Erythema Infectiosum

What is it?

Erythema (air-uh-THEE-muh) infectiosum (in-fek-tee-O-sum) is also called fifth disease. It is a mild infection (in-FEK-shun) that is most common in school-aged children. Fifth disease usually happens during winter and early spring. Your child may first have cold-like symptoms. Then a red face rash and lace-like body rash may appear and last up to 10 days. There is no vaccine or medicine to prevent fifth disease.

What causes fifth disease?

Fifth disease is caused by a virus (germ) called parvovirus B19. It is spread by breathing, drinking, or eating after a sick person. It can also be spread from having a blood transfusion (trans-FEW-shun). A blood transfusion is a procedure in which blood is given to your child through an IV (small tube placed in your child's blood vessel).

What are the signs and symptoms?

Children may become sick up to 3 weeks after being exposed to (in contact with) fifth disease. While most children have some symptoms of fifth disease, some children have no symptoms at all. Fifth disease usually happens in stages.

• At first, you may think your child has a cold. Your child may have 1 or more of the following:
  
  
  • Body aches or headache.
    
    
  • Chills and low fever.
    
    
  • Tired.
    
    
  • Stuffy or runny nose and sore throat.
    
    
  • Nausea or diarrhea.
  
  
• Next, you may see a rash.
  
  
  • Face rash: A face rash may appear about 1 week after your child's cold symptoms started. Your child's face may look like your child has been "slapped" on each cheek. The rash is often bright red and warm.
    
    
  • Body rash: After the face rash appears, your child may get a body rash. It is usually red and lace-like and may first appear on your child's arms. Then it may spread to the trunk (chest, back, and belly), legs, and buttocks (rear-end). The rash may itch. It may also get brighter and itch after your child exercises, goes out in the sun, or takes a warm bath. Your child's rash should be gone in about 10 days.
    
    
  • Rash after the fifth disease is gone: It is common for the rash to come and go for a while after your child's fifth disease is over. It may reappear (come back for a short time) when your child is hot or cold. The rash may also reappear when something rubs or pushes against your child's skin.

Fifth disease may cause joint pain and swelling. A joint is the place where 2 bones meet, such as the elbow or knee. Joint pain and swelling happens most often in older children and adults. It may last from 1 week to several months. Adults with fifth disease often have joint problems, but no rash.

How is fifth disease diagnosed and treated?

Your child's doctor can usually look at your child's rash and know he has fifth disease. There is no treatment for fifth disease, except to make your child as comfortable as possible.

How can I help my child feel better while he has fifth disease?

• Give your child acetaminophen (uh-c-tuh-MIN-o-fin) or ibuprofen (i-bew-PRO-fin) to treat fever or joint pain. Do not give your child aspirin. Giving aspirin to your child when he is ill may cause a very serious illness called Reye's syndrome.
  
  
• Help your child rest if he does not feel well. Encourage him to take a nap. Give him books, games, or markers and a drawing pad for quiet activities. Let him watch a movie or TV.
  
  
• If your child's rash itches, ask your child's caregiver about ways to stop the itching.

When is my child contagious (cun-TAY-jus)?

• Your child may be contagious (can spread fifth disease to others) during the week before his rash appears. This is usually while your child is having cold-like symptoms. When your child's rash appears, he should not be contagious anymore.
  
  
• By the time you know your child has fifth disease, it is usually too late to protect others. The best way to try preventing infection is to wash your and your children's hands often. Wash your hands before preparing food for meals and before eating and drinking. Do not share cups, plates, food, or eating utensils.

When can my child go back to daycare or school?

Tell your child's daycare or school that your child has fifth disease. They may need to tell other parents that their children have been exposed. Some schools do not require your child to stay home from school once he has a rash. Do not send your child to daycare or school if he has a fever or does not feel well.

Can fifth disease cause health problems for some people?

• If a child has blood problems such as sickle cell anemia, fifth disease can make him very sick. It can also make a child with cancer or low immunity (catches infections easily) very sick. If your child has one of these problems and catches or is exposed to fifth disease, tell your child's caregiver.
  
  
• Pregnant women may choose to stay away from places where fifth disease is spreading. Rarely, fifth disease may cause a miscarriage (lose the baby) or other problems in unborn babies. If you are pregnant and working around children, wash your hands often. Tell your caregiver if you think you have been exposed to fifth disease. Your caregiver can do a special blood test to learn if you have ever had fifth disease. If you had fifth disease as a child, your unborn baby is safe from infection.

Can my child catch fifth disease again?

No. Once your child is infected with fifth disease, he will not get it again.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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