Fifth disease 


Last Updated December 20th, 2021

Why do your cheeks look slapped?

It is a viral illness that commonly affects children.  It is also known as erythema infectiosum and is one of the five viral rashes that affect children.  The other four rashes are measles, rubella, chicken pox, and roseola.  Generally, the symptoms would include cold or flu-like symptom which is followed by a red rash on the cheeks, torso, and limbs a few days later.  Joint pain and swelling too may occur in some cases.  The disease is not confined only to children as adults too can become infected with the virus.

Adults develop a more severe flu-like illness, with minimal development of rash.  Symptoms of joint pain are more likely to affect adult women as compared to children.  It has also been found that 10% of adults who develop joint pain may continue to have symptoms for a prolonged period of time.

What causes fifth disease?

Parvovirus B19, a single-stranded virus that affects red cells in the bone marrow causes fifth disease.  Since the virus spreads through saliva and respiratory secretions, it is more common among elementary school children.  The virus generally affects during winter, spring, and early summer.

However, it has the ability to spread in any weather.  The virus commonly spreads through coughing, sneezing, as well as hand-to-hand contact.  It can spread rapidly when there are a group of people in a closed environment such as schools.  Transmission through blood is considered to be very rare.

The virus may also affect animals such as dogs and cats.  These viruses are called canine parvovirus and feline panleukopenia virus.  The disease cannot be transmitted from animals to humans or humans to animals.  Once a person is affected by the rash, they are no longer capable of transmitting the disease to another person.  Generally, adults are prescribed with antibiotics if they have had previous exposure during childhood.  If the disease is contracted during adulthood, the symptoms are generally severe.  For example, if you contract it during pregnancy, it can cause life-threatening complications to fetus such as anemia.

Symptoms of fifth disease

General symptoms

It has been found that around one in three patients do not experience symptoms when affected by the disease.  The disease is considered to be contagious during the incubation period which is about 13 to 18 days.  During this period, the affected person may not experience any symptoms, but the person can spread the disease to others.  Once the disease develops from a mild cold or flu-like symptoms to the rash, the person is no longer contagious and will not be able to transmit the disease to others.

Children

When a child is affected by the disease, the symptoms generally resemble any other virus attacks such as cold or flu-like symptoms associated with low-grade fever and weakness.  Once the disease advances, the child develops rash involving the cheeks, torso, and limbs.  Since the rash on the cheek is red, they resemble a slapped cheek.  The rash may or may not be itchy and would generally clear up within 10 days.

Adults

As discussed earlier, the symptoms are more severe in adults with flu-like symptoms that are severe, but may not develop a rash on the cheeks.  Adults are also affected by pain in the joints that are experienced after one to two weeks.  It has been estimated that around 78% of the adults affected by the disease experience joint pain.  The disease affects the joints symmetrically and involves the hands, wrists, and knees.  Symptoms related to the joint resolve in a week or two.  Around 10% of the affected adults may experience prolonged symptoms that can last for years.

Stages of symptoms

Early symptoms include low-grade fever, tiredness, sore throat, itching, stomach upset, headache, and irritability.  Once the disease develops other symptoms develop such as fever, flu-like symptoms, runny/stuffy nose, sore throat, and weakness.

Finally, a rash appears on the cheeks, torso, and limbs.  The rash generally appears in three stages.  Initially, red papules appear on the cheeks.  These papules group together and become swollen plaques within a few hours, which is the first stage.  The nose and the mouth are spared.  This is then followed by red marks appearing on the hands and torso after four days.  These marks then develop into a lacy pattern, which is considered to be the second stage.  Finally, during the third stage, the rash becomes invisible but may appear when exposed to sunlight.  The rash generally lasts as long as six weeks but may start to disappear after three weeks.

Less common symptoms may occur such as abdominal pain, nausea, and diarrhea.  Pain and soreness in the joints are only associated with adults and does not affect children.  It is highly rare to experience any neurological or cardiovascular problems.

