What are the symptoms of Fifth Disease. How is Fifth Disease diagnosed and treated. Can Fifth Disease be prevented. What complications can arise from Fifth Disease. How does Fifth Disease spread.

Understanding Fifth Disease: A Comprehensive Overview

Fifth disease, also known as erythema infectiosum, is a mild viral infection caused by parvovirus B19. This condition primarily affects children but can also occur in adults. The name “fifth disease” originates from its historical classification as the fifth in a series of common childhood rash-causing illnesses.

The virus typically incubates for 4 to 14 days before symptoms appear. While many cases are mild and resolve on their own, understanding the signs, symptoms, and potential complications is crucial for proper management and prevention of spread.

Key Facts About Fifth Disease

• Caused by parvovirus B19
• More common in children than adults
• Usually mild and self-limiting
• Characterized by a distinctive “slapped cheek” rash
• Can cause joint pain, especially in adults

Recognizing the Symptoms of Fifth Disease

The symptoms of fifth disease can vary from person to person, but typically follow a pattern. Is there a specific sequence of symptoms? Generally, the illness progresses in two stages:

Initial Symptoms

The first stage of fifth disease often mimics a mild cold or flu. Symptoms may include:

• Low-grade fever
• Runny or stuffy nose
• Headache
• Sore throat
• Fatigue

These initial symptoms usually last for a few days and may go unnoticed or be mistaken for a common cold.

Characteristic Rash

The second stage is marked by the appearance of a distinctive rash. Do all patients develop this rash? While not universal, the rash is a hallmark of fifth disease and occurs in most cases, especially in children.

1. “Slapped cheek” rash: A bright red rash appears on the cheeks, giving the appearance of having been slapped.
2. Body rash: A few days later, a lacy, red rash may spread to the trunk, arms, and legs.

The rash may be itchy, particularly on the soles of the feet. It typically lasts for 7 to 10 days but can persist or recur for several weeks, especially with exposure to sunlight or heat.

Joint Pain and Swelling: A Common Complication

While the rash is more prominent in children, adults with fifth disease often experience joint-related symptoms. These can include:

• Pain and swelling in joints, particularly hands, wrists, knees, and ankles
• Stiffness and discomfort, especially in the morning
• Symptoms resembling rheumatoid arthritis

Joint symptoms can persist for weeks or even months in some cases. Are these joint issues permanent? Fortunately, they typically resolve without long-term complications, but in rare cases, they may last longer.

Transmission and Contagiousness of Fifth Disease

Understanding how fifth disease spreads is crucial for prevention. The virus is transmitted through respiratory secretions when an infected person coughs or sneezes. When is a person with fifth disease most contagious? The period of highest contagiousness occurs before the onset of the rash, typically during the initial “cold-like” phase.

Transmission Routes

• Respiratory droplets
• Close personal contact
• Blood or blood products (rare)
• From mother to fetus during pregnancy

Once the characteristic rash appears, most individuals are no longer contagious. This fact often allows children to return to school once the rash is evident, as they are unlikely to spread the infection at this stage.

Diagnosis and Medical Assessment

Diagnosing fifth disease typically involves a combination of clinical observation and, in some cases, laboratory testing. How do healthcare providers confirm a fifth disease diagnosis?

Clinical Diagnosis

In many cases, especially with children, the distinctive “slapped cheek” rash is sufficient for a healthcare provider to diagnose fifth disease. The pattern and progression of symptoms, along with the characteristic rash, often provide enough evidence for a clinical diagnosis.

Blood Tests

In certain situations, particularly for adults or in cases where the diagnosis is uncertain, blood tests may be performed. These tests can detect:

• Antibodies to parvovirus B19, indicating recent or past infection
• The presence of the virus itself through PCR testing

Blood tests are especially important for pregnant women who may have been exposed to the virus, as parvovirus B19 can potentially affect the developing fetus.

Treatment Approaches for Fifth Disease

Fifth disease is generally a mild, self-limiting condition that resolves on its own. However, symptomatic treatment can help alleviate discomfort. What are the main treatment strategies for fifth disease?

