Fifth Disease
(erythema infectiosum, parvovirus B19 infections)

What is fifth disease?
Fifth disease is a mild, usually non-febrile (without fever) illness caused by parvovirus B19. Although severe complications resulting from this illness are rare, persons with chronic blood disorders who also get fifth's disease may develop an inability to form new blood cells. Additionally, if a woman gets the disease during pregnancy, the virus can infect the unborn child, which may result in death of the fetus.
How do you get it?
The virus spreads by exposure to secretions or droplets from the nose and throat of persons with the disease. Anyone can get fifth disease, but it occurs most commonly in children of elementary school age. Susceptible pregnant women who have had contact with persons with the disease, and persons with red blood cell disorders should consult with their doctor.

What are the symptoms of fifth disease?
Fifth disease initially starts with a low grade fever and fatigue. A striking red rash which looks much like a slap mark, commonly appears on the cheeks. A fine, lace-like rash may then appear on the body. Sometimes the rash may be itchy. Some children may have mild signs of illness or no symptoms at all.

When do symptoms start?
The symptoms usually begin 1 to 2 weeks after exposure to the virus.

For how long is a person contagious?
A person with fifth disease is most contagious about 1 week before the onset of the rash. Once the rash starts, it probably cannot be spread to others.

What is the treatment for fifth disease?
At this time, there is no specific treatment for fifth disease, except that medications can be prescribed to help relieve symptoms. In rare cases, blood transfusions may be required.

If you get fifth disease once, can you get it again?
It is thought that people who have had fifth disease develop long-term immunity. Studies have shown that about 50% of adults have immunity to fifth disease.

Should a person infected with fifth disease be excluded from work or school?
No. A person with fifth disease should not be excluded from work or school. However, any outbreaks (two or more cases) should be promptly reported to the Health Department.

How can you keep from getting it?
Susceptible women who are pregnant should avoid exposure to persons infected with the disease.

Pregnant women with sick children at home should be advised to wash hands frequently and avoid sharing eating utensils.

Health care workers should be careful to follow approved infection control measures.