Fifth Disease: Facts and Details

What is fifth disease?

Fifth disease is a mild rash illness that occurs commonly in children. It is caused by infection with human parvovirus B19. The virus only infects humans. This disease is also called erythema infectiosum.

What are the symptoms of fifth disease?

A child with fifth disease typically has a “slapped-cheek” rash on the face and a lacy red rash on the arms, upper body, buttocks, and legs. He or she may have a slight fever or sore throat, in addition to a cold a few days before the rash breaks out. A child with fifth disease is usually not very ill, and the rash resolves in seven to ten days.

An adult may have no symptoms or may develop the typical rash of fifth disease, joint pain or swelling, or both. Usually, joints on both sides of the body are affected and most frequently affect the hands, wrists and knees. The joint pain and swelling will usually be gone in a week or two, but could last several months. Approximately 20 percent of adults and children who are infected with the virus do not develop any symptoms.

How soon do symptoms appear after infection occurs?

A person who has not had the disease before usually becomes ill four to 14 days after being infected with the virus, but may become ill for as long as 20 days after infection.

How long is fifth disease contagious?

A person infected with parvovirus B19 is contagious during the early part of the illness, before the rash appears. By the time a child has the characteristic "slapped cheek" rash of fifth disease, he or she is probably no longer contagious and may return to school or child care center.

How is fifth disease spread?

Parvovirus B19 is found in saliva, sputum and/or nasal mucus of an infected person before the rash appears. This is during the time when the person may appear to just have a cold and when it can be spread from person-to-person. It is believed that the virus is spread by direct contact with those secretions by doing things like sharing drinking cups or utensils.

How serious is fifth disease?

Fifth disease is usually a mild illness that resolves on its own among children and adults who are otherwise healthy. Joint pain and swelling in adults usually resolves without long-term disability. People who have leukemia or cancer, are born with immune deficiencies, who have received an organ transplant, have human immunodeficiency virus (HIV), or have sicklecell disease or similar types of chronic anemia are at risk for serious illness due to parvovirus B19 infection. Occasionally, serious complications may develop from parvovirus B19 infection during pregnancy.

How is fifth disease treated?

Treatment of symptoms such as fever, pain, or itching is usually all that is needed. Adults with joint pain and swelling may need to rest, restrict their activities, and take medicines such as aspirin or ibuprofen. People who develop severe anemia caused by the infection may need to be hospitalized. Those with immune problems may need special medical care to help their bodies get rid of the infection. Occasionally, serious complications may develop from parvovirus B19 infection during pregnancy.

How can you prevent fifth disease?

There is no vaccine or medicine to prevent parvovirus B19 infection. Frequent hand washing is recommended to decrease the chances of becoming infected. Excluding persons with fifth disease from work, child care centers or schools is not likely to prevent the spread of the virus, as people are contagious before they develop the rash. 

For more Information contact the Sedgwick County Health Department Epidemiology Office at 316-660-7392.