Symptomatic Relief

• Rest and hydration to support the body’s natural healing process
• Over-the-counter pain relievers like acetaminophen or ibuprofen for fever and discomfort
• Antihistamines to reduce itching associated with the rash
• Cold or warm compresses for joint pain

Management of Complications

In rare cases where complications arise, additional treatments may be necessary:

• Blood transfusions for severe anemia
• Intravenous immunoglobulin for individuals with weakened immune systems
• Specialized care for pregnant women with confirmed parvovirus B19 infection

It’s important to note that antibiotics are not effective against fifth disease, as it is caused by a virus, not bacteria.

Prevention Strategies and Public Health Measures

While there is no vaccine available for fifth disease, several preventive measures can reduce the risk of infection and transmission. How can individuals and communities prevent the spread of fifth disease?

Personal Hygiene Practices

• Frequent handwashing with soap and water for at least 20 seconds
• Covering mouth and nose when coughing or sneezing
• Avoiding touching face, especially eyes, nose, and mouth
• Staying home when feeling unwell to prevent spreading the virus

Environmental Measures

In settings where the virus may spread more easily, such as schools or daycare centers, additional precautions can be taken:

• Regular cleaning and disinfection of frequently touched surfaces
• Proper ventilation to reduce the concentration of airborne viruses
• Encouraging sick individuals to stay home until they are no longer contagious

Special Considerations for Vulnerable Populations

Certain groups may need to take extra precautions:

• Pregnant women should consult their healthcare provider if exposed to someone with fifth disease
• Individuals with weakened immune systems or blood disorders should take extra care to avoid exposure
• Healthcare workers, especially those who are pregnant, should be aware of the risks and follow strict infection control practices

Complications and Special Cases in Fifth Disease

While fifth disease is usually mild, certain individuals may be at risk for more serious complications. What are the potential risks and who is most vulnerable?

Complications in Vulnerable Groups

• Pregnant women: Risk of fetal anemia or miscarriage, especially in the first half of pregnancy
• People with weakened immune systems: Prolonged infection and potential for severe anemia
• Individuals with chronic anemia: Risk of aplastic crisis

Rare Complications

In rare cases, fifth disease can lead to more serious issues:

• Myocarditis (inflammation of the heart muscle)
• Encephalitis (inflammation of the brain)
• Persistent arthropathy (joint disease)

These complications are extremely uncommon but underscore the importance of monitoring and seeking medical attention if symptoms worsen or persist.

Living with Fifth Disease: Management and Recovery

For most individuals, fifth disease is a temporary inconvenience that resolves on its own. However, understanding how to manage symptoms and support recovery can make the experience more comfortable. What steps can be taken to facilitate recovery from fifth disease?

Self-Care Measures

• Adequate rest to support the immune system
• Staying hydrated to help flush out the virus
• Using moisturizers to alleviate dry, itchy skin associated with the rash
• Avoiding excessive sun exposure, which can exacerbate the rash

Managing Joint Pain

For adults experiencing joint pain:

• Gentle stretching and range-of-motion exercises
• Alternating hot and cold therapy for affected joints
• Over-the-counter anti-inflammatory medications as recommended by a healthcare provider

Emotional Support

While fifth disease is generally mild, the visible rash and potential for prolonged symptoms can be distressing. Providing emotional support and reassurance, especially for children, can be an important aspect of management.

Fifth disease, while typically mild, requires attention to prevent spread and manage symptoms effectively. By understanding its progression, recognizing symptoms, and implementing preventive measures, individuals and communities can minimize its impact. For most, fifth disease resolves without complications, but awareness of potential risks in vulnerable populations is crucial. As research continues, our understanding of this common childhood illness continues to evolve, enabling better management and care strategies.

About Fifth Disease | CDC

• Signs & Symptoms
• Complications
• Transmission
• Diagnosis
• Prevention & Treatment

Fifth disease is a mild rash illness caused by parvovirus B19. It is more common in children than adults. A person usually gets sick with fifth disease within 14 days after getting infected with parvovirus B19. This disease, also called erythema infectiosum, got its name because it was fifth in a list of historical classifications of common skin rash illnesses in children.