How is it diagnosed?

The diagnosis of the disease is quite straightforward due to the visible signs and symptoms that are easy to detect.  There may be a slight confusion as the symptoms may resemble scarlet fever, but the appearance of the rash is different.  It has been estimated that the majority of adults are immune to parvovirus infections, the reason being that they might have experienced the infection during childhood.

Blood tests

Ordering blood tests is generally very rare and is considered to check for antibodies under following conditions such as if the patient is pregnant, has compromised immune system because of   HIV or AIDS, has a chronic disorder such as sickle-cell anemia.  Further action is taken depending on the results and these include:

If the patient is immune:  No treatment is required as the patient may not be re-infected.

If the results detect a recent parvovirus infection:  Further lab tests are ordered to check for complications such as anemia, which requires treatment.

If a pregnant woman is infected:  This is considered to be serious as it may affect the fetus.  Further tests including an ultrasound scan are required to monitor the fetus for any complications.

Complications associated with fifth disease

Majority of cases do not develop complications.  Since Parvovirus B19 affects the red blood cells, complications may arise in a few patients such as:

Pregnancy

If a woman becomes infected during pregnancy, there is a risk that it may affect the fetus or lead to miscarriage.  It is estimated that this infection may result in fetus death which stands at 2-6%.  It is very rare that a pregnant woman will be infected, but there is one in a three chance of a woman getting infected during pregnancy.  Fetal hydrops is one of the complications that may arise due to the fifth disease during pregnancy.  This may lead to congestive heart failure as well as severe anemia due to edema.

Sickle-cell anemia

Genetic Disorder_sickle cellSevere anemia can develop in children, who are already affected with hereditary anemia due to Parvovirus B19.

Weakened immune system

Bone marrow problems may arise in patients who are organ transplant recipients as well as patients affected by HIV or AIDS.

Arthritis

Around 10% of adults affected by the disease may experience prolonged joint pain, especially in teens.  These symptoms generally are associated with rheumatoid arthritis.

Treatment for the fifth disease

In the majority of cases, there is minimal to no treatment required.  Medications are helpful to reduce symptoms of fever, itching, and joint pain.  The following treatment is rendered, which is discussed below.

Rash

Generally, no treatment is required.

Itching

It is not associated with all the cases and is generally minimal.  Severe itching may be dealt with antihistamines.

Cold and flu-like symptoms

These symptoms would generally make you feel weak.  Treatment would include increasing water intake and adequate rest.  You may consider consuming medications such as paracetamol or ibuprofen to relieve symptoms of fever and headache.  Children can take the liquid form of the medication, but under the supervision of a professional to manage the dosage.

Joint pains and swelling

These symptoms are associated with adults and hence the doctor would prescribe an anti-inflammatory drug to relieve symptoms.  These medications may cause irritation to the stomach if overused and hence caution is advised.

Anemia

It may require a blood transfusion in severe cases as well as hospitalization.

Immunocompromised

Antibodies are provided through blood transfusion, which requires hospitalization.

Pregnancy

Further tests including ultrasound are required to monitor the fetus.  If severe anemia is found, blood transfusions may be given to reduce the risk of miscarriage.

Prevention

Since no vaccine is found to prevent parvovirus B19 infection, it is quite difficult to prevent the occurrence.  You could follow certain instructions to reduce your chance of being infected, such as:

  • Wash hands thoroughly with soap and water after physical contact with outsiders.
  • Stay far and cover your nose and mouth when others cough or sneeze.
  • Prevent your child from putting their hands in the mouth often.
  • Stay away from people who are experiencing flu-like symptoms.
  • Stay at home when you are sick to avoid transmission.
  • A pregnant woman should be cautious and understand the risks associated with it.

