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    Fifth Disease

    Updated at December 6th, 2022

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    Definition

    • Fifth disease is a viral rash that starts with red cheeks
    • Then it spreads to the shoulders and upper thighs
    • Average age: 4 to 12 years

    Health Information

    Symptoms

    • Bright red cheeks on both sides for 1 to 3 days. Looks like “slapped cheeks”.
    • Followed by pink “lace-like” (net-like) rash of arms and legs.
    • “Lacy” rash mainly occurs on thighs and upper arms/shoulders.
    • Rash also occurs on chest and stomach in 50% of children.
    • The rash isn’t itchy or painful.
    • No fever or low-grade one less than 102° F (39° C).

    Cause

    • Fifth disease is caused by the human parvovirus B19.
    • Not related to dog parvovirus.

    Prevention of Spread to Others

    • Good hand washing can prevent spread of infection.
    • Once the rash occurs, the child can no longer spread the virus.

    Care Advice

    1. Overview:
      • Fifth disease is a unique viral rash that is harmless.
      • It does not cause itching or pain.
      • It can be treated at home.
      • Here is some care advice that should help.
    2. Fever:
      • For fevers above 102° F (39° C), give acetaminophen (such as Tylenol) or ibuprofen. Note: Lower fevers are important for fighting infections.
      • For ALL fevers: Keep your child well hydrated. Give lots of cold fluids.
    3. Pregnant Women:
      • The risk of Fifth disease is to the unborn babies of pregnant women. It is not harmful to the woman herself.
      • A pregnant woman should see her OB doctor if she is exposed to Fifth disease.
      • He will do a test to see if the mother already had the disease. If she has, she is protected.
      • If not, the pregnancy will need to be watched closely. Some fetuses infected with Fifth disease before birth develop complications. Ten percent develop severe anemia and 2 % may die.
      • Birth defects, however, are never a result of this virus.
    4. What to Expect:
      • The lace-like rash can come and go for 1 to 3 weeks. 5.
    5. Return to School:
      • Once your child has the “slapped cheeks”, they can no longer spread the illness. Likewise, the lacy rash cannot be spread to others either.
      • Your child does not need to stay home from child care or school.
      • The disease can be spread during the week BEFORE the rash begins.
      • Therefore, exposed children should try to avoid contact with pregnant women. This may be hard to know in advance.

    Call Your Doctor If

    • Fever above 102° F (39° C) occurs
    • You think your child needs to be seen
    • Your child becomes worse


    Author: Barton Schmitt MD, FAAP

    Copyright 2000-2020 Schmitt Pediatric Guidelines LLC