illness, before the rash appears, when flu-like symptoms are present. Once the rash appears, the person is generally no longer considered contagious.
Precautions
Handwashing: Frequent handwashing with soap and water is crucial.
Respiratory Hygiene: Cover coughs and sneezes with a tissue or elbow.
Avoid Sharing: Avoid sharing food, drinks, and utensils.
Pregnant Women: Pregnant women should avoid contact with individuals known to have fifth disease, as it can pose a risk to the fetus. Contact your doctor immediately if you are pregnant and suspect you have been exposed.
Individuals with Weakened Immune Systems or Blood Disorders: Those at high risk of complications should also avoid exposure.
School/Daycare: Children can generally return to school or daycare once the rash appears, as they are no longer considered contagious at that point. Check your local policies.
How long does an outbreak last?
Individual cases of fifth disease usually last 1-3 weeks. Outbreaks, especially in schools, can last for several weeks or months as the virus spreads through the community.
How is it diagnosed?
Fifth disease is usually diagnosed based on the characteristic "slapped cheek" rash. In some cases, a blood test to detect parvovirus B19 antibodies may be performed, especially in pregnant women or individuals with weakened immune systems, to confirm the diagnosis.
Timeline of Symptoms
Incubation Period (4-14 days): Time between exposure and the start of symptoms.
Early Symptoms (7-10 days after infection): Flu-like symptoms such as mild fever, headache, fatigue. Contagious during this period.
"Slapped Cheek" Rash (1-4 days after early symptoms): Bright red rash on cheeks.
Lacy Rash (1-4 days after cheek rash): Rash appears on trunk, arms, and legs.
Arthritis (Variable onset): Joint pain and swelling, especially in adults.
Resolution (1-3 weeks total): The rash and other symptoms typically resolve within 1-3 weeks. The rash may recur with sun exposure, heat, or exercise for weeks or months after the initial illness.
Important Considerations
Pregnancy: Fifth disease during pregnancy can, in rare cases, lead to fetal anemia and miscarriage, particularly during the first trimester. Pregnant women who suspect they have been exposed should contact their doctor immediately.
Underlying Blood Disorders: Individuals with blood disorders like sickle cell anemia or thalassemia can develop severe anemia if infected with parvovirus B19.
Weakened Immune Systems: People with weakened immune systems (e.g., those with HIV/AIDS or undergoing chemotherapy) may experience a prolonged or more severe infection.
Misdiagnosis: The rash of fifth disease can sometimes be mistaken for other viral rashes or allergic reactions. If you are unsure, consult a doctor.
Rash Recurrence: The rash can reappear for several weeks or months after the initial illness, especially when triggered by sunlight, heat, or exercise. This recurrence is not contagious.