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Fifth Disease
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Fifth disease is a mild illness, caused by parvovirus B19, that occurs most commonly in children. It is commonly characterized by a rash on the face that resembles a slapped cheek.
Fifth disease is so named because in the late nineteenth century, it was recognized as the fifth of six exanthems of childhood. An exanthem is a widespread rash that is usually accompanied by such things as fever, body aches, and a headache. Exanthems can be caused by a number of things, including infections with viruses, and medicines such as antibiotics.
Parvovirus B19 is a virus that commonly infects humans. About 50 percent of all adults have been infected sometime during childhood or adolescence. Parvovirus B19 is a small, single-stranded DNA virus that only infects humans.
A parvovirus can cause a variety of illnesses, including:
Many of these conditions occur because parvovirus B19 causes problems with bone marrow cells.
The virus that causes fifth disease (parvovirus B19) has been found in the respiratory secretions (saliva, sputum, or nasal mucus) of infected people before the onset of the rash, when they still appear to "just have a cold." Fifth disease transmission probably occurs from person to person by direct contact with those secretions, such as sharing drinking cups or utensils.
Fifth disease infections can occur year-round, but they are more common during winter and spring months.
(Click Fifth Disease Transmission for more information.)
When a person becomes infected with a parvovirus, the virus begins to multiply within the body. In most cases, symptoms begin after 4 to 14 days; however, it may take 20 days for symptoms to appear. The period between becoming infected and the start of symptoms is called the fifth disease incubation period.
Common symptoms are usually mild and can include:
A few days before the characteristic rash appears, some people may have early symptoms that include:
(Click Fifth Disease Symptoms for more information.)
In order to diagnose fifth disease, the doctor will ask a number of questions about a person's symptoms and history of medical conditions. He or she will also perform a physical exam. During the physical exam, a doctor can often diagnose this condition by seeing the typical fifth disease rash.
In cases in which it is important to confirm the diagnosis of fifth disease, a blood test may be done to look for antibodies (proteins that the body makes to fight viruses) to parvovirus.
(Click Diagnosing Fifth Disease for more information.)
There is no treatment that will kill the virus that causes fifth disease; therefore, treatment goals focus on managing the symptoms as the body fights the parvovirus. Fortunately, fifth disease is usually a mild illness among children and adults who are otherwise healthy.
(Click Fifth Disease Treatment for more information.)
Parvovirus B19 infection may cause a serious illness in people with certain medical conditions (see Fifth Disease Prognosis).
About 50 percent of adults have already had fifth disease as children or adolescents, and therefore are immune to the parvovirus. If an adult is not immune, he or she can get fifth disease (see Adult Fifth Disease). Unlike a child's fifth disease symptoms, adults can develop joint pain, swelling, or both. Usually, joints on both sides of the body are affected. The joints most frequently affected are the hands, wrists, and knees. The joint pain and swelling usually go away in a week or two, but can last for several months.
Adults can also get a rash with fifth disease, but it is most often absent or does not have the "slapped cheek" look that is seen in children.
(Click Adult Fifth Disease for more information.)
Usually, there are no serious complications for a pregnant woman or her baby due to fifth disease. About 50 percent of women are already immune to parvovirus B19, and these women and their babies are protected from infection and illness. Even if a woman is susceptible and gets infected with parvovirus B19, she usually experiences only a mild illness. Likewise, her unborn baby usually does not have any problems as a result of parvovirus B19 infection.
In rare cases, however, parvovirus B19 infection will cause the unborn baby to have severe anemia and the woman may have a miscarriage (see Miscarriage After Fifth Disease).
(Click Fifth Disease and Pregnancy for more information.)
Other Fifth Disease NamesOther names that people use to describe this condition include:
Certain sections of this article on fifth disease include a hyperlink to more detailed eMedTV articles. Click on the specific link to view the related article. Other eMedTV articles on this topic include:
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