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Fifth Disease

  • Definition

    fifth disease is a viral disease, caused by parvovirus 19 that takes its name from being the fifth of six pediatric disorders identified by scientists.

    The first four were rubella, measles, scarlet fever and Dukes disease, which is a mild form of scarlet fever. The sixth disorder is exanthema subitum, also called roseola infantum.


    Fifth disease is an acute, benign infectious disease, mainly of children, characterized by fever and an erythematous rash beginning on the cheeks and appearing later on the arms, thighs, buttocks and trunk. As the rash progresses, earlier lesions fade. Sunlight aggravates the eruption, which usually lasts about 10 days.

    For a period of time the rash may reappear whenever the skin is irritated. Its cause is unknown, no treatment is necessary, and prognosis is excellent. It is also known as erythema infectiosum.

    Most cases of fifth disease occur in children 5 to 14 years old, and outbreaks are more common during winter and spring. Once infected, a person has lifetime immunity. For adults who passed through childhood without catching fifth disease, symptoms can be more severe, including arthritis and arthralgias (joint pains). Younger children with school age siblings are who are in school settings may also be infected.


    Fifth disease is caused by infection with parvovirus 19, a common virus.


    Usually, the first symptoms are low-grade fever and a feeling of malaise. Then, anywhere from seven to 10 days later, the rash will appear. In many children, the symptoms are mild, and in approximately 20 percent of those infected, there are no symptoms at all.

    If anything about fifth disease can make a lasting impression, it is the distinctive "slapped cheek" appearance of the facial rash. The rash then spreads to the trunk and extremities, frequently developing a lacy pattern. The rash generally fades within two weeks, but external factors such as sun exposure, bathing, excitement, or exercise can cause it to reappear several weeks later.

    Parvo Virus B-19 can rarely cause significant medical complications. These include aplastic anemia, heart infection (myocarditis), and a temporary arthritis. In aplastic anemia, the patient’s bone marrow stops producing new red blood cells. In most individuals, their red cell production quickly recovers. In individuals who must produce many more red cells each day than a health person because their red cell are destroyed prematurely (for instance in sickle cell disease), this anemia can be life-threatening and they may need transfusions. Rarely, Parvo Virus B-19 can cause pregnancy complications that cause the death of the fetus.


    There is no treatment. If the rash persists, plain calamine lotion and cool water should provide relief. If complications develop, they are treated individually. A vaccine for Parvo Virus B-19 has been developed and appears to be effective, but it has not yet been fully evaluated.


    Does the diagnosis clearly establish the existence of fifth disease?

    Is this matter of concern?

    What can be done to alleviate the symptoms?

    (If pregnant) Can fifth disease lead to fetal damage or even fetal death?

    (If pregnant) Should a blood test be done to determine whether immunity exists?

    (If pregnant) Can you determine whether the fetus has developed complications?

    (If pregnant) What can be done to protect the fetus?