Signs & Symptoms

The symptoms of fifth disease are usually mild and may include

• fever
• runny nose
• headache
• rash

You can get a rash on your face and body
You may get a red rash on your face called “slapped cheek” rash. This rash is the most recognized feature of fifth disease. It is more common in children than adults.

Some people may get a second rash a few days later on their chest, back, buttocks, or arms and legs. The rash may be itchy, especially on the soles of the feet. It can vary in intensity and usually goes away in seven to 10 days, but it can come and go for several weeks. As it starts to go away, it may look lacy.

You may also have painful or swollen joints
People with fifth disease can also develop pain and swelling in their joints. This is called polyarthropathy syndrome. It is more common in adults, especially women. Some adults with fifth disease may only have painful joints, usually in the hands, feet, or knees, and no other symptoms. The joint pain usually lasts 1 to 3 weeks, but it can last for months or longer. It usually goes away without any long-term problems.

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Complications

Fifth disease is usually mild for children and adults who are otherwise healthy. But for some people, parvovirus B19 infection can cause serious health complications, such as chronic anemia that requires medical treatment.

You may be at risk for serious complications from fifth disease if you have a weakened immune system caused by leukemia, cancer, organ transplants, or HIV infection.

Transmission

Parvovirus B19—which causes fifth disease—spreads through respiratory secretions, such as saliva, sputum, or nasal mucus, when an infected person coughs or sneezes. You are most contagious when it seems like you have “just a fever and/or cold” and before you get the rash or joint pain and swelling. After you get the rash you are not likely to be contagious, so it is usually safe for you or your child to go back to work or school.

People with fifth disease who have weakened immune systems may be contagious for a longer amount of time.

Parvovirus B19 can also spread through blood or blood products. A pregnant woman who is infected with parvovirus B19 can pass the virus to her baby.

Once you recover from fifth disease, you develop immunity that generally protects you from parvovirus B19 infection in the future.

Diagnosis

Healthcare providers can often diagnose fifth disease just by seeing “slapped cheek” rash on a patient’s face. They can also do a blood test to determine if you are susceptible or possibly immune to parvovirus B19 infection or if you were recently infected. This is not a routine test but can be performed in special circumstances. The blood test may be particularly helpful for pregnant women who may have been exposed to parvovirus B19 and are suspected to have fifth disease. Any pregnant woman who may have been exposed to parvovirus B19 should contact their obstetrician or healthcare provider as soon as possible.

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Prevention & Treatment

Prevention

There is no vaccine or medicine that can prevent parvovirus B19 infection. You can reduce your chance of being infected or infecting others by

• washing your hands often, for at least 20 seconds, with soap and water
• covering your mouth and nose when you cough or sneeze
• not touching your eyes, nose, or mouth
• avoiding close contact with people who are sick
• staying home when you are sick

Once you get the rash, you are probably not contagious. So, it is usually safe for you to go back to work or for your child to return to school or a child care center.

Healthcare providers who are pregnant should know about potential risks to their baby and discuss this with their doctor.

All healthcare providers and patients should follow strict infection control practices to prevent parvovirus B19 from spreading. For information about handwashing, see CDC’s Clean Hands Save Lives!

Treatment

Fifth disease is usually mild and will go away on its own. Children and adults who are otherwise healthy usually recover completely. Treatment usually involves relieving symptoms, such as fever, itching, and joint pain and swelling.

People who have complications from fifth disease should see their healthcare provider for medical treatment.

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Fifth Disease (Erythema Infectiosum): Symptoms and Treatment

Fifth disease is a mild illness caused by a virus called parvovirus B19. It is rarely serious.
Its most obvious symptom is the bright red rash or “slapped cheek” look of the face.

The disease occurs most often during the late winter and early spring in children between
the ages of 4 and 10. However, older children and adults, especially females, can get it.

