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Fifth Disease (Parvovirus B19)

Fifth disease is a mild rash illness that occurs most commonly in children. The ill child typically has a "slapped-cheek" rash on the face and a lacy red rash on the trunk and limbs. Occasionally, the rash may itch but very mildly. A child may rarely have a low-grade fever, malaise, or a "cold" a few days before the rash breaks out. The child is usually not very ill, and the rash resolves in 7 to 10 days. It really has a name called "Erythema Contagiosum" but we call it the Fifth Disease because it was the fifth rash disease described in children.

Fifth disease is caused by infection with human parvovirus B19. This virus infects only humans and does not come from animals.

An adult who is not immune can be infected with parvovirus B19 and either have no symptoms or develop the typical rash of fifth disease, joint pain or swelling, or both. Usually, joints on both sides of the body are affected.

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, for example, he or she is probably no longer contagious and may return to school or child care center.

During outbreaks of fifth disease, about 20% of adults and children who are infected with parvovirus B19 do not develop any symptoms.

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 resolve without long-term disability.

Parvovirus B19 infection may cause a serious illness in persons with sickle-cell disease or similar types of chronic anemia. Occasionally, serious complications may develop from parvovirus B19 infection during pregnancy. For details, please see the CDC information sheet entitled, "Parvovirus B19 Infection and Pregnancy."

Treatment is mainly the treatment of symptoms. Since the virus is gone when the rash occurs, there are not very severe symptoms and most children do not take any medications.  Since they are not contagious, they are sent back to school.