Recently there has been some concern raised about a possible outbreak of Fifth disease in the community. Fifth disease is a contagious illness that primarily affects school age children. It is generally a mild illness that resolves on its own and does not need any specific treatment.
Fifth disease got its name because it was the fifth out of six childhood illnesses identified that cause rashes. The other illnesses were rubella (German measles), regular measles, scarlet fever, chicken pox and roseola. Interestingly children are now routinely vaccinated for rubella, measles, and chicken pox, but not the others. Fifth disease is also known as erythema infectiosum or sometimes is referred to as slapped cheek disease or illness.
Fifth disease is caused by a human parvovirus. You may be familiar with the parvovirus if you have dogs because canine parvovirus can cause severe illness in puppies and the vet will commonly vaccinate puppies against this virus.
The specific virus that causes Fifth disease is human parvovirus 19. Fifth disease is contagious. It generally causes illness about 5-10 days after exposure. The illness tends to cause cold like symptoms with nasal congestion, slight fever, cough, headache often accompanied by nausea and diarrhea. These symptoms can last for several days and the person is contagious at that time. It can be hard to make the diagnosis during this phase of the illness because it acts much like a common cold. After the cold symptom phase the individual will commonly develop pink cheeks giving the appearance of a slapped face and that is why it is sometimes referred to as slapped cheek disease. Then, after the cheeks turn pink, a fine, lacey pink rash appears on the trunk and extremities. The individual is no longer contagious when the rash occurs. The rash helps make the diagnosis. Some individuals develop joint pains also during the rash phase. It is reported that up to 20% of children who have the virus, have such mild symptoms that it is barely noticed.
Fifth disease is most common in the winter and spring. There is no specific treatment for the disease and there is no vaccine. Generally the disease is mild and is more of a nuisance. It tends to be a childhood illness. However, it can be a significant problem in certain situations. The disease can be a serious problem for pregnant women since it can infect the fetus and cause a miscarriage. Also, it can be a serious problem for patients with certain types of anemia, on chemotherapy, or with immune deficiency.
The best way to avoid Fifth disease is to practice careful hand washing and avoid contact with people who are sick. The virus tends to be spread by secretions that are expelled with coughing or sneezing or touching.
Fifth disease is something you don’t hear about every day. It is generally mild and self-limited. Now that school is out and we are into summer it will likely fade away. It can generally be avoided through good hygiene measures. Stay healthy my friends.
By: P. Michael Shattuck, M.D. – Community Health Network Family Physician