Fifth Disease: Keep Your Kid Away From the Pregnant Lady!

Jeanne Sager

fifth diseaseWhen my husband called to announced his friend's son had just been diagnosed with Fifth Disease, I didn't freak.

Sure, our daughter had been exposed in a major way considering the two played a rather hands-on game of football several days prior, but I had Fifth Disease as a kid and remember it being mild.

Then the other shoe dropped -- we'd have to cancel a host of activities this summer IN case she actually developed it.

But according to the first pregnant friend I reached out to to break the news, I'm the first one who actually was concerned enough for her fetus to keep my daughter away.

It's because Fifth Disease is so low key in kids that parents seem to brush it off as no big deal, so The Stir spoke to Maryanne Bourque, MS, RN, the community education coordinator at the Nemours/Alfred I. duPont Hospital for Children, to find out when we should freak -- and why.

What is Fifth Disease?

Fifth Disease (also called erythema infectiosum) is caused by parvovirus B19.

This is NOT the same parvovirus that veterinarians are concerned with in dogs; also parvovirus B19 CANNOT be passed from humans to animals or from animals to humans. Fifth Disease occurs everywhere in the world -- outbreaks tend to occur in late winter and early spring, but there can be sporadic cases any time throughout the year.

How does it show up in kids?

Fifth Disease begins with a low-grade fever (greater than normal, but less than 100.4 degrees) and mild cold-like symptoms (cough, stuffy or runny nose). Symptoms will pass within days to a week and then a few days later; a rash appears on the face that looks like the cheeks were slapped.

Several days later, the rash may spread down the body, arms, and legs -- first appearing as red blotches, then as they begin to clear, resembles a lacy pattern. Soles of feet and palms of hands are usually not affected by the rash. Generally kids under 10 years of age get the rash more often.

  • Prevention -- there is no vaccine. Parvovirus B19 is a virus so no antibiotics are necessary. Once a person if infected with the virus, the body is immune to getting the virus again.
  • Incubation period (time between infection and the onset of symptoms) -- ranges from 4 to 28 days, with the average being 16 days
  • Duration -- the rash lasts 1 to 3 weeks. Sometimes in older kids (older than 10), there may be joint pain or swelling that can last up to months

So should we worry? When should we?

The rash associated with Fifth Disease is due to an immune reaction after the infection has passed, so kids are not considered contagious while they have the rash.

Parvovirus is spread easily from person to person in fluids from the nose, mouth, and throat of someone with the infection -- usually through sneezes and coughing.

Children are most contagious before symptoms appear (incubation period) or during the time mild cold symptoms are being experienced. In a home where one child has Fifth Disease, another family member who hasn't previously had parvovirus B19 has about a 50 percent chance of also getting the infection. Studies have shown that 40 to 60 percent of adults worldwide have already had parvovirus B19.

Most children will recover with no complications -- by the time the rash appears and during the time they have the rash, they usually feel well enough to go back to their regular activities.

Kids can attend day care and school with the rash, because, again, the infection has passed. Children with certain blood disorders (such as sickle cell anemia) and weakened immune systems (such as AIDS or leukemia) may become significantly ill.

Parvovirus B19 infection during pregnancy may cause problems for the fetus, such as the development of severe anemia. This is especially true if the infection occurs during the first half of the pregnancy. However, it is very important to remember that half of all pregnant women are already immune to the virus as they've had a previous infection with parvovirus B19. If a pregnant woman is concerned about exposure to a child with Fifth Disease, she should check with her obstetrician.

Parents should call their doctor if a rash appears over the body, with or without cold symptoms.

What's with the name?

Years ago, doctors saw five rash-related infections in childhood -- they were: measles, scarlet fever, rubella (German measles), a fourth that is not known to doctors today (now called "Fourth Disease"), and Fifth Disease (Parvovirus B19).

Has your child had Fifth Disease yet?


Image via National Institute of Health

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