Fifth disease is contagious (spread from person to person) in the early stages before
symptoms appear. Once the rash appears, it is no longer contagious. It is spread by
coughing, sneezing or by touching secretions from the nose and mouth of an infected
person. After your child has fifth disease he or she will not get it again.

Symptoms

Fifth disease has 3 stages:

The first stage (incubation period) lasts 7 to 14 days. This is when the child can spread
the disease to others without knowing.

• Mild fever
• Mild headache
• Cold-like symptoms (stuffy or runny nose, sore throat)
• Fatigue
• Mild muscle or joint pain and swelling, especially in older children and women

Second stage starts 2 to 3 weeks after exposure. This is when the child is no longer
contagious.

• Bright red, “slapped cheek” rash on face
• Rash fades after 5 to 10 days

Third stage may last 1 to 3 weeks.

• Rash spreads to chest, arms and thighs
• Looks blotchy and like lace
• May be itchy but is painless

The rash may come back after several weeks. It can be triggered by sunlight, exercise,
extremes of heat or cold or emotional stress.

Treatment

There is no treatment for fifth disease. Most children get well without treatment.

If your child has a fever or joint discomfort, you may give acetaminophen (Tylenol®)
or ibuprofen (Motrin® or Advil®). Read the label to know the right dose for the age
of your child.

Do not give ibuprofen to children younger than 6 months. For children younger than 6
years, do not give over-the-counter (OTC) cold or cough medicine without asking your
child’s doctor. Do not give aspirin or products that contain aspirin.

Prevention

There is no vaccine to prevent fifth disease.

To prevent the spread of infection:

• Wash hands often (Picture 1)
• Cover the mouth and nose when coughing or sneezing
• Avoid touching the mouth or nose

Pregnant women should avoid being near children with fifth
disease. If exposed, they should call their health provider.
Fifth disease may harm an unborn child.

When to Call the Doctor

Call the doctor if your child has:

• Fever more than 102° F after treating for 3 days
• Severe joint pain or swelling
• A condition that weakens the immune system (like sickle cell disease, cancer, or
  hemolytic anemia)

Return to School

Your child can return to school after the rash disappears and he has no fever.

Fifth Disease (PDF)

HH-I-212 12/01, Revised 11/17 Copyright 2001, Nationwide Children’s Hospital

Treatment of roseola in children in the Primorsky district of St.

Petersburg

Roseola is a viral disease caused by herpes type 6 or 7. Most often, children get sick with roseola in infancy (from 3-4 months to 2 years), because the immune system is weakened. After that, a person acquires immunity to roseola for life, although he remains a carrier of the herpes virus.

Roseola is also called exanthema, pseudorubella, three-day fever. The disease is very easy to confuse with other ailments, such as allergies or SARS, so you should consult a doctor. The herpes virus is dangerous because it can cause complications (convulsions), it affects the internal organs (brain, bladder).

A characteristic feature of roseola is a pink-red rash on the child’s body.

Symptoms of roseola in an infant:

• increase in body temperature up to 40 degrees;
• poor sleep;
• rashes on the body;
• irritability;
• enlarged lymph nodes;
• loose stools;
• possible sore throat;
• slight runny nose.

The disease never becomes epidemic, although it is contagious. The virus is transmitted by airborne and household routes. The child most often becomes infected from the carrier. Sometimes roseola begins after an acute respiratory viral infection. Exacerbations of herpes type 6-7 (roseola) in children are most often observed in the autumn and spring periods.

Peculiarities of the rash in roseola

The rash on the child’s body appears 3 days after the fever. The rash lasts for about 5-7 days, it spreads throughout the body. If you press on the rash with your finger, it turns pale. This rash with roseola differs from rubella. The size of the rashes is 3-5 millimeters in diameter. The incubation period for roseola is 5-15 days. The rash does not itch, and more importantly, it does not appear on the face of the child.

Roseola diagnostics

The presence of roseola (herpes virus) is determined by donating blood and detecting specific antibodies to this pathogen in it.

Treatment of infantile roseola in the Osnova Children clinic

If you see a rash on the child’s skin or if he has a fever, he feels unwell, be sure to seek professional medical help. Only a specialist will be able to distinguish roseola from other dangerous diseases and give the right recommendations for a quick cure.

