Fifth disease is an infection caused by the Parvovirus 819 virus; it leads to mild fever and a characteristic rash that has the appearance of a slapped cheek. Fifth disease is spread from person to person when there is direct contact with fluids or mucus from the nose or mouth of someone infected with it. The incubation period is usually 4 to 14 days, but it may be as long as three weeks before symptoms appear.
It is most common among school-age children and those with lowered immune defenses (from cancer or AIDS) or blood diseases (from sickle-cell anemia) can become seriously ill with fifth disease because the virus slows down the production of red blood cells. Among older children, pain and swelling in the hands, wrists, ankles, and knees may occur. The joint problems usually go away on their own but may last for a few months.
Fifth disease typically begins with a mild fever, maybe a headache, and cold symptoms (runny nose, sore throat, and cough). These symptoms may last for a few days before the rash appears on the face; the cheeks look bright red, as if they have been slapped. After some days, a lacy red rash may spread down the body, often on the arms and legs, but the palms of the hands and the soles of the feet are usually spared. The rash, which is itchy for some children, lasts from one to three weeks. Occasionally, the rash may become more noticeable owing to sunlight exposure, heat, or physical activity. Other symptoms and signs can include swollen lymph glands, red eyes, sore throat, and diarrhea. In many patients, fifth disease may not cause any symptoms at all.
It is difficult to avoid infection with fifth disease; once a person has the rash, he is no longer contagious. Still, decrease the changes of developing this viral illness by covering your mouth when coughing or sneezing, washing hands and toys frequently, and avoiding contact with people who are sick.
A child with fifth disease usually has minimal discomfort, so treat symptoms as necessary. Usually, rest and a lot of liquids will help with any cold symptoms. Anti-itch medications with antihistamine (such as Children's Benadryl) may be helpful if the rash is itchy. Acetaminophen (for example, Children's Tylenol) can be given if fever or joint pain occurs. Antibiotics are not helpful against viruses.
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