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February 9, 2012

Fifth Disease
(Parvovirus)

Medical Author:
Medical Editor:
Fathoming Fifth Disease

Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: Barbara K. Hecht, PhD

Get information about fifth disease, a contagious viral illness.Fifth disease is a mild viral illness that is common in children. It is caused by infection with the human parvovirus B19. The name fifth disease reflects the historical belief that it was one of the five diseases that produced a rash in children.

Fifth disease is also called erythema infectiosum. Erythema (redness) refers to the characteristic "slapped cheek" red rash on the face. This rash may itch. There may also be a lacy red rash on the trunk, arms, and legs. Before there is any rash, the child may have a low-grade fever and symptoms of a cold for several days. The rash itself goes away in seven to 10 days.

The causative virus, parvovirus B19, is thought to be transmitted from person to person via secretions from the mouth or nose. Sharing contaminated drinking cups or toothbrushes may transmit the virus. Unlike some other illnesses with rash, the contagious period in fifth disease is the time before the rash appears, when the child appears to just have a cold or a mild, nonspecific illness.

Fifth disease is very contagious. The CDC (U.S. Centers for Disease Control and Prevention) states that during an outbreak of fifth disease in a school, up to 60% of exposed children can contract the disease.

What is "fifth disease"?

Fifth disease is a viral illness caused by parvovirus B19. Fifth disease is also known as "erythema infectiosum" and "slapped cheek disease." The clinical illness was described in the 1880s and was named fifth disease because of its position in the numerical classification of childhood illnesses associated with rashes (exanthems). Other numbered diseases included measles, scarlet fever, and rubella—and these did not get renamed until the molecular era, when it became possible to isolate viruses and bacteria. Fifth disease was number five of six diseases named. It is a very common infection, and almost 50% of adults have been infected with the virus but do not remember having it because it often does not cause symptoms.

What are the symptoms of fifth disease?

Though fifth disease generally occurs in children between 4-10 years of age, it can affect any age group, including adults. It most commonly occurs during the winter and spring. The illness classically begins with a low-grade fever and malaise (a sense of not feeling well). After about a week, this is followed by a characteristic bright red rash on the cheeks (the so called "slapped cheeks" rash). Finally, after three to four days, a fine, red, lacelike rash can develop over the rest of the body. This rash may last for five days to a week and occasionally comes and goes for up to three weeks. The other symptoms are usually gone by the time the rash appears, and patients with the rash are usually not contagious. Unfortunately, as with many other viral illnesses, the features and timing of the different stages of illness are not always predictable.

While the illness is not serious in children, around 5% of children and around 50% of adults with fifth disease can have joint aches and pains. This arthritis or arthropathy is more common in females than males and is usually temporary, lasting days to weeks, but may become a long-term problem for months. People with arthritis from fifth disease usually have stiffness in the morning, with redness and swelling of the same joints on both sides of the body (a "symmetrical" arthritis). The joints most commonly involved are the knees, fingers, and wrists.



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Fifth Disease

What is septic arthritis?

Septic, or infectious, arthritis is infection of one or more joints by microorganisms. Normally, the joint is lubricated with a small amount of fluid that is referred to as synovial fluid or joint fluid. The normal joint fluid is sterile and, if removed and cultured in the laboratory, no microbes will be found. With septic arthritis, microbes are identifiable in an affected joint fluid.

Most commonly, septic arthritis affects a single joint, but occasionally more joints are involved. The joints affected vary somewhat depending on the microbe causing the infection and the predisposing risk factors of the person affected. Septic arthritis is also called infectious arthritis.

What microbes cause septic arthritis?

Septic arthritis can be caused by bacteria, viruses, and fungi. The most common causes of septic arthritis are bacteria, including Staphylococcus aureus and Haemophilus...

Read the Septic Arthritis article »







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