Erythema Infectiosum (Fifth Disease)

Around the turn of the century, doctors began numbering contagious diseases that produce somewhat similar rashes. Over time, most of these numbers fell out of use, replaced by more popular names such as measles (known in the numbering system as first disease), scarlet fever (second disease), and rubella (third disease). The only one of these illnesses to which the number stuck, in fact, was erythema infectiosum, which sometimes still goes by the name fifth disease. Erythema infectiosum is a mild childhood infection--so mild, in fact, that a child can have it without the parents' even noticing. Its hallmarks include a fine, pink rash covering the trunk and limbs and bright, red patches on the cheeks.

WHAT CAUSES FIFTH DISEASE?
A highly contagious microorganism called parvovirus B19 has been identified as the source of fifth disease. Symptoms appear between four and 14 days after a child contracts the virus. The illness often occurs in epidemics during late winter and spring. During an epidemic, as many as half of the children in a school may contract erythema infectiosum.

WHEN SHOULD I SUSPECT THAT MY CHILD HAS FIFTH DISEASE?
Red cheeks--sometimes referred to as slapped cheeks because they look like they've recently received a sharp smack--are the most obvious sign. The patches of red, which are usually in the center of both cheeks, are slightly raised and warm to the touch.

A slightly raised, lacy, pink rash develops within a few days after the rash appears on the cheeks. It starts on the arms, then spreads to the thighs and lower legs, involving mainly exposed areas of skin. The trunk (chest, back and abdomen) is less often affected.

Children rarely feel very ill with fifth disease. Even when the rash is present, the child may have a normal temperature and experience only minor discomfort. On the other hand, symptoms can include headache, sore throat, fatigue, mild fever, itching, and pink eyes. In rare cases, a child may feel achy in the knees and wrists.

IS MEDICAL ATTENTION NECESSARY?
Usually it isn't. There is no specific medical treatment for fifth disease. Within five to ten days, the entire rash should fade, first from the face, then from the arms, trunk and legs.

In some cases, days or weeks later, the rash will reappear for a short time, especially after sun exposure, exercise, bathing or being outside in the cold. This brief recurrence causes little or no discomfort.

PREVENTING FIFTH DISEASE
There is no way to keep a child from contracting fifth disease once she has been exposed to the virus. The period of contagion is unknown, but probably prolonged. You theoretically can prevent your child from spreading the disease, however, by keeping her away from other people until both the rash and fever have disappeared. Isolation from other children is generally ineffective and unnecessary, however, because the disease is so mild and causes no complications.

CARING FOR A CHILD WITH FIFTH DISEASE

• If the child has a fever, treat it with the appropriate dose of acetaminophen (Tylenol, Panadol, Tempra, Datril and other brands) depending on the child's weight and height.

• If a stuffy nose interferes with sleeping and eating, ask your pediatrician whether the child can use an over-the-counter decongestant.

• Encourage the child to drink plenty of fluids.

• Dress the child in loose, comfortable clothing

• Keep the child from coming in close contact with any pregnant women. Although most people have probably had fifth disease by the time they reach adulthood, a few are not immune to the virus. If a pregnant woman does contract the virus--particularly in the first trimester--it can be harmful to the fetus.

GETTING HELP
Call your doctor if the child:

• Develops a high fever and becomes listless

• Displays any new symptoms such as itchiness

• Complains of severe sore throat, joint aches or muscle aches

Excerpt from THE DISNEY ENCYCLOPEDIA OF BABY & CHILD CARE, © 1995 DSH Communications, Inc. This material is based on current medical research and, to the best of the editors' knowledge and understanding, is accurate and valid. However the reader should not use information contained in this material to alter a medically prescribed regimen or as a form of self-treatment, without seeking the advice of a licensed physician.