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Infectious Diseases

Fifth Disease

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What is fifth disease?

Fifth disease is an infection that occurs especially in children. It is caused by a virus called parvovirus B19.

The illness is often very mild. Sometimes a child may not even feel sick. Adults usually get a more severe case, with fever and painful muscles and joints. At least 50 to 80 per cent of adults have had fifth disease in childhood and will not get it again if they come into contact with a person with the infection. Outbreaks of fifth disease can occur in school-age children

How is it spread?

A person is most contagious before the rash appears and probably not contagious after the rash starts. It spreads the same way as a cold virus. The virus is spread from person to person in the secretions from the nose, mouth and throat of an infected person, especially via large droplets from coughing and sneezing. It can also be spread by sharing drinking glasses and utensils, and can be spread from mother to fetus.

What are the symptoms?

The symptoms may begin with a headache, body aches and a fever. These symptoms usually end, but in seven to 10 days, a very red rash on the cheeks appears, making the face look like it has been slapped. This is why the disease is called “slapped cheeks syndrome”. The red lace-like rash may also appear elsewhere on the body and lasts from one to three weeks and may reappear over weeks to months.

How soon do symptoms of fifth disease appear?

Symptoms appear four to 21 days after being infected.How is fifth disease diagnosed?

A doctor can make the diagnosis by examining the rash. A blood test can be taken to confirm a diagnosis of fifth disease or to determine if you have had it in the past.

What is the treatment for fifth disease?

There is no specific medication or vaccine for fifth disease. Treatment is limited to easing the symptoms.

How do I protect myself and others?

  • Good hygiene, including frequent handwashing,throwing out used facial tissues, and not sharing eating utensils with sick persons is advised.
  • Your child may continue attending a child care facility if feeling well enough to take part in the activities. (By the time the rash develops, the child is probably no longer contagious.

Are there any special concerns about fifth disease?

If you are pregnant and you have been in contact with someone with fifth disease, you should contact your doctor who may order a blood test to determine if you have or have had fifth disease and discuss other testing options. Pregnant women who have had fifth disease in the past are not at risk of getting the disease again. For pregnant women who have not had the disease, there is a very small risk that their unborn children may develop anemia before birth.

Routine exclusion of pregnant women who work in a child care environment where fifth disease is occurring is not recommended. This is due to the fact that:

  • persons are probably no longer contagious after the rash appears;
  • More than 50 to 80 per cent of women are already immune to fifth disease; immune pregnant women and their babies are protected from infection and illness;
  • There is only a very small risk to the fetus for developing anemia if a susceptible mother is exposed.

The infection is more serious for children with chronic anemia and HIV.

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