Roseola infancy is treated at the Osnova Deti clinic in St. Petersburg. It is believed that the disease is incurable, but you can significantly alleviate the condition of the child. Antipyretic drugs, antiviral agents, interferon-based drugs to increase immunity, and vitamins are prescribed. With roseola, a child sometimes has seizures. In such cases, you need to quickly call an ambulance.

The doctor will give advice to parents on how to improve the child’s immunity (nutrition, comfort, outdoor walks) and control the effectiveness of the prescribed treatment. It is recommended to ventilate the room more often, avoid bodily contact during illness, do not use the same dishes and hygiene products. Adults most often tolerate roseola easily, without fever, rash and complications.
Make an appointment with us and come to the specialists of the clinic “Osnova Children” without queues. We receive not only pediatricians, infectious disease specialists, pediatric neurologists, but we also have our own laboratory and diagnostic center.

symptoms and treatment (reminder for parents)

09/01/2018

Enteroviral infections – is a group of diseases caused by several types of viruses. The disease is caused by Coxsackieviruses, polioviruses and ECHO (ECHO).

After an enterovirus infection, persistent lifelong immunity is formed, however, it is serospecific. This means that immunity is formed only to the serological type of virus that the child has had and does not protect him from other varieties of these viruses. Therefore, a child can get sick with an enterovirus infection several times in his life. Also, this feature does not allow the development of a vaccine to protect our children from this disease. The disease has a seasonality: outbreaks of the disease are most often observed in the summer-autumn period.

Causes of infection with enterovirus infection.

Infection occurs in several ways. Viruses can enter the environment from a sick child or from a child who is a carrier of the virus. Virus carriers do not have any manifestations of the disease, but the viruses are in the intestines and are excreted into the environment with feces. This condition can be observed in children who have been ill after a clinical recovery, or in children in whom the virus has entered the body, but could not cause the disease due to the strong immunity of the child. The virus carrier can persist for 5 months.

Once in the environment, viruses can persist for quite a long time, as they tolerate adverse effects well. Viruses are well preserved in water and soil; when frozen, they can survive for several years; heated to 45ºС die in 45-60 seconds).

How enterovirus infection is transmitted.

The transmission mechanism can be airborne (when sneezing and coughing with droplets of saliva from a sick child to a healthy one) and fecal-oral if personal hygiene is not observed. Most often, infection occurs through water, when drinking raw (not boiled) water. It is also possible to infect children through toys if children take them in their mouths. Most often, children aged 3 to 10 years are ill. In children who are breastfed, there is immunity in the body received from the mother through breast milk, however, this immunity is not stable and quickly disappears after the cessation of breastfeeding.

Symptoms of enterovirus infection.

Viruses enter the body through the mouth or upper respiratory tract. Once in the child’s body, the viruses migrate to the lymph nodes, where they settle and begin to multiply. The further development of the disease is associated with many factors, such as virulence (the ability of the virus to resist the protective properties of the body), tropism (the tendency to infect individual tissues and organs) of the virus, and the state of the child’s immunity.

Enteroviral infections have both similar manifestations and different ones, depending on the species and serotype. The incubation period (the period from the virus entering the child’s body until the first clinical signs appear) is the same for all enterovirus infections – from 1 to 10 days (usually 2-5 days).

The disease begins acutely – with an increase in body temperature to 38-39º C. The temperature most often lasts 3-5 days, after which it drops to normal numbers. Very often, the temperature has a wave-like course: the temperature stays for 2-3 days, after which it decreases and stays at normal levels for 2-3 days, then rises again for 1-2 days and finally returns to normal. When the temperature rises, the child feels weakness, drowsiness, headache, nausea, and vomiting may occur. With a decrease in body temperature, all these symptoms disappear, but with a repeated increase, they may return. The cervical and submandibular lymph nodes also increase, as viruses multiply in them.

