Erythema infectiosum
Erythema infectiosum, also known as fifth disease or slapped cheek disease, is a viral infection caused by the parvovirus B19, which primarily affects the skin. It is most commonly seen in children and presents with mild symptoms, including a low-grade fever, headache, and a runny nose, followed by a distinctive bright red rash on the face and a lighter, blotchy rash on the body. While the infection typically resolves without medical intervention in healthy individuals, those with weakened immune systems, sickle cell anemia, or pregnant women may require medical advice due to potential complications.
The virus spreads through direct contact with respiratory secretions, making good hygiene practices essential for prevention. Although there is no specific antiviral treatment for fifth disease, symptomatic relief can be provided with medications like acetaminophen for pain or fever. It's important for individuals who suspect they have the infection to consult a healthcare provider, especially pregnant women, as there is a slight risk of complications for the fetus. Awareness of fifth disease's symptoms and transmission can aid in managing and preventing outbreaks, particularly in communal settings like schools.
Erythema infectiosum
- ANATOMY OR SYSTEM AFFECTED: Skin
- ALSO KNOWN AS: Fifth disease, slapped cheek disease
Definition
Erythema infectiosum, commonly known as fifth disease, is an infection that results in a mild rash on the face, trunk, and limbs. In healthy people, fifth disease usually disappears without medical treatment, but pregnant women and persons who have an impaired immune system or have sickle cell anemia or other blood disorders may need to consult a physician.
Causes
Fifth disease is caused by a parvovirus B19 infection. This is not the same parvovirus that infects dogs and cats; parvovirus B19 only infects humans. It is estimated that about one-half of all adults have been infected with parvovirus B19 at some time. Because parvovirus is found in respiratory secretions (such as saliva, sputum, and nasal mucus), it is usually spread from person to person through direct contact with these secretions.
Risk Factors
The factors that increase one’s chance of developing fifth disease are age (the disease is most common in children) and contact with someone infected with parvovirus B19.
Symptoms
The symptoms of fifth disease may be caused by other, less serious health conditions, but if a person experiences any of these symptoms, they should consult a doctor. The first signs of fifth disease usually occur within four to fourteen days of becoming infected with parvovirus B19. These symptoms include a low-grade fever, headache, and a stuffy or runny nose. A few days after these symptoms pass, a bright red rash begins to develop on the face (known as a slapped cheek rash). Several days later, this rash spreads as a lighter red, blotchy rash down the trunk and limbs. The rash usually resolves within seven to ten days. In previously uninfected adults, there may be no initial symptoms or development of a typical rash. Some adults may also have joint pain and swelling.
Screening and Diagnosis
A doctor will ask about symptoms and medical history and will perform a physical exam. Tests may include an examination of the rash and a blood test to identify antibodies to parvovirus.
Treatment and Therapy
Because fifth disease is caused by a virus, antibiotics are ineffective in treating it, and no antiviral medications exist that will treat the disease. Usually, fifth disease does not require any treatment other than rest. Medications such as acetaminophen may be used to relieve joint pain and reduce fever. Anti-itch medications may be used to relieve itching associated with the rash.
In people with sickle cell disease or other types of chronic anemia, parvovirus B19 can sometimes cause acute, severe anemia. In this case, the anemia will require treatment, which may include hospitalization and blood transfusion. People with immune problems may need special medical care, such as treatment with antibodies, to help cure the infection. Sometimes, a parvovirus B19 infection in pregnant women will cause severe anemia in the fetus or possibly cause miscarriage. This is infrequent (less than 5 percent of the time). Usually, there are no serious complications; however, pregnant women who believe they may have parvovirus B19 infection or may have been exposed to someone with parvovirus B19 infection should consult an obstetrician for evaluation.
Prevention and Outcomes
It is difficult to prevent the spread of fifth disease because the virus is most contagious before the rash appears. To help reduce the chance of getting fifth disease, one should practice good hygiene, especially handwashing, which can help prevent the spread of many infections. According to the Centers for Disease Control and Prevention, in 2024, the United States saw a significant increase in cases of fifth disease among children aged five through nine. This increase in cases had also been seen in other areas worldwide.
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