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As we continue this series Childhood Diseases – On a Mission to Educate we will move on to another common childhood disease called Fifth disease. This is a viral illness that most children recover from quickly and without complications. Fifth disease is also called erythema infectiosum and is caused by Parvovirus B19. According to Centers for Disease Control & Prevention ( https://www.cdc.gov/parvovirusb19/fifth-disease.html) this disease got its name because it was the “fifth in a list of historical classifications of common skin rash illnesses in children.” Fifth is more common in children than adults. It is especially common in kids ages 5-15.
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According to Kids Health (http://kidshealth.org/en/parents/fifth.html) this disease causes “a distinctive red rash on the face that makes a child appear to have a ”slapped cheek.” A few days later, the rash spreads down to the trunk, arms and legs.“ Fifth Disease generally will last 1-3 weeks. Kids Health also noted that the fifth disease can cause joint swelling and pain that can last from weeks to months in older kids and adults. On a rare occasion, sometimes it can last years.
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What Are the Symptoms of Fifth Disease in Children?
The first symptoms of Fifth Disease are usually mild and may include the following according to the CDC (https://www.cdc.gov/parvovirusb19/fifth-disease.html):
Initial Symptoms:
- Fever
- Runny nose
- Headache
- Fatigue
- Sore throat
- Nausea
This is followed by a rash on the face and body:
- Red rash on the face called slapped cheek rash. (This is the most recognized feature of fifth disease.)
- Some get a second rash a few days later on chest, back, buttocks, arms & legs.
- The rash gets itchy which variates in intensity person to person. May last 7 – 10 days.
- May also have painful or swollen joints (polyarthropathy syndrome). More common in adults, especially women. Joint pain lasts 1-3 weeks but some cases last months or longer.
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What Causes Fifth?
Basically the human parvovirus B19 is the cause. According to Parents (http://www.parents.com/health/rashes/what-is-fifth-disease) it is unclear what causes this virus to develop but the way people get it is from person to person. This is done through the “respiratory secretions, like saliva & mucus. Kids cough and sneeze and don’t always cover their mouths nor always wash their hands thoroughly.” The children will most likely be the most contagious when they have fever and cold-like symptoms.
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How is Fifth Disease Diagnosed?
According to Arthritis Foundation (http://www.arthritis.org/about-arthritis/types/fifth-disease) “a physician is able to diagnose fifth disease by seeing the typical rash during an examination. If the joint symptoms have outlasted the rash, or if there is no rash present, a blood test can detect antibodies to the virus. “ This blood test must be conducted early because level of antibodies for the parvovirus B19 infection is elevated only two months after the initial infection.
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How is Fifth Disease Treated?
For most healthy people, there is no treatment that is necessary. According to Arthritis Foundation “the fever and joint pain of fifth disease in children may need no treatment or can be alleviated with acetaminophen or ibuprofen. Adults with joint pain and swelling may need to rest, alter their activities, and take nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen or naproxen sodium.” So in general one just needs to wait for the body to fight off the virus which may take 1-3 weeks.
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When to Seek Medical Advice?
There are some situations where you may need to seek medical advice according to WebMD (http://www.webmd.boots.com/children/guide/slapped-cheek-syndrome):
If your child has sickle cell anemia, any chronic anemia or an impaired immune system and was exposed to someone with fifth disease or starts to exhibit some symptoms, check with you child’s doctor.
If it happens that the rash starts to become purple or blistered or lasts longer than 5 weeks, again check with the physician.
Finally if your child appears to be very ill it would be safer for the doctor to see him/her.
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What About Fifth Disease During Pregnancy?
Approximately 1 in 499 mothers in the United States are infected with Fifth disease each year according to American Pregnancy Association (http://americanpregnancy.org/pregnancy-complications/fifth-disease-during-pregnancy). “The majority of women who contract Fifth disease while pregnant will go on to have healthy babies.“ But just as with any type of illness, it is very important to understand the signs, symptoms, treatment, and any possible effects it might have on mother and baby.
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Signs & Symptoms of Fifth Disease During Pregnancy?
According to American Pregnancy Association women who are pregnant should be aware of the following:
-Soreness in your joints which could last for several days or weeks
-Fever
-Headache
-Sore throat
-Lacy red rash on the cheeks, legs, belly and neck
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How Do You Diagnosis Fifth Disease During Pregnancy?
A blood test will need to be carried out in order to test for the infection. Adults sometimes do not get the rash like children do and the rash is the best way to visually check for Fifth Disease. If Fifth disease is contracted during pregnancy, the main focus and concern is for the unborn child.
According to American Pregnancy Association many physicians will suggest additional ultrasound tests for 8 to 12 weeks in order to determine any potential pregnancy complications. If the ultrasound shows signs of illness, sometimes an amniocentesis or cordocentesis is recommended to confirm infection and its severity.
Potential Complications of Fifth Disease During Pregnancy?
Complications during pregnancy are rare, but there is about a 5% rate of Fifth related complications. The biggest concern for the unborn child is Anemia. Because there is a lack of healthy red blood cells during anemia, there is a concern that the new born may develop anemia and thereby develp Hydrops. The American Pregnancy Association stated that hydrops is “a buildup of fluid in the baby’s body. Hydrops is serious as it can lead to congestive heart failure and possibly death."
Some efforts to combat Hydrops are blood transfusions while the baby is in utero or if the baby has Hydrops in the third trimester, he/she may be induced to facilitate an early birth.
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How Do You Treat Fifth Disease While Pregnant?
Fifth Disease is very rare in pregnant women being only 1 in 400 cases of the 5% who will experience a complication during pregnancy. Also it is a mild disease that will resolve on its own without treatment in healthy children and adults. During pregnancy, the healthcare provider will monitor your pregnancy and intervene with the above mentioned approaches to treat the baby while in utero.
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How Do You Prevent Fifth Disease During Pregnancy?
Currently there are no vaccines that can be used to prevent Fifth Disease. So currently the best way to keep you safe is using good preventative measures. The following are suggested by American Pregnancy Association:
- Regular washing of hands with soap and hot water
- Careful disposal of tissues or other items that carry bodily fluids
- Covering your mouth when sneezing, coughing, etc.
- Limited exposure to those who have Fifth disease
It is important to note that these above mentioned measures can also help you to avoid other bacteria, viruses and infections as well.
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So in a nut shell, Fifth Disease is a viral illness that most children and adults recover from without major medical intervention. It can be spread person to person so the best way is to follow good hygiene measures. Occasionally there are some complications which need to be monitored by the physician. The greatest risk is to the unborn child of a pregnant woman who has Fifth Disease.
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I hope you learned something from this article about Fifth Disease. There are many resources on the internet if you need more specific information. I will continue this series with another childhood disease post. I hope you will continue to join me in this quest to learn about these illnesses that children usually encounter when they are young. Thank-you for reading my article on Childhood Diseases – On a Mission to Educate: Fifth Disease. If you would like to follow me, please check HERE
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