INTRODUCTION:

The name "fifth disease" comes from its place on the standard list of rash-causing childhood diseases, which also includes measles (first), scarlet fever (second), rubella (third), Dukes' disease (fourth, but is no longer widely accepted as distinct), and roseola (sixth). Fifth disease is viral illness that most kids recover from quickly and without complications. Also called erythema infectiosum, it's caused by parvovirus B19.

Epidemiology:

· Any age may be affected, although it is most common in children aged 5 to 15 years. Fifth disease causes a distinctive red rash on the face that makes a child appear to have a "slapped cheek."

· A few days later, the rash spreads down to the trunk, arms, and legs. It usually lasts 1 to 3 weeks. In older kids and adults, fifth disease can cause joint swelling and pain that can last from weeks to months and, very rarely, years.

· By the time adulthood is reached, about half the population will have become immune following infection at some time in their past.

· Outbreaks can arise especially in nursery schools, preschools, and elementary schools. Infection is an occupational risk for school and day-care personnel.

· No vaccine is available for human parvovirus B19, though attempts have been made to develop one.

History:

It was first described by Robert Willan in 1799 as "rubeola, sine catarrho". It was better defined by Anton Tschamer in 1889 as a rubella variant (Ortliche Rotheln), identified as a distinct condition in 1896 by Theodor Escherich, and given the name "erythema infectiosum" in 1899. The virus was first described in 1957 at the University of Pennsylvania by Werner, Brachman et al.

Signs and symptoms:

· Fifth disease starts with a low-grade fever, headache, rash, and cold-like symptoms, such as a runny or stuffy nose. These symptoms pass, then a few days later, the rash appears.

· The bright red rash most commonly appears in the face, particularly the cheeks. This is a defining symptom of the infection in children (hence the name "slapped cheek disease").

· Occasionally, the rash will extend over the bridge of the nose or around the mouth. In addition to red cheeks, children often develop a red, lacy rash on the rest of the body, with the upper arms, torso, and legs being the most common locations.

· The rash typically lasts a few days and may itch; some cases have been known to last for several weeks. Patients are usually no longer infectious once the rash has appeared.

· Teenagers and adults may present with a self-limited arthritis. It manifests in painful swelling of the joints that feels similar to arthritis.

· Older children and adults with fifth disease may have difficulty in walking and in bending joints such as wrists, knees, ankles, fingers, and shoulders.

· The disease is usually mild, but in certain risk groups, it can have serious consequences:In pregnant women, infection in the first trimester has been linked to hydrops fetalis, causing spontaneous miscarriage.

· In people with sickle-cell disease or other forms of chronic hemolytic anemia such as hereditary spherocytosis, infection can precipitate an aplastic crisis. Those who are immuno compromised (HIV/AIDS, chemotherapy) may be at risk for complications if exposed.

· Sometimes fifth disease also can cause swollen glands, red eyes, sore throat, diarrhea, and rarely, rashes that look like blisters or bruises.

· Joint swelling or pain (often in the hands, wrists, knees, or ankles) can sometimes happen, especially in adults and older teens.

Images related to Fifth diseases:

Fifth Disease Causes:

· Fifth disease is caused by human parvovirus B19.

· It often affects preschoolers or school-age children during the spring.

· The disease spreads through the fluids in the nose and mouth when someone coughs or sneezes.

· About 20 percent of people who get the virus don't have symptoms, but they can still pass the virus along to others.

Transmission:

· Fifth disease is transmitted primarily by respiratory secretions (saliva, mucus, etc.), but can also be spread by contact with infected blood.

· The incubation period (the time between the initial infection and the onset of symptoms) is usually between 4 and 21 days.

· Individuals with fifth disease are most infectious before the onset of symptoms. Typically, school children, day-care workers, teachers, and parents are most likely to be exposed to the virus.

· When symptoms are evident, the risk of transmission is small; therefore, symptomatic individuals do not need to be isolated.

Treatment:

· Fifth disease is caused by a virus, so can't be treated with antibiotics (antibiotics kill bacteria, not viruses). In most cases, this is a mild illness that clears up on its own, so no medicine is needed.

· Usually, kids with fifth disease feel OK and just need to rest.

· After the fever and mild cold symptoms are gone, there may be little to treat except any discomfort from the rash. If your child's rash is itchy, ask the doctor for advice about easing discomfort.

· The doctor may also recommend acetaminophen for a fever or joint pain.

· Do not give aspirin to your child, as it has been linked to a rare but serious illness called Reye syndrome. Antipyretics (i.e., fever reducers) are commonly used.

· The rash usually does not itch, but can be mildly painful. No specific therapy is recommended.

PREVENTION:

· There is no vaccine to prevent fifth disease, and no real way to prevent spreading the virus because a person usually isn't contagious by the time the rash appears.

· Washing hands well and often is always a good idea because it can help prevent the spread of many infections.

Diagnosis:

Doctors can usually diagnose fifth disease by seeing the distinctive rash on the face and body. If someone doesn't have the rash but does have other symptoms, the doctor may do blood tests to see if they're caused by fifth disease.

Complications:

· Fifth disease might cause some children with weakened immune systems (such as those with AIDS or cancer) or with certain blood disorders (like sickle cell disease or hemolytic anemia) to become ill.

· The virus that causes it (parvovirus B19) can temporarily slow down or stop the body's production of oxygen-carrying red blood cells (RBCs), this can lead to severe anemia, which needs to be treated in a hospital.

· Parvovirus B19 infection during a woman's pregnancy may cause problems for the fetus, especially during the first half of the pregnancy.

Fifth Disease Self Care:

· One of the best ways to take care of your health if you have bursitis or tendinitis is to take a proactive role in your own treatment – a process called self-management. Fifth disease is usually mild and will go away on its own.

· Children and adults who are otherwise healthy usually recover completely, having a healthy, balanced diet, drinking an adequate amount of fluids and getting rest will help you successfully manage this disease.

REFERENCES:

1. Sabella C, Goldfarb J (October 1999). "Parvovirus B19 infections". Am Fam Physician. 60 (5): 1455–60. PMID 10524489. Retrieved 2009-11-06.

2. Servey JT, Reamy BV, Hodge J (February 2007). "Clinical presentations of parvovirus B19 infection". Am Fam Physician. 75 (3): 373–6. PMID 17304869. Retrieved 2009-11-06.

3. Weir E (March 2005). "Parvovirus B19 infection: fifth disease and more". CMAJ. 172 (6): 743. doi:10.1503/cmaj.045293. PMC 552884 . PMID 15767606.

4. Mankuta D, Bar-Oz B, Koren G (March 1999). "Erythema infectiosum (fifth disease) and pregnancy". Can Fam Physician. 45: 603–5. PMC 2328398 . PMID 10099795.

5. Yoto, Y., et al., (2003). "Retrospective study on the influence of human parvovirus B19 infection among children with malignant diseases". Acta Haematol pg.8–12, PMID 8237278

6. Kwon, Kenneth T (March 19, 2009). "Pediatrics, Fifth Disease or Erythema Infectiosum". eMedicine. Retrieved November 7, 2009.

Received on 23.09.2018 Modified on 22.10.2018

Int. J. of Advances in Nur. Management. 2018; 6(4): 342-344.

DOI: 10.5958/2454-2652.2018.00079.3