FIFTH DISEASE

Fifth disease is common at this time of year (late winter/early spring). It is caused by a virus, called parvovirus. The medical term for fifth disease is erythema infectiosum. It is the least well known—and least serious—of five childhood infections, the others being measles, mumps, rubella (German measles) and chicken pox.

Fifth disease can start with a sore throat or fever, but usually is asymptomatic during the initial phase. The diagnosis is made when the rash occurs—first the classic "slapped cheek" rash on the face and then a fine lacy rash on the trunk and extremities. The rash may be itchy and may come and go several times over 1-6 weeks. It may worsen with temperature changes or exposure to sun. By the time the rash breaks out, the child is no longer contagious. Adults who develop fifth disease can get joint pain and swelling, in addition to the rash. The incubation period (time from exposure to onset of illness) is 6-14 days.

For most people, fifth disease is a benign illness; it comes and goes without complications. However, it can cause miscarriage if a woman contracts it during the first trimester of pregnancy. This can only occur if she has not had the disease in the past. Once a person has had it, he or she develops immunity and does not get it again. Fifth disease can also be dangerous for people who have certain red blood cell abnormalities, such as sickle cell disease or thalassemia, or who are immunocompromised (cancer, chemotherapy, HIV positive).

The treatment is symptomatic—acetaminophen (Tylenol) and fluids for the fever, sore throat and achiness, if present, and antihistamines for relief of itching. Since children are no longer contagious once the rash occurs, they may return to school or day care when they seem well enough, even though the rash is still present.



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