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Fifth disease is a common or highly contagious  childhood  viral infection caused by parvovirus B19. This virus is a human virus and not the same as the parvovirus veterinarians are concerned about in pets like dogs or cats. It cannot be passed on from humans to animals or vise versa.  This is called the fifth disease because of its historical fifth position in the numerical classification of childhood diseases associated with rashes. It is also called the slapped-cheek disease ( because of the distinctive rash that develops) or erythema infectiosum. Symptoms usually include fatigue, fever, slapped cheek rash, whole body rash and joint aches. Although this illness is very common in children, adults may get it too. Studies show that adults usually get very mild forms and are asymptomatic. However it can be dangerous in pregnant women and cause miscarriage or serious health problems for the fetus. It is also very serious in people with compromised immune system and some kind of anemia. In children, fifth disease usually requires very little or no treatment . There is usually an outbreak of fifth disease in late winter or early spring although there has been  some evidence of sporadic cases throughout the year.


Fifth disease is a parvovirus infection caused by the human parvovirus B19. This is very different from the parvovirus seen in dogs and cats hence it cannot be passed from humans to pets or vise versa. Outbreaks usually occur in the late winter and early spring in elementary school aged children but anyone can get it at anytime of the year. A person with the virus is contagious before the rash. Once the rash appears kids are not contagious because the rash is the result of an immune system reaction after the infection has passed. The virus is very contagious and can spread from person to person through respiratory secretions from  large droplets when the person coughs or  sneezes. Once a person is infected with a parvovirus B19, he develops immunity to it and usually does not get infected again.


Symptoms usually vary depending on the age of the person who has been infected. Some people do not get symptoms at all. In children, Fifth disease usually begins with a low-grade fever, fatigue, upset stomach, headache, itching and sore throat. A few days later, these symptoms disappear and a bright red rash appears on the face –  usually on both cheeks.  Several days later, the rash spreads and extends to the arms, trunk, thighs and buttocks. The rash usually spares the palms of the hands and soles of the feet. As the rash begins to fade away or disappear it takes a lacy net-like appearance. The rash may take 1-3 weeks to disappear, worsening when the child is exposed to extreme temperatures or spends more time in the sun and then finally fades away. The slapped-face rash usually does not occur in adult. The common symptoms for adults is joint (hands,wrists, knees and ankles) soreness which may last from days to weeks. People generally do not see a physician for fifth disease but if  the person has anemia, compromised immune system or is pregnant, it is important to see a health-care professional right away.


Diagnosis is usually based on a physical examination of  the distinctive rash on the face. If a child or adult has no rash but has been sick for a while, the doctor will perform a test to see if the illness was caused by the parvovirus B19. Doctors usually do tests to check for immunity of a person to fifth disease from a previous childhood asymptomatic infection. .



Mild and uncomplicated forms of  fifth disease are usually treated successfully at home. Fluids, acetaminophen and enough rest usually help to relieve symptoms.  If the person has anemia, they are usually hospitalized to receive blood transfusions.



There are usually no complications of fifth disease in healthy children and adults. However, in people with anemia, the parvovirus can prevent the production of red blood cells causing anemia crisis. A parvovirus infection during pregnancy may affect red blood cells of  the fetus and cause severe anemia or still birth. Severe anemia may also be a complication in people with compromised immune system when they get fifth disease.


There is no vaccine for fifth disease. People who get this infection receive lifelong immunity to it. Practice good hygiene like frequent hand washing to prevent getting the infection or spreading it.













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