Erythema Infectiosum or the fifth disease is a common childhood condition caused by the human parvovirus of the family erythrovirus. The trademark of this condition is bright red cheeks. It is sometimes called slapped cheek syndrome, slapped cheek or slapped face.
This condition primarily affects children ages 3 to 15 but can also be seen from other age groups. Infection usually happens during late winter or early spring. Erythema Infectiosum is a self limiting disease that resolves without complications. The term fifth disease was given because of its numerical position in the childhood illnesses associated with rashes (exanthems). Fifth disease is number five of the six diseases with this similar symptom.
Erythema Infectiosum is transmitted by respiratory secretions but can also be spread by infected blood. The period between the exposure from the virus and the first manifestation of symptoms is usually between 4 to 21 days.
The illness usually begins with low grade fever and body weakness. After a week of experiencing these symptoms, they are followed by the defining symptom of the fifth disease which is bright red cheeks. This rash can occasionally extend over the bridge of the nose or around the mouth. Aside from the red cheeks, a patient may manifest red lacy rashes on any part of the body usually with the upper arms and legs as the most common locations. This lace-like rash usually appears after three to four days after the red cheek rash.
The rash, which also may be itchy, usually lasts for a couple of days but it can extend for weeks. When rashes appear, the patient is not contagious anymore. Although patients may not transmit the disease at this time, this fifth disease, like any other viral disease, can be unpredictable when it comes to features and timing of the stages of illness.
- Impact on Grownups -
The illness is not serious in children but it can cause joint pain in adults. This condition is temporary lasting days to weeks and is more common on adult women than men. However, some cases may become a long term problem that can last for months.
People with arthritis caused by this disease usually experience morning stiffness, and swelling of joints on both sides of the body. This symptom is not mainly caused by the circulating virus but is caused by the deposition of immune complexes in the skin and joints.
Erythrocyte Aplasia is a rare complication of this disease. This is a condition characterized by low red blood cell count because the bone marrow stops producing these cells. Although this condition is rare and transient, it is proven to be fatal. Patients who are immunocompromised are at high risk to develop this complication.
Pregnant women should avoid contact with infected persons because this can cause miscarriage and death of fetus.
Treatment for Erythema Infectiosum is only the supportive. Providing rest, comfort, fluids and acetaminophen is essential. Anti inflammatory medications such as ibuprofen and naproxen are given for joint swelling.