Final Thoughts

It is now clearly understood that fifth disease may not cause any serious long-term complications other than a few people who have a weakened immune system.  It is a common viral attack that affects a healthy child and the symptoms are considerably milder whereas the symptoms are quite severe when it affects the adults.  The disease can harm the fetus if a pregnant woman gets infected.  Immediate medical attention is required in such a scenario.  Healthy hygiene generally keeps these infections at bay.

 

Dos and Don'ts

Dos
  • Maintain a clean hygiene by washing hands after a physical contact.
  • Cover your nose and mouth when someone coughs or sneezes.
  • Avoid visiting people who are down with flu symptoms.
  • Stay indoors when you are sick.
Don'ts
  • Maintain unhealthy hygiene.
  • Expose yourself to people when they cough or sneeze.
  • Visit people who are sick.
  • Travel outdoors when you are sick.

 

 

 

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Kava: Is it the healthy substitute for alcohol you have been waiting for? Native to the beautiful South Pacific islands, Kava is a famous beverage rooted in the local culture. It…
Okra: How can this nutrient-dense vegetable help you fight diabetes? Okra is a food which is rich in nutrients and minerals which are extremely essential for a healthy…
How can berberine supplements help you live longer and healthier? Berberine is a turmeric look-alike herbal extract that is credited with numerous health benefits ranging from diabetes cure…
Glucose-6-Phosphate Dehydrogenase (G6PD) test Glucose-6-phosphate dehydrogenase (G6PD) is an enzyme that is found in every cell of the body and it plays…
stress depressed anxiety
Are you depressed or just stressed? Know when to see a doctor Why are some people more anxious than others? Is being depressed the same as feeling sad? Have you…
rosacea-treatment--before-_-after
The best and safest ways to treat rosacea Rosacea is a skin disease that is characterized by reddish hives and rashes on the face. Read more…
General adaptation syndrome: Understanding stress, one step at a time The struggle of the body to produce hormones during a stressful situation is the main theme of general…
Thyroid disorders
Thyroid Profile Thyroid profile is a panel of blood tests performed to check if an individual is suffering from any…
APL IgM Test
Antiphospholipid Antibody(APL)-IgM test The antiphospholipid antibodies are specific protein in the body directed against the phospholipids. It is used to detect…
alcohol toxic
7 startling facts that will make you quit alcohol today Does drinking really make you friendly and happy? How many calories does a can of cold beer add…
helping friend with depression
Support and care tips for helping people with depression Read to find out what is depression, its causes and symptoms. Also check out the steps describing how…
Blood Disorders cancer
Immunotherapy immunotherapy is a treatment that boosts the body's immune system to identify the cancer cells and fight cancer.
Lung cancer xray
Lobectomy Lobectomy is a surgery where a lobe of the diseased lung is removed. It is mainly done to…
heartfail_2
Open Heart Surgery An open heart surgery is a major procedure performed to treat heart diseases like congenital heart problem, heart…
DHEA wrinkles
DHEA: Now get unbelievable age defiance with this wonder hormone! DHEA is known popularly as the age-defying hormone. This supplement is widely used to slow down aging and…
BRAT Diet: What is the right way to follow this diarrhea-relieving diet? BRAT diet, a simple diet consisting of just bananas, rice, applesauce, and toast, can help you combat the…
lipoprotein A
Lipoprotein (A) Test Lipoprotein (A) test is used to measure and monitor the levels of LDL(Low-Density Lipoprotein) in the bloodstream in…
Tart Cherry: The healthiest excuse for taking that second serving of pie Tart cherry has been traditionally used in delectable desserts such as pies. Recent studies have revealed that its…
Vitamin K2: 8 reasons why you need this bone-building & cancer-fighting nutrient Vitamin K2 is claimed to be essential for your bone health, for reducing the risk of cancer, and…
Jack in the box fast food
