- Knowledgebase: Information on Specific Illnesses
- Here you will find discussions of specific illnesses and their management.
- 47. Fifth Disease - Top
- Alternative Names
"Slapped Cheek"; erythema infectiosum; parvovirus B19
Definition
An acute viral disease characterized by mild symptoms and a blotchy rash beginning on the cheeks and spreading to the extremities.
Causes, Incidence and Risk Factors
Fifth disease is caused by the human parvovirus B19 agent. It occurs most often during the spring with localized outbreaks in preschoolers or school-age children and adolescents. It is spread by respiratory secretions and the incubation period is to 12 days. The duration of the illness is usually five days. However, the rash may recur for several weeks and may be brought on by exposure to sunlight, heat, exercise, fever, or emotional stress.
Erythema infectiosum usually begins with bright red cheeks producing a "slapped-cheek" appearance. Following this a rash appears on the extremities and trunk. The rash fades centrally giving a lacy (reticulated) appearance to the rash. The rash fades over a period of one to two weeks. This illness is seldom associated with fever.
Parvovirus B19 is thought to cause other disease manifestations. In healthy adults it may be responsible for an infectious arthritis (particularly in women). In individuals with AIDS (or other immunocompromised persons) it may produce a profound anemia. This form of anemia is called 'transient aplastic crisis'.
The incidence of parvovirus B19 infection is unknown but studies suggest that 40 percent to 50 percent of adults have antibodies to the virus; this indicates a high degree of infection and also suggests that many infections go unnoticed.
Symptoms
rash, first appearing on the cheeks, often called "slapped cheeks"
a rash spreading to the extremities about one day later, often has a "lacy" appearance (looks like lace)
headache (mild)
joint pain also called arthralgia (mild)
Signs And Tests
The patient is examined for the appearance and pattern of the rash. The appearance of the rash usually makes the diagnosis straight forward. Antibody titer studies for parvovirus B9 are available although rarely performed. They can be obtained through the Centers for Disease Control and some state health departments.
Viral titers for parvovirus B19 are usually obtained when trying to diagnose 'transient aplastic crisis' and persistant anemias, occasional manifestations of parvovirus B19 infection in individuals with sickle cell anemia, hemolytic anemias, HIV infection and other types of immunodeficiency. Virus studies may also be obtained when there is a question of exposure in a pregnant mother whose immune status is not known.
Treatment
No treatment is usually required for fifth disease in children. If fever (unlikely) or joint discomfort is present then acetaminophen - oral may be given.
Expectations (Prognosis)
Since this is a mild and benign viral infection, complete recovery can be expected.
Complications
There are usually no complications in normally healthy children.
- Updated: March 5, 2001
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