Fifth disease
Fifth disease, also known as erythema infectiosum, is an infectious viral illness primarily affecting children, characterized by a distinctive "slapped cheek" rash and mild fever. Caused by the human parvovirus B19, it is most commonly seen in children aged five to fourteen years, with outbreaks typically occurring in late winter and early spring. The virus spreads through respiratory secretions, and after a few days of incubation, symptoms such as fever, sore throat, and malaise may appear, followed by the characteristic rash that can last from ten days to two weeks. While the disease is usually mild and self-limiting, it can pose risks for individuals with weakened immune systems, pregnant women, and those with certain blood conditions. Treatment focuses on alleviating symptoms through rest, hydration, and, when necessary, medications for pain and fever. Notably, isolation is not required once the rash appears, as transmission risk is low at that stage. Although fifth disease is generally benign, ongoing research continues to explore its implications in more vulnerable populations.
Subject Terms
Fifth disease
ALSO KNOWN AS: Erythema infectiosum
ANATOMY OR SYSTEM AFFECTED: Nose, skin, throat
DEFINITION: An infectious disease of children characterized by an erythematous (reddish) rash and low-grade fever.
CAUSES: Viral infection
SYMPTOMS: "Slapped cheek" rash, fever, sore throat, achiness, malaise
DURATION: Ten to fourteen days
TREATMENTS: Alleviation of symptoms through bed rest, administration of liquids
Causes and Symptoms
Fifth disease is caused by infection with the human parvovirus (HPV) B19. The disease is more prevalent during late winter or early spring. Fifth disease is most commonly observed in young children, with the peak attack rate between five and fourteen years of age. Adults may become infected, but they rarely show evidence of disease.
The virus is spread from person to person through nasal secretions or sneezing. Following an incubation period of several days, a rash develops on the face, which has the appearance of slapped cheeks. The bright red color fades as the rash spreads over the rest of the body. An erythematous, pimply eruption may also appear on the trunk or extremities. A mild fever, sore throat, and nasal stuffiness may also be apparent. The rash generally lasts from ten days to two weeks. Often, it will fade only to reappear a short time later. Sunlight may aggravate the skin during this period, also causing a reappearance of the rash.
The diagnosis of fifth disease is primarily clinical, based on the symptoms. Laboratory tests for the virus are generally not performed.
Treatment and Therapy
No antiviral medication is available for fifth disease. Since the disease is rarely serious, treatment is mainly symptomatic, including medications for fever, pain, and itchiness. Bed rest and the administration of liquids, as commonly used in treating mild illness in children, are generally sufficient. Isolation is unnecessary since transmission is unlikely following appearance of the rash.
Perspective and Prospects
Fifth disease was first described during the late nineteenth century as the fifth in the series of erythematous illnesses often encountered by children; the others are measles, mumps, chickenpox, and rubella. HPV B19 was isolated in 1975 and shown to be the etiological agent of the disease in the mid-1980s.
The disease is common and generally benign. HPV B19 has been implicated, however, in certain forms of hemolytic anemias and arthritis in adults. It may be serious in patients who have weakened immune systems, are anemic, or are pregnant. Research continues on the virus.
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