Children and Fifth Disease

Fifth disease is a viral infection sometimes referred to as erythema infectiosum or "slapped-cheek disease." It starts with a fairly uniform red flush on the cheeks, followed by a reddish rash on the arms and legs. The rash is typically more apparent on the top (dorsal) side of the upper arms and upper legs and may cover most of the trunk.  Sometimes the rash develops a lacy appearance.

Fifth disease is usually seen in children, from preschool through junior high school age, and it often occurs in the spring.

Causes

Fifth disease is caused by parvovirus B19 and is very contagious. It spreads through saliva by coughing, sneezing or skin-to-skin contact. Although the rash usually only lasts about five days, it can recur a number of times over several weeks if the child is exposed to sunlight, heat, exercise, fever or stress.

Symptoms

• Fifth disease usually starts with a bright red flush on the cheeks that looks as if the child has been slapped. The rash then spreads to the arms, legs and body. It fades over one to two weeks and may have a lacy look as it fades.

• There may be a mild fever or cold symptoms a few days before the rash appears.

• There may be mild joint pains or mild headache.

• Teenagers and adults may complain of itching associated with the rash.

• Immunocompromised people, particularly those with HIV, may develop anemia following infection with parvovirus B19. 

• People with hemolytic conditions such as sickle cell anemia and spherocytosis may have rapid onset of anemia.

Self-Care

• Encourage extra fluids.

• For joint pain or a headache, you may give your child acetaminophen. Do not give aspirin.