Fifth Disease

Medically reviewed by Daniel Murrell, MD on January 10, 2018Written by Autumn Rivers and Winnie Yu

What is fifth disease?

Fifth disease is a viral disease that often results in a red rash on the arms, legs, and cheeks. For this reason, it’s also known as “slapped cheek disease.” It’s fairly common and mild in most children, but it can be more severe for pregnant women or anyone with a compromised immune system.

Most doctors advise people with fifth disease to wait out the symptoms. This is because there’s currently no medication that’ll shorten the course of the disease. However, if you have a weakened immune system, your doctor may need to closely monitor you until the symptoms disappear.

What causes fifth disease?

Parvovirus B19 causes fifth disease. This airborne virus tends to spread through saliva and respiratory secretions among children who are in elementary school. It’s in the winter, spring, and early summer. However, it can spread at any time and among people of any age.

Many adults have antibodies that prevent them from developing fifth disease because of previous exposure during childhood. However, when people do contract it as adults, the symptoms can be severe. If you get fifth disease while pregnant, there are serious risks for your unborn baby, including life-threatening anemia.

For children with healthy immune systems, fifth disease is a common, mild illness that rarely presents lasting consequences.

What does fifth disease look like?

Fifth disease

What are the symptoms of fifth disease?

The initial symptoms of fifth disease are very general. They may resemble symptoms of the flu. Symptoms often include:

According to , symptoms tend to appear 4 to 14 days after exposure to the virus. After a few days of having these symptoms, most young people develop a red rash that first appears on the cheeks. The rash often spreads to the arms, legs, and trunk of the body within a few days. The rash may last for weeks. However, by the time you see it, you’re usually no longer contagious.

The rash is more likely to appear in children than in adults. In fact, the main symptom adults usually experience is joint pain. Joint pain can last for several weeks and is usually most prominent in the wrists, ankles, and knees.

How is fifth disease diagnosed?

Doctors can often make the diagnosis by simply looking at your the rash. Your doctor may test you for specific antibodies if you’re likely to face serious consequences from fifth disease. This is especially true if you’re pregnant or have a compromised immune system.

How is fifth disease treated?

For most healthy people, no treatment is necessary. If your joints hurt or you have a headache or fever, you may be advised to take acetaminophen (Tylenol) as needed to relieve these symptoms. Otherwise, you’ll need to wait for your body to fight off the virus. This usually takes one to three weeks.

You can help the process along by drinking a lot of fluids and getting extra rest. Children can often return to school once the red rash appears since they’re no longer contagious.

In rare instances, intravenous immunoglobulin (IVIG) can be administered. It’s reserved for severe, life-threatening cases.

What can be expected in the long term?

Fifth disease has no long-term consequences for most healthy people. However, if your immune system is weakened due to HIV, chemotherapy, or other conditions, you’ll likely need to be under a doctor’s care as your body attempts to fight off fifth disease.

You’ll likely need medical attention if you have any type of anemia in particular. This is because fifth disease can stop your body from producing red blood cells (RBCs), which can reduce the amount of oxygen that your tissue gets. This is especially likely in people with sickle cell anemia. If you have sickle cell anemia, you should see a doctor right away after being exposed to fifth disease.

Fifth disease can harm your unborn baby, so it can be dangerous to develop the condition if you’re pregnant. Fifth disease can also lead to anemia in your unborn child, which can be life-threatening for them.

If necessary, your doctor may offer you a blood transfusion to help protect your unborn child. According to the , other pregnancy-related complications may include:

How can fifth disease be prevented?

Since fifth disease usually spreads from one person to another through airborne secretions, you should try to minimize with people who are sneezing, coughing, or blowing their noses. Washing your hands frequently can also help reduce the chances of contracting fifth disease.

Once a person with an intact immune system has contracted this disease, they’re considered immune for life.

Q&A

Q:

My child was recently diagnosed with fifth disease. How long should I keep her out of school to prevent it from spreading to other children?

A:

According to the , people with parvovirus B19, which causes fifth disease, usually develop symptoms between 4 and 14 days after exposure. Initially, children may have a fever, malaise, or cold symptoms before the rash breaks out. The rash can last for 7 to 10 days. Children are most likely to spread the virus early in the disease before the rash even develops. Then, unless your child has immune problems, they’re probably no longer infectious and can go back to school.

Jeanne Morrison, PhD, MSNAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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