Information From Your Health Care Provider

ERYTHEMA INFECTIOSUM

(Fifth Disease)

Basic information

description

Erythema infectiosum is an infectious, mild, viral illness that occurs in outbreaks (often during the winter and spring months). It most often affects children ages 5 to 14, and is rare in infants and adults. The word erythema means skin redness, and infectiosum means infectious. The name fifth disease comes from its place on a list made up many years ago of the five most common childhood infections.

FREQUENT SIGNS & SYMPTOMS

The illness begins with a headache, stuffy or runny nose, and sometimes, a low-grade fever and feeling of fatigue. These symptoms may get better.
From 3 to 10 days later, a rash appears. It is called "slapped cheeks appearance" because it starts as a rash on the cheeks. The rash spreads to the trunk, buttocks, and limbs. It has a lace-like pattern, and it may be itchy.
Rarely, other symptoms may occur such as sore throat, red eyes, diarrhea, and swollen glands.
In adults, there may be mild joint pain or swelling.
About 20% of infected people will have no symptoms.

causes

A virus called parvovirus B-19. The germs come from fluids in the nose, mouth, and throat of someone who has the infection. When an infected person coughs or sneezes, the germs are spread into the air. The period of time from exposure to the germs until symptoms begin is 4 to 28 days with an average of 16 to 17 days. Once the rash appears, the germs are no longer being spread.

risk increases with

Children in school and daycare centers.

PREVENTIVE MEASURES

No specific preventive measures. Outbreaks can last for months, so there is no need to keep a child out of school or daycare.
A pregnant woman should avoid daycare centers and schools if there is an outbreak.
Wash hands often to prevent spread of any germs.

expected outcomes

Complete recovery. The rash usually clears in 10 days to 2 weeks. Once you have had the infection, you are immune (you cannot get it again).

possible complications

None expected in most cases. In patients with disorders such as sickle-cell anemia or a weak immune (body's germ-fighting) system, the illness can cause a serious anemic reaction.
In pregnant women there is a small risk of miscarriage if the infection occurs during the first 20 weeks of pregnancy. There is no evidence that it causes birth defects.

diagnosis & treatment

general measures

Home care is usually all that is needed for treatment. Call your health care provider if you have concerns about the symptoms, or if you or a child has a chronic illness. Pregnant women should call their obstetric provider if they have been exposed or if they have any symptoms of the illness.
Your health care provider will examine the appearance of the rash to diagnose the infection. In a few cases, a blood test is done to confirm the diagnosis.
For home care, use Aveeno (an oatmeal bath product) for a cool, soaking bath. This can help with the itching.
The rash may become redder, or it may come back again after it seemed to clear up, after spending time in the sun, taking a warm bath, getting excited, or exercising. This is no cause for concern.

medications

There are no drugs for treating the illness. You may use acetaminophen for fever. Don't give a child younger than 18 aspirin for fever.
If the rash itches, use plain calamine lotion.
Your health care provider may prescribe other drugs.

activity

No limits needed. Get extra rest during the illness if you or your child feels tired. Use sun protection when outdoors.

diet

No special diet. Drink plenty of fluids.

notify our office if

If you or your child has symptoms of erythema infectiosum and you have concerns about the illness.
Symptoms don't improve or worsen after home treatment.
You are pregnant and have been exposed to erythema infectiosum.