Fifth Disease

Fifth Disease sounds like it's a disease that someone made up because of the unusual name, and when you hear that it's caused by parvovirus, that even seems more weird because dog owners associated Parvo with a bad illness in their canine pets.  In humans, for the most part, it's actually rather underwhelming.

The most prominent aspect of Fifth Disease is the rash.  It often starts off with extremely red cheeks, red enough that it has the appearance of "slapped cheeks."  When parents see this, because usually the child is acting pretty normally, they usually attribute it to a little too much time in sun, or getting somewhat chapped by the wind (whatever weather phenomenon we're currently experiencing in San Antonio).  However, the rash then moves to the arms and legs, usually initially affecting the upper arms and upper legs in a red mottled appearance that looks like someone held a lace doily to the child and sprayed bright pink or red pain through the doily onto the skin.  The redness is not usually raised but might be slightly raised, and is not scaly.  It usually doesn't bother the patient at all despite how alarmingly red it looks.  The rash spreads with the same pattern to the torso, before eventually disappearing in about 1-2 wks.

One would normally expect that with such a prominently red rash that the affected child is very contagious, but actually, by the time the rash is there, the child no longer is contagious.  S/he was actually contagious during the few days before the rash appeared when there possibly were no symptoms at all, or possibly just mild low grade fever, maybe mild fussiness, mild upper respiratory symptoms ... all symptoms that seem like just regular colds or teething.  The only people who are at risk of developing complications from Fifth Disease are people with bone marrow disease or unborn babies so if you realize that your child came into contact with someone with those medical conditions, you definitely want to notify those contacts to seek medical attention from their doctros.  For everyone else, really it's just the rash, and once you get Fifth Disease, you are immune from getting it again.

A key thing to note about the character of the rash is that it will get significantly more red and flared-up looking anytime the child's body temperature is up; this could be with running around playing, after a bath, after sleep, etc.  This does NOT mean that anything is worsening, but it just follows the pattern of all red rashes becoming more red with elevated body temperature.  The rash is also not responsive to benadryl or hydrocortisone, because it's an external manifestation of the original internal viral infection.  Since for the most part it doesn't bother the patient, there is no need to treat it with anything, and it will go away on its own.  If it is slightly itchy, regular lotion or cool compresses should help.

Even though we get epidemics of Fifth Disease here and there, and even though the rash is quite distinctive and quite prominent, for the most part, you can breathe out a sigh of relief because usually, there is nothing to worry about!