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Fifth Disease (Erythema Infectiosum)

Fifth Disease (Erythema Infectiosum)

Fifth Disease (Erythema Infectiosum) is a common infection in children, and one among the five skin-related diseases that infect children.
Nilesh Parekh
Last Updated: Apr 9, 2018
Erythema Infectiosum, also known as Fifth Disease, is caused by the human Parvovirus - B19 (PV-B19), which is an erythrovirus. This disease is common in children between the ages 4 to 16. The distinctive nature of this syndrome shows up in the form of red rashes on the patient's cheeks, and appears as if the patient has been slapped or hit on the face. This disease spreads across the other parts of the body, like legs, trunk, arms, etc. The infection in children is very self-limiting, and the patient starts recovering after some time without development of more complications.
This disease is referred as Fifth Disease, as it is the fifth number disease recognized in a group of diseases, which causes rashes in children.
Susceptibility
The ratio of males and females getting infected with this disease is almost same. It is prevalent in children, but it does not cause much harm to them, as the patient recovers in a very short period without developing more complications.
This disease in adults (especially those who have damaged immune system and pregnant women) may get much more complicated than in children, and the result may vary depending on the extent of complications.
(Please Note: This disease causing the virus Parvovirus is different than the Parvovirus found in animals, and it does not convert/transform to the human form of virus and vice versa.)
Causes
The patient is considered infectious during the incubation period of this disease, which involves its initiation and development, after which the symptoms starts showing up till the time when the disease matures in the patient. This disease is considered to be transmitted mainly through the body fluids from the infected patient. The body fluid is also considered to be transmitted when the patient coughs or sneezes, and an un-infected person comes in vicinity enough for him/her to get infected.
It is also transmitted through blood transfusion or through blood products. It also spreads from an infected mother to her fetus.
Symptoms
  • The patient may experience headache, mild fever, pharyngitis, malaise, etc., in the initial phase.
  • Some patients may also experience problems, such as diarrhea, nausea, pain in the abdominal area, arthralgias, etc.
  • In the first stage of the disease, the skin of the patient begins to appear reddish (cheeks, arms, legs, etc.), and gives an impression of being slapped. The erythematic marks appear abruptly on the skin, and they start fading in about 4 to 5 days.
  • In the next stage, an erythematous eruption starts occurring on the patient's skin, targeting the exterior surfaces (this stage lasts for about 4 to 6 days). This pattern slowly converts into a reticulated pattern of patches/blotches on the skin of the patient, which may last from 3 to about 22 days.
  • As compared to children, if an adult is exposed to the virus Parvovirus-B19, the disease shows different characteristics and slightly different symptoms. The most common symptom experienced by an adult suffering from this disease involves symmetric joint pain, which increases over a period.
  • Patients may also experience reddening of eyes, swelling of glands, problems related to throat such as sore throat and joint pain, etc.
Complications Involved
The disease in adults may get more complicated over a period as compared to children. People with a weakened immune system and with a background of shortened life span of red blood cells are prone to conditions, such as prolonged viremia leading to damaged bone marrow cells and other complications. PV-B19 virus may also trigger or cause diseases, like papular-purpuric gloves and socks syndrome, systemic sclerosis, acute vasculitic syndromes, rheumatoid arthritis, hemocytophagia, systemic lupus erythematosus, myocarditis, hepatitis, idiopathic thrombocytopenic purpura, anemia, pulmonary diseases, erythematos exanthema (atypical), ileitis, neurological problems, nephrotic syndrome, thalassemia, sickle cell anemia, Pyruvate Kinase deficiency, etc.
Infection in pregnant women may lead to a direct, cyto-toxic effect on the fetal red blood cells, and other problems such as congestive heart failure, anemia, hydrops fetalis, miscarriage, etc. Anemia and other complications may also be passed to the fetus.
Diagnosis
The reddish rashes on patient's body and skin can help doctors in diagnosing the disease. Other than the physical examination of the patient, the doctor also may opt for a few tests such as blood test, IgM assays, which involve immunoassyas and radioimmunoassay, Loop-Mediated Isothermal Amplification test, Dot-Blot Hybridization, Polymerase Chain-Reaction, etc.
Treatment
Treatment varies, based on various parameters such as the age group to which the patient belongs, patient's immune system, etc. Doctors may also prescribe medicines or lotions, based on the stage of the disease.
Prevention
As the initial symptoms take some time to show up, and this period falls under the period in which this disease can spread from the infected person to a healthy person (also known as the period between infection and incubation), it is very hard to baseline the preventive measures against this disease. However, children should be advised to maintain hygiene, and not use each other's used tissues or handkerchiefs. They should also be careful while interacting with sick children.
Disclaimer: This HealthHearty article is for informative purposes only, and should not be used as a replacement for expert medical advice.