Depending on which organs are most affected, there are several forms of enterovirus infection. Enteroviruses can affect: the central and peripheral nervous systems, oropharyngeal mucosa, eye mucosa, skin, muscles, heart, intestinal mucosa, liver; in boys, testicular damage is possible.

When the mucous membrane of the oropharynx is affected, enterovirus angina develops. It is manifested by an increase in body temperature, general intoxication (weakness, headache, drowsiness) and the presence of a vesicular rash in the form of bubbles filled with liquid on the mucous membrane of the oropharynx and tonsils. These bubbles burst, in their place ulcers are formed, filled with white bloom. After recovery, no traces remain at the site of the sores.

When the eyes are affected, conjunctivitis develops. It can be one- or two-sided. It manifests itself in the form of photophobia, lacrimation, redness and swelling of the eyes. There may be hemorrhages in the conjunctiva of the eye.

With muscle damage, myositis develops – muscle pain. Pain appears on the background of an increase in temperature. Soreness is observed in the chest, arms and legs. The appearance of pain in the muscles, as well as temperature, can be undulating. When the body temperature decreases, the pain decreases or disappears completely.

With damage to the intestinal mucosa (enteritis), there is a liquid stool. Stools of normal color (yellow or brown), liquid, without pathological (mucus, blood) impurities. The appearance of loose stools can be both against the background of an increase in temperature, and isolated (without an increase in body temperature).

Enteroviral infections can affect various parts of the heart. So, with damage to the muscle layer, myocarditis develops, with damage to the inner layer with capture of the heart valves, endocarditis develops, with damage to the outer shell of the heart, pericarditis develops. The child may experience: increased fatigue, weakness, palpitations, drop in blood pressure, rhythm disturbances (blockade, extrasystoles), pain behind the sternum.

With damage to the nervous system, encephalitis, meningitis can develop. The child has: severe headache, nausea, vomiting, fever, convulsions, paresis and paralysis, loss of consciousness.

With liver damage, acute hepatitis develops. It is characterized by an increase in the liver, a feeling of heaviness in the right hypochondrium, pain in this place. Perhaps the appearance of nausea, heartburn, weakness, fever.

When the skin is damaged, exanthema may appear – hyperemia (red coloration) of the skin, most often on the upper half of the body (head, chest, arms), does not rise above the level of the skin, appears simultaneously.

Boys may have inflammation in the testicles with the development of morchitis. Most often, this condition develops 2-3 weeks after the onset of the disease with other manifestations (tonsillitis, loose stools, and others). The disease passes quite quickly and does not bear any consequences, however, in rare cases, the development of aspermia (lack of sperm) in adulthood is possible.

There are also congenital forms of enterovirus infection, when viruses enter the child’s body through the placenta from the mother. Usually, this condition has a benign course and is cured on its own, however, in some cases, an enterovirus infection can cause an abortion (miscarriage) and the development of a sudden death syndrome in a child (the death of a child occurs against the background of complete health).

Very rarely, damage to the kidneys, pancreas, lungs is possible. The defeat of various organs and systems can be observed both isolated and combined.

Treatment of enterovirus infection

There is no specific treatment for enterovirus infection. Treatment is carried out at home, hospitalization is indicated in the presence of damage to the nervous system, heart, high temperature, which cannot be reduced for a long time when using antipyretics. The child is shown bed rest for the entire period of fever.

Meals should be light, rich in proteins. A sufficient amount of liquid is needed: boiled water, mineral water without gases, compotes, juices, fruit drinks.

Treatment is carried out symptomatically, depending on the manifestations of the infection – tonsillitis, conjunctivitis, myositis, loose stools, heart damage, encephalitis, meningitis, hepatitis, exanthema, orchitis. In some cases (tonsillitis, diarrhea, conjunctivitis …) bacterial complications are prevented.

Children are isolated for the entire period of the disease. In the children’s team may be after the disappearance of all symptoms of the disease.

Prevention of enterovirus infection.

For prevention, it is necessary to observe the rules of personal hygiene: wash hands after going to the toilet, walking on the street, drinking only boiled water or water from a factory bottle, it is unacceptable to use water from an open source (river, lake) to drink a child.