Fifth disease

Fifth disease, also known as erythema infectiosum, is a viral infection characterized by a body rash. It is usually mild and is more common in children than adults.

The rash starts on the cheeks, giving the child a "slapped cheek" appearance. After approximately 4 days, a rash can appear on the torso, then on the arms, the legs and the rest of the body. The rash disappears after 1 to 3 weeks, during which time it may come and go, or worsen after a hot bath, exposure to sun or exercise.

The rash is sometimes preceded by cold-like symptoms:

• Runny or stuffed nose
• Headache
• Fever
• Sore throat
• Stomach ache (diarrhea, nausea)
• Joint pain

Once a person is infected, they develop immunity against fifth disease because their body's immune response protects them against the illness.

Causes and triggers

Fifth disease is caused by parvovirus B19. This infection is contagious and spreads like a cold:

• By coming into contact with the virus in the air after an infected person has coughed or sneezed.
• By touching the hands of someone who is infected or by touching contaminated objects.

The virus can also be spread from a mother to her unborn child.

The infection is contagious a few days before the rash develops. Once the rash appears, the infection can no longer be passed on to anyone else.

Some people have a higher risk of developing complications if they have fifth disease. This is the case, for example, if a person:

• Has a weakened immune system
• Has chronic anemia
• Is undergoing chemotherapy
• Is pregnant

For women who are pregnant and exposed to fifth disease, there are usually no serious complications for them or the unborn child. In rare cases, when the virus is spread to an unborn child, this can result in a miscarriage or severe anemia for the baby.

Treatment

There is no vaccine to prevent this illness and there is no medication to treat it. In fact, the infection goes away on its own. Antibiotics are not effective in treating fifth disease because it is caused by a virus.

If you have this infection, it is simply recommended that you rest and drink plenty of water.

Fever and pain can be relieved with a pain reliever such as acetaminophen (e.g., Tylenol). Ibuprofen (e.g. Advil) can be given to children over 6 months old.

To avoid spreading the infection to those around you, there are some simple measures you can take, such as:

• Washing your hands often with soap
• Coughing or sneezing into your elbow
• Not touching your eyes, nose or mouth
• Avoiding close contact with people who are sick
• Staying home and resting

When should I see a healthcare professional?

See your healthcare provider if you or your child:

• Have a blood disorder
• Have a weakened immune system
• Have a fever that does not improve after 2 or 3 days
• Have ear or neck pain

You should also see your healthcare provider if you are pregnant and have symptoms, or if you have been exposed to a person infected with fifth disease.

For more information:

• Canadian Paediatric Society