INFORMATION FROM THE HEALTH OFFICE
HORACE MANN SCHOOL
Lee-Ann Halbert, R.N., School Nurse
Signs & Symptoms
Fifth Disease (Erythema
Infectiosum) is a viral illness caused by parvovirus B19. It begins with a
low-grade fever, headache, and mild respiratory symptoms (a stuffy or
runny nose like a common cold). These symptoms pass, and the illness
seems to be gone, until a rash appears 6 to 11 days later.
This rash classically begins on the face as a facial flushing that give
the child a "slapped cheek" appearance. The rash quickly spreads as
red blotches, extending down to the trunk and to the arms and legs, but
usually sparing the palms and soles of the feet. AS the centers of
the blotches begin to clear, the rash takes on a lacy net-like appearance.
Older children and adults sometimes complain that the rash itches, but most children with a rash caused by Fifth Disease do not look sick and have no fever. It usually takes one to three weeks for the rash to clear up totally, and it may seem to get better or worse at any time during this period.
Certain stimuli seem to reactivate the rash including sunlight, heat, exercise, stress. Other symptoms sometimes seen with Fifth Disease include swollen glands, red eyes, sore throat, diarrhea, and unusual rashes that look like blisters or bruises. In some cases, especially in adults and older teens, and attack of Fifth Disease may be followed by swelling or pain in the joints. The hands, wrists, knees, and ankles are most often affected.
Some children with specific blood disorders may become significantly ill when they have an infection with parvovirus B19. Parovirus B19 temporarily can suppress the body's production of red blood cells. Under usual conditions, this would not be noticed. But children who need to have a high production rate of new blood cells - such as those with sickle cell anemia - can become severely anemic if their red blood cell production is slowed by the effects of the virus. These children can become very pale, with a rapid pulse and abnormally fast breathing. They look sick, have fever and malaise (a generally ill feeling), and are lethargic, but they very rarely have the rash seen in Fifth Disease.
Description: Fifth Disease is a viral illness caused by Parvovirus B19. It occurs everywhere in the world, especially in school children between the ages of 5 and 15. Community outbreaks of Fifth Disease tend to happen in late winter or early spring, but there may also be sporadic cases of Fifth Disease throughout the year. The name "fifth", incidentally, is historic. This infection was counted among the five classical common infections of childhood. ("first, second, third, fourth, FIFTH!")
Studies show that from 40%-60% of adults worldwide have laboratory evidence of a past B19 infection, but most of these adults cannot remember having had symptoms of Fifth Disease. This leads experts to believe that most people with a B19 infection have either very mild symptoms or no symptoms at all.
B19 spreads from person to person in fluids from the mouth and throat of someone with a B19 infection, especially via large droplets from coughs and sneezes. In households where a child had Fifth Disease, another family member catches the infection in 15%-30% of cases. Mothers and classmates of children with Fifth Disease seem to be at special risk of catching the infection.
PLEASE NOTE, A PREGNANT WOMAN WHO HAS A B19 INFECTION MAY PASS THE VIRUS ON TO HER UNBORN CHILD. IN MOST CASES, THIS CAUSES NO LASTING PROBLEMS FOR THE BABY, BUT RARELY, THE FETUS MAY BE INFECTED IF THE MOTHER HAS THE INFECTION DURING THE FIRST TRIMESTER.
Prevention: There is no vaccine for Fifth Disease, and researchers do not recommend giving immune globulin to those who have been exposed to it. Since the rash of Fifth Disease is a reaction of the body's immune system AFTER a B19 infection, isolating someone with a Fifth Disease rash will not prevent spread of the infection because the virus is probably already gone. By the time the Fifth Disease rash is obvious, the person usually is not contagious.
Incubation: The incubation period for Fifth Disease ranges from 4 to 28 days, with the average being 16 or 17 days.
Duration: The Fifth Disease rash usually lasts 1-3 weeks. In older children and adults, when joint swelling and pain follow the disease, joint symptoms have lasted from a few months to over four years.
Contagiousness: Persons with Fifth Disease infection can spread the virus in fluids from the mouth and throat beginning 7-11 days after they were exposed to the illness. This contagious period falls either during the incubation period or during the time when they have only mild respiratory symptoms (before the rash). Since the Fifth Disease rash is an immune reaction AFTER the infection passes, a child with Fifth Disease rash is usually not contagious.
Home Treatment: Usually, children with Fifth Disease feel fairly well and need little home treatment. Since the Fifth Disease infection is typically identified by its rash, AFTER fever and mild cold symptoms have passed, there may be little to treat except any discomfort from the rash itself. If your child has itching from the Fifth Disease rash, ask your doctor about which lotions or creams might best relieve the discomfort.
Professional Treatment: Fifth Disease is caused by a virus and cannot be treated with the antibiotics used to treat bacterial infections. Although antiviral medicines exist, they are not used to treat Fifth Disease. In most instances, Fifth Disease is such a mild illness that no medicine is necessary.
REMEMBER, IF YOU ARE PREGNANT AND DEVELOP ANY TYPE OF RASH, CALL YOUR OBSTETRICIAN IMMEDIATELY. IF YOU ARE PREGNANT AND HAVE BEEN EXPOSED TO SOMEONE WITH FIFTH DISEASE, OR TO ANYONE WHO HAS AN UNUSUAL RASH, ALSO CALL YOUR OBSTETRICIAN.
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