Fifth disease: symptoms & contagious child and adult

Fifth disease is a common mild spotting disease that mainly affects children between the ages of 5 and 14, but adults can get it too. The cause is a virus. If you are pregnant and get fifth disease, it can lead to a miscarriage or stillbirth. Fifth disease usually begins with flu-like symptoms. Sometimes fever also occurs, which is often accompanied by a stuffy nose, sore throat, fatigue, muscle pain and headache. Children often get small red spots on the face and bright red cheeks. Fifth disease heals on its own, no treatment is required.

  • What is fifth disease?
  • Contamination and transmission
  • Cause of fifth disease
  • Fifth disease symptoms
  • No symptoms
  • Flu-like symptoms
  • Spots on the face
  • Joint complaints in adults
  • Examination and diagnosis
  • Blood tests
  • Differential diagnosis
  • Fifth disease treatment
  • When to consult the doctor?
  • Prognosis and progression
  • Complications

What is fifth disease?

Fifth disease (erythema infectiosum) is a common mild spot disease that mainly affects children between the ages of 5 and 14, but adults can also get it. The causative agent of fifth disease is Parvovirus B19.

Contamination and transmission

The disease spreads through airborne droplets; respiratory particles transmitted by coughing and sneezing. People who have the disease can infect others from one week before the first symptoms appear until the rash appears. Because the disease is not very contagious, it is mainly transmitted through prolonged or intensive contact, such as in a family, daycare center, daycare center or school. Not everyone becomes ill after exposure to the virus. If someone does develop symptoms, this happens 1 to 3 weeks after infection with the virus. About 60% of adults are protected against the disease because they have already experienced it in the past, often as a child.

Cause of fifth disease

Fifth disease is caused by the human parvovirus B19, which was discovered accidentally by the Australian virologist Yvonne Cossart while screening donor blood for hepatitis B in 1974. The addition B19 is the number of the blood sample in which the virus was found.

Sick child / Source: Istock.com/Nadezhda1906

Fifth disease symptoms

No symptoms

In roughly 20% of cases, the child has no symptoms. Children over the age of ten in particular do not experience any symptoms.

Flu-like symptoms

Fifth disease usually begins with flu-like symptoms. Fever occurs in 15%-30% of cases, which is often accompanied by a stuffy nose, sore throat, fatigue, muscle pain and headache. That usually takes several days.

Spots on the face

Only after 7 to 10 days does the characteristic rash appear in children: small red spots develop on the face and the cheeks may become bright red. The spots then spread over the body and this may be accompanied by itching. The spots are initially butterfly-shaped. This rash normally disappears within a week. Up to a few weeks after that time, the spots can still return, for example due to heat, cold, exercise or excitement. The spots usually disappear quickly.

Joint complaints in adults

In adults, the disease often leads to joint complaints: pain and stiffness of the hands and feet. These complaints usually last 1 to 2 weeks, but they can also last for months. Adults only rarely suffer from a skin rash.

Examination and diagnosis

Blood tests

The doctor can make the diagnosis based on blood tests. This may be important, as fifth disease poses a small risk for some people, such as non-immune pregnant women and people with an immune disorder. For example, women who are in the first half of pregnancy and develop fifth disease have an approximately 9 percent chance of miscarriage or stillbirth.

Chickenpox / Source: 9Gawin/Shutterstock.com

Differential diagnosis

There are a number of conditions with a similar clinical picture to fifth disease, especially the childhood diseases associated with spots:

  • The measles;
  • Scarlet fever (streptococcal infection);
  • Rubella;
  • Exanthema subitum (sixth disease);
  • Chickenpox (varicella zoster);
  • Mononucleosis infectiosum (infectious mononucleosis – another name is glandular fever, because of swollen glands); and
  • Enterovirus infections (echo and Coxsackie virus).

General practitioner / Source: Istock.com/Wavebreakmedia

Fifth disease treatment

There is no treatment for fifth disease; it will heal on its own. Contact your doctor if you or your child suffer from symptoms consistent with fifth disease and if you have any questions about this. If your child feels very bad, you can give (children’s) paracetamol.

When to consult the doctor?

If you are pregnant or have a weak immune system or certain blood disorders, always consult your doctor. Fifth disease can cause problems for a pregnant woman’s fetus. In people with chronic hemolytic anemia and people with a congenital or acquired immune disorder, fifth disease can lead to complications.

Prognosis and progression

Most children and adults only have mild symptoms and recover completely within a week or so after the first symptoms appeared.

Complications

Fifth disease does not cause complications in most people. If you are pregnant and suspect you have been exposed to someone with the virus, contact your doctor. Usually there is no problem, but it is still good to discuss this with your doctor. Most pregnant women are protected against the virus because they have already experienced the disease in childhood. Women who are not immune usually experience mild symptoms. However, the virus can cause anemia in an unborn baby and even lead to miscarriage. However, this only occurs in a small percentage of women. It is more common in the first half of pregnancy.

Other risk groups
There are a number of other risk groups with an increased risk of complications. These are:

  • People with a weakened immune system due to cancer, leukemia or HIV infection; and
  • People with certain blood diseases, such as sickle cell anemia.

Fifth disease can cause severe anemia in these groups, requiring medical treatment.

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