Fifth Disease (also know as Parvovirus infection)
Parvovirus infection is also commonly called fifth disease because it was fifth of a group of once-common childhood diseases that all have similar rashes. The other four diseases are measles, rubella, scarlet fever and Dukes' disease.
Parvovirus infection is a common but mild infection in children that generally requires little treatment. However, in some pregnant women, it can lead to serious health problems for the fetus. Parvovirus infection is also more serious for adults with some kinds of anemia or who have a compromised immune system.
Signs and symptoms
Most children with parvovirus infection feel well. Some develop mild, cold-like signs and symptoms early in the illness:
- Sore throat
- Slight fever
- Upset stomach
- Headache
- Fatigue
- Itching
Several days later, a distinctive bright red facial rash usually appears on both cheeks. Eventually it may extend to the arms, trunk, thighs and buttocks where the rash has a pink, lacy, slightly raised appearance.
Generally the rash occurs near the end of the illness. It's possible to mistake the rash for other viral rashes or a medicine-related rash. Infants and toddlers develop the same signs and symptoms that school-age children do.
The initial symptoms typically last five to 10 days. The rash may come and go for up to three weeks, becoming more visible when a child is exposed to extreme temperatures or spends time in the sun.
In adults, the most prominent symptom of parvovirus infection is joint soreness (arthralgia), lasting days to weeks. Joints most commonly affected are the hands, wrists, knees and ankles.
Parvovirus infection can also occur without any signs or symptoms in either children or adults.
Causes
The human parvovirus B19 causes parvovirus infection. This isn't the same as the parvovirus seen in dogs and cats, so you can't get the infection from a pet or vice versa. Parvovirus B19 is most common among elementary school-age children during outbreaks in the winter and spring months, but anyone can become ill with it any time of the year. It spreads from person to person, just like a cold, often through respiratory secretions and hand-to-hand contact. The illness is contagious in the week before the rash appears. Once the rash appears, the person with the illness is no longer considered contagious and doesn't need to be isolated.
When to seek medical advice
If your child develops what appear to be signs and symptoms of parvovirus infection, but you're not sure, contact your doctor to see if there may be some other cause for the signs and symptoms. Also contact your doctor if your child has a temperature greater than 102 F or if you have other concerns.
If you're pregnant and you suspect you've been exposed to parvovirus, see your doctor. A pregnant woman with parvovirus infection may pass the illness along to her baby. Although the great majority of pregnant women who have parvovirus infection will deliver normal, healthy children, there's a small risk to the unborn baby of severe and even life-threatening health conditions.
Also, see your doctor for help with treatment if you have a weakened immune system, perhaps because of another preexisting disease, cancer treatment or an organ transplant.
Screening and diagnosis
If a rash is present, your doctor may be able to make a diagnosis by examination. About half of adults are immune to parvovirus infection, most likely because of a previous, unnoticed, childhood infection. If you're pregnant or if you're an adult with a compromised immune system, blood tests can help determine if you're immune to the infection or if you've recently become infected. The blood tests commonly used are tests for antibodies that are specific for parvovirus infection. Subsequent action depends on test results.
- If the blood tests indicate immunity, you don't need to be concerned. You can't be reinfected:
- If the tests confirm evidence of recent parvovirus infection, you may need additional testing to determine what, if any, complications — such as anemia — need treatment.
- If you're pregnant and you have parvovirus infection, your doctor may perform additional tests such as ultrasound and possibly additional blood tests to watch for potential fetal complications.
Complications
If you're pregnant and you become infected with parvovirus B19, particularly in the first half of your pregnancy, there's a chance your fetus may develop serious complications, such as severe anemia. But this occurs in only a small percentage of infected pregnant women.
Most pregnant women with parvovirus infection have normal, healthy babies. Parvovirus infection doesn't increase the risk of birth defects or mental retardation.
Other complications in adults include the following:
- In people with sickle cell anemia (or other types of anemia in which red blood cells are used up faster than your bone marrow can replace them), parvovirus infection can lead to severe anemia.
- In people with weakened immune systems (particularly people who've undergone chemotherapy), signs and symptoms of the infection can be severe, requiring medical care.
Treatment
For a non-complicated parvovirus infection, self-care treatment at home is generally sufficient. The rash itself doesn't need treatment.
People with severe anemia may need to be hospitalized and receive blood transfusions. Those with weakened immune systems may receive antibodies (immune globulin) to treat the infection.
If you're pregnant and develop parvovirus infection, your doctor may wish to monitor possible effects on your baby. Treatments may include blood transfusions and medications if your baby has anemia, congestive heart failure or edema.
Prevention
There's no vaccine to prevent parvovirus infection. Washing your hands and your child's hands frequently may help diminish the chances of getting an infection. Throw away used tissues immediately after use — wash your hands after handling them.
Self-care
Self-care treatment is aimed primarily at relieving symptoms and easing any discomfort. Make sure you or your child gets plenty of rest and drinks lots of fluids. You can use acetaminophen (Tylenol, others) to relieve temperatures of more than 102 F or minor aches and pains. Avoid giving aspirin to children. Aspirin may trigger a rare but potentially fatal disorder known as Reye's syndrome.
It's impractical and unnecessary to isolate your sick child. You won't know your child has parvovirus infection until the rash appears, and by that time, your child is no longer contagious.