DEAR DOCTOR K:
A child in my son’s class has “fifth disease.” What is this? Is it contagious? What can I do to prevent my son from catching it?
Fifth disease, also known as erythema infectiosum, is a common viral infection among school-aged children. It is caused by a virus called parvovirus B19.
Fifth disease usually is a mild illness. Some people who are infected with the virus may never realize they have it. When symptoms do occur, they may include a stuffy nose, runny nose, slight fever, or body aches, headache, nausea, diarrhea and fatigue. These symptoms pass after three or four days.
In children with a new infection by the virus, these symptoms are followed by a bright red “slapped cheek” rash. The child’s cheeks are bright red. The skin around the child’s mouth is unusually pale — which makes the red cheeks look even redder. I’ve put a photo of this rash below.
The slapped cheek rash doesn’t appear until an infected person is no longer contagious. The rash on the cheeks is followed by a lacy, flat rash that appears on the arms, legs, trunk and buttocks. It may itch. Fifth disease usually goes away within three weeks.
The rash, however, may occasionally last for months. Sometimes it goes away, but then comes back when the child is under emotional stress, exercises, or is exposed to a sudden change in temperature (like moving between a warm home and a frigid outdoors in winter).
Fifth disease spreads through direct contact with fluids or mucus from the nose or mouth of an infected person. Your child may encounter the virus in the droplets of coughs and sneezes, on dirty tissues, on drinking glasses and eating utensils.
It is difficult to avoid exposure to the illness because fifth disease is most contagious three to 14 days before the facial rash appears. During this time, most infected people don’t know that they are ill and contagious.
The best way to reduce the risk of your child catching the virus is to encourage him to wash his hands frequently with soap and warm water. It is especially important to wash hands before eating and after touching contaminated items like dirty tissues, drinking glasses and eating utensils.
If your child does become infected, remember that fifth disease is a mild illness that usually does not require treatment. If your child develops an itchy rash, oatmeal baths or other over-the-counter bath treatments may help. You can give your child over-the-counter pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) for body aches or headaches. Never give your child aspirin.
Contact your doctor if your child has a blood disorder, cancer or an immune deficiency. Fifth disease can cause serious illness in children with these conditions.
Since fifth disease occasionally can lead to complications, be sure to check in with your son’s pediatrician if you think your son may have caught it from his classmate.