Fifth Disease – What is it, Causes and Symptoms!

Fifth Disease – What it is, Causes and Symptoms that we should not ignore. In addition, fifth disease is a viral disease caused by parvovirus B19 is also known as erythema infectiosum and hit cheek disease. The clinical disease was described in the 1880s and was named fifth disease because of its “fifth” position in the numerical ranking of childhood diseases associated with rashes.

Other numbered diseases included measles, scarlet fever, and rubella and these did not get renamed until the molecular era, when it became possible to isolate viruses and bacteria. Fifth disease was number five of six diseases named. It’s a very common infection, and nearly 50% of adults have been infected with the virus, but I don’t remember having it because it often causes no symptoms.

Symptoms:  Most people with erythema infectiosum have no symptoms. However, early signs of erythema infectiosum in children may include:

• Sore throat ;
• stomach pain ;
• fatigue ;
• Itch;
• low fever;
• Headache

Several days after the first symptoms appear, a reddish spot may appear on both sides of the child. Eventually, it can extend to the arms, torso, thighs, and buttocks. The coloration of the spots is pink or reddish and with a slight relief.

The rash can come and go for up to three weeks, becoming more visible when a child is exposed to extreme temperatures or spends time in the sun. Towards the end of the illness there may also be itching.

This rash can last anywhere from five days to a week and occasionally comes and goes for up to three weeks. The other symptoms are usually gone when the rash appears, and patients with the rash are usually not contagious. Unfortunately, as with many other viral diseases, the characteristics and timing of the different stages of the disease are not always predictable.

While the disease is not serious in children, around 5% of children and around 50% of adults with fifth disease may experience joint pain and aches. This arthritis or arthropathy is more common in women than men and is usually temporary, lasting day to week but can become a long term problem for months.

People with fifth disease arthritis often have morning stiffness, with redness and swelling of the same joints on both sides of the body (a “symmetrical” arthritis). The joints most commonly involved are the knees, fingers, and wrists.

What are the serious complications:  Rarely, patients develop erythrocyte aplasia. This is when the bone marrow stops forming a normal number of red blood cells.

This complication is rare and usually transient, but can be fatal. Patients who are immunocompromised (having an immune system that has been impaired by disease or treatment) are at high risk of this complication.

Pregnant women (who have not yet had the disease) should avoid contact with patients who have the fifth disease. The fifth disease virus can infect the fetus before birth.

And while any birth defects have been reported as a result of fifth disease, in 2%-10% of infected pregnant women, it can cause severe anemia or even death of the fetus referred to as hydrops fetalis.

What is the treatment:  Treatment is supportive only. Fluids, acetaminophen (Tylenol), and rest are important. Antibiotics are not helpful in treating fifth disease as it is a viral disease. In people with persistent arthritis, anti-inflammatory medications such as ibuprofen (Advil) or naproxen (Aleve) may be used.