Fifth Disease

Fifth disease, or erythema infectiosum, is a viral infection that commonly affects children between age four and ten years. Although the infection is common, it is often not associated with any symptoms. The condition occurs most often in late winter and early spring, and may occur as an outbreak in schools, daycare facilities, and families. Infection requires close contact and is spread by coughing and sneezing. Individuals remain contagious only until the appearance of a characteristic rash.

The infection is mild and self-limiting. Following an infection period of 4 to 14 days, approximately half of the patients develop a mild fever, headache, sore throat, general discomfort, and gastrointestinal symptoms. A facial rash follows three to seven days later. The rash is red, swollen, and appears on both sides of the face, giving the cheeks a 'slapped' appearance. Flat, slightly raised red spots with a lace-like appearance often occur on the trunk, neck, arms, and legs one to four days later. The rash is often itchy and may last for up to three weeks. Pain in the joints may also occur.

Currently, there is no vaccine to prevent infection with the virus. Individuals, particularly those at risk of infection-related complications, should try to reduce the spread of infection by avoiding close contact with potentially contagious persons, washing hands frequently and not sharing food or drinks with others.

Treatment may be given to relieve symptoms. Emollient creams may be used to prevent dry skin, which can worsen an already itchy rash. Showering or bathing in lukewarm water may provide relief. Avoid tight fitting clothing and/or those made from coarse woolen fabrics, which may be uncomfortable.

Fever and headache may be relieved with acetaminophen. Ibuprofen may be used to treat joint pain. The itchy rash may be relieved by oatmeal bath preparations and/or hydrocortisone cream. Antihistamines are not recommended for itch associated with viral infections. Speak to your pharmacist for information about symptom relief.

For more information on fifth disease, visit the National Center for Infectious Diseases at www.cdc.gov/ncidod/index.htm or the eMedicine website at www.emedicine.com.