Jack In the Box : The perils of surging fast food culture in the USA Jack in the Box - How a culture of fast-food can clog your arteries, weaken your heart, fatten…
anti ds dna test
Anti Ds-DNA antibody Test The  Anti Ds-DNA antibody test is used to diagnose the disease called lupus or more aptly the SLE(Systematic…
Ca 19.9 test
CA19.9 Test CA 19.9 is a cancer antigen that exists on the surface of cancer-causing cells. The levels of CA…
Vagus nerve: 7 health benefits of stimulating the “gut-brain” connection As a matter of fact, there are two vagus nerves namely the left and the right but is…
Chest X-Ray A chest x-ray is a diagnostic test that uses x-rays to visualize the structures inside your chest. It…
CLA: A breakthrough weight loss supplement with minimal side effects Tried every weight loss supplement in the market with no substantial gain? Why not try CLA supplements, derived…
HSV-1_IGG
Herpes Simplex Virus I (HSV)-IgG Test Herpes simplex virus I(HSV)-IgG is an Immunoglobulin protein that acts as an antibody & stays in the blood…
What is Qigong and how can it help you channelize you inner “Qi”? Qigong is an integrated way of performing a traditional exercise regimen that can help in promoting health, mental…
Tissue Transglutaminase Antibody (tTG) Test Transglutaminase is an enzyme present in our body and is involved in protein metabolism. A tTg test is…
6 arguments in favour of glucosamine and where can you find it Studies have shown that glucosamine works by preventing the breakdown of cartilage of the joints. This is usually…
xylitol gum
Xylitol : Is this the right sugar substitute for you? Discovered during World War 2 owing to sugar shortage, xylitol has become a common name in pharamaceutical industry.…
Cordyceps: How the Caterpillar fungus works as a proven cancer-shield Strange as it may sound, but cordyceps or "caterpillar fungus", a fungus variety native to the Himalayas may…
Bronchoscopy procedure
Bronchoscopy Bronchoscopy is a procedure where in a scope is inserted into the lung pathway to observe any growth…
Hydroquinone: Is it the best topical treatment for hyperpigmentation? Darkening of the skin due to high melanin levels is called hyperpigmentation.  Hydroquinone interferes with melanin production thus treating…
SIBO Diet: The important dos and don’ts of this gut-healing diet A SIBO diet is a diet that works by eliminating certain sugars from your diet and adding fibers…
Milk Thistle skin
Milk Thistle: Find possible cures for fatal diseases in these purple blooms Milk thistle is well-known for treating liver conditions. However, did you know that it comes with a plethora…
Tamarind: The top health benefits of this staple Asian ingredient Did you know this sweet and sour pulpy fruit does more than just add a tangy flavor to…
Hibiscus: Nourish your beauty and health with these vibrant blooms Hibiscus is a trumpet shaped flower found abundantly in tropical countries. It has been historically used for its…
Erythritol: A healthy sugar substitute or yet another marketing ploy? Erythritol is a popular choice of a healthy alternative sweetening agent in foods. But how healthy can a…
Trisodium Phosphate: How a paint thinner made its way into your breakfast Ever thought how toxic chemicals find their way into our foods? How can they harm our body? And…
folate test
Folate test The Folate test measures and monitors the levels of folic acid in the blood. This test is also…
Alp enzyme-test
ALP test – Alkaline Phosphate ALP or alkaline phosphate is an enzyme mainly produced by the liver and gallbladder. ALP test measures the…
iron deficiency profile
Iron Deficiency Profile An iron deficiency profile is a battery of blood tests which are performed in order to determine the…
antiHEV IgM test
Anti hepatitis E virus (Anti HEV) IgM Test Anti HEV IgM test determines the level of the IgM antibodies in the blood, The disease is often…
sodium chloride
Halotherapy: How inhaling salt can work wonders for your body Halotherapy is quickly gaining popularity amongst those with respiratory diseases. It has shown promise in its treatment.
Love tea, hate tannins? Rooibos tea is just what you need The market is brimming with a multitude of herbal teas. But what makes rooibos tea (or red bush)…

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