Fifth disease
parvovirus; 19; slapped; face; virus; rashes; fever; pregnant; pregnancy; miscarriage; abortion; arthritis; sickle; cell; anaemia; parvo;;
Fifth disease is a common viral infection in childhood which is sometimes called 'slapped face disease' or 'slapped cheek disease'. It usually causes a mild illness. The most common sign is a rash on the face, which looks as if the face has been slapped. They may get a rash on the rest of their body.
What is Fifth disease?
- Fifth disease is sometimes called Slapped Face Disease. The rash on the face is red, sometimes itchy and 'lacey' (there are normal coloured areas inside the red areas on the face).
- Fifth Disease is caused by a virus (parvovirus B19) which affects only humans. (The infection is also called Erythema Infectiosum).
- Dogs and cats can become very sick from different types of parvovirus infections. They cannot catch this infection from humans, and they cannot pass their parvovirus infections to humans.
How does it spread?
- It is spread by droplets in the air from sneezing or coughing. They may be breathed in or moved from surfaces by hands to the mouth or nose.
- People with the infection can pass it on for several days before they become unwell, or when they have what seems to be a mild 'cold'.
Who is at risk?
- Most of the people who get the disease are primary school age children, but people of any age who have not had the infection can get it too.
- Fifth disease spreads easily, and up to half of the children who have not had the infection will catch it when someone in their family or class at school has it.
- At least half of adults will have had the infection before, and be immune, but they can catch the infection if they have not had it already.
- If a woman, who has not already had the infection, gets Fifth disease during pregnancy there is a small risk that the infection can harm her unborn baby.
How long does it take to develop?
- It takes from four to fourteen days (rarely up to twenty days) to get Fifth disease after a person has been in contact with it.
How long is it infectious?
- When the rash appears, the person is usually no longer able to pass the infection on.
- People with damaged immune systems (people who are very ill) may be infectious for months.
Signs and symptoms
- The illness is usually mild, with a fever and 'cold' like symptoms.
- Some people (up to 20%) do not have any sign of being unwell, and some others are mildly unwell without having a rash.
- A red rash on the face, looking like slapped cheeks, is the most common sign. The rash often spreads over the upper chest, and can spread over the rest of the body and limbs. It can be itchy. It usually is completely gone within 7 to 10 days.
- Usually when the rash appears, the person begins to feel well again.
- Some people, more often adults, will have pain and swelling in some joints (usually hands, wrists and knees), and this may last for several weeks).
- Both adults and children get over it completely.
- People who have had the infection will not get it again (they are immune) even if they did not have the rash or other symptoms.
- At least 50% of adults have had the infection, possibly more, and are no longer likely to catch it.
- The rash is usually a clear sign that the infection is Fifth disease, and no other tests are needed.
- If there is no rash, usually no tests are done, because the infection causes only a mild illness which is like many other mild illnesses.
- If a pregnant woman is exposed to Fifth disease, and is not sure if she is immune, a blood test could be done to see if she has had the infection before, or if she could be 'at risk'. She needs to discuss with her doctor whether a blood test could be useful.
- Once people have had an illness with Parvovirus B19 they become immune to the virus, and do not get that illness again. However there are many viruses that can cause similar illnesses and rashes. If a child has a second illness that looks like Slapped Face either this second infection, or the first one, will have been caused by a different virus.
Health problems from Fifth disease
- Fifth disease causes only a mild illness in most people who have it, and they recover fully.
- The joint pain may take longer to go, but it almost always goes in a few weeks.
- If a pregnant woman gets Fifth disease during her pregnancy, she will also only have a mild illness (or she may not have any symptoms).
- Most unborn babies also will not have health problems from having an infection.
- A very small number who get the infection will develop severe anaemia, which can lead to a miscarriage or stillbirth.
- This only happens rarely, and is more likely to happen in the first 6 months of the pregnancy, but if there are concerns about the unborn baby, the health of the baby can be watched (ultrasound can help here).
- If there are problems with the baby's health, treatment of anaemia in unborn babies has been done successfully.
- Parvovirus infections do not affect the development of the baby's body or brain.
- People with Fifth disease only need treatment for symptoms that are distressing.
- If there is a fever, paracetamol may help the child feel more comfortable (see 'Using paracetamol or ibuprofen').
- If the rash is very itchy, a soothing lotion from your pharmacist may help.
What parents can do
Children with a fever need to have extra drinks, even small sips or ice to suck helps. If you are worried, see your doctor.
The topic 'Feeling sick' has more ideas about caring for a sick child.
Preventing the spread of Fifth disease
- There is no immunisation for Fifth disease.
Children:
- Exclusion (keeping children home from school or early childhood services), is not necessary, because the only clear sign of the disease (the rash) comes when they can no longer pass it on. However if children are not well it is always best to keep them out of school or early childhood services.
- Careful hand washing seems to be effective at reducing the risk of getting Fifth disease.
Pregnant women
- It is also usually not recommended that pregnant women who work with children stay away from work if there are children at that worksite who have Fifth disease for this same reason (she would only know that she may have been exposed after the exposure happened).
- Pregnant women who might be exposed to Fifth disease need to discuss this with their doctor and make a decision which fits their particular circumstances.
- Careful hand washing is likely to be of some value for pregnant women too.
Centers for Disease Control USA. Parvovirus fact sheets
http://www.cdc.gov/ncidod/diseases/submenus/sub_parvovirus.htm
Department of Health (South Australia): 'Parvovirus B19 infection'
http://www.dh.sa.gov.au/pehs/ygw/parvovirusb19-pehs-sahealth-2009.pdf
The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).
This topic may use 'he' and 'she' in turn - please change to suit your
child's sex.