What is fifth disease?
Fifth disease is a viral infection
caused by human parvovirus B19. In most instances, fifth disease is a relatively mild,
self-limited rash illness of childhood.
Who gets fifth disease?
Anyone can become infected with the virus which causes fifth disease,
but the disease is most often recognized in elementary school-aged
children. Occurrence of parvovirus B19 infection is worldwide and can
occur throughout the year in all age groups as either sporadic cases or as
clusters of cases of fifth disease.
What are the symptoms of fifth disease and when do they
Four to fourteen days after exposure to the virus, an individual may
experience low grade fever and tiredness. This is often followed by a
distinctive facial rash often referred to as "slapped cheeks".
The facial rash may then progress to a lace-like rash on the trunk, legs,
and arms; this rash tends to fade and reappear with changes in
temperature, sunlight, and emotional stress.
Approximately 20 percent of infected children and
adults do not have any symptoms. Some adults do not develop rash but may
complain of painful and swollen joints.
How is fifth disease spread?
The virus is spread by exposure to airborne droplets from the nose and
throat of infected individuals. Approximately 50 percent of susceptible
(have not been previously infected) household contacts of a case of fifth
disease will become infected. In school outbreaks of fifth disease, about
30 percent of susceptible staff and as many as 60 percent of susceptible
children will become infected with the virus.
When and for how long is a person able to spread fifth
Persons with fifth disease usually spread the virus during the week
before the appearance of their rash. By the time their rash is evident,
the individual is no longer spreading the virus.
How is fifth disease diagnosed?
In most cases, fifth disease is diagnosed based on the appearance of
the characteristic rash. In addition, a specific blood test (which is not
widely available) can confirm the diagnosis; this blood test is available
through your local public health agency for those individuals who are at
risk of serious consequences (severe anemia or miscarriage) if infected
with B19 virus.
Does past infection with the virus make a person
It is thought that persons who have previously been infected acquire
long-term or lifelong immunity. Studies have shown that approximately 50
percent of adults may be immune to parvovirus B19.
What are the complications associated with fifth
While most individuals infected with parvovirus B19 virus will
experience a mild, self-limited infection, newly emerging information
suggests that some individuals may be at increased risk if they become
infected with this virus. While most women infected during pregnancy will
not be affected, limited studies have shown that parvovirus B19 may infect
the fetus and increase the risk of miscarriage within the first 20 weeks
of pregnancy. In individuals with impaired immune function (eg. leukemia
or cancer) or with chronic red blood cell disorders, such as sickle-cell
disease, infection may result in severe anemia.
Persons who are exposed to parvovirus B19 and are either
pregnant or have an impaired immune function or a chronic red blood cell
disorder should consult with their physician.
Where can I call for additional information regarding
fifth disease during pregnancy? How can I arrange to have a blood test
done if I am pregnant and have been exposed to a case of fifth disease?
In addition to your physician, further information about fifth disease
and arrangements for blood testing can be obtained from your local public
What is the treatment for fifth disease?
At this time there is no specific treatment beyond the supportive
blood transfusions which are sometimes necessary for those with impaired
immune function or chronic red blood cell disorders.
Is there a vaccine against the virus which causes fifth
There is currently no vaccine to prevent infection with this virus.
What can be done to prevent the spread of fifth
Measures to effectively control fifth disease have not been developed
yet. When outbreaks of fifth disease occur in a school or community,
options for preventing transmission are limited. Because the risk of
transmitting B19 virus to others is greatest before signs and
symptoms develop, transmission cannot be prevented by identifying and
excluding symptomatic individuals. Individuals with fifth disease should not
be excluded from schools or daycare centers unless they have a fever. When
their fever subsides and they feel well, they can return to school and
daycare. Good handwashing may be a practical and effective method to
reduce spread of virus in schools or daycare centers where there are known