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The Signs and Symptoms of Fifth Disease

The tag line of one of my current favourite podcasts, “This Week in Virology” is “the show about viruses – the kind that make you sick.”  The audience for this podcast has skyrocketed due to COVID-19.  The professors who present in this series remind us of the many “other” viruses among us that have always been a part of our lives.  

Fifth disease is a common viral illness, caused by parvovirus 19, which received its most unimaginative name because it was the fifth in a list of rash-causing childhood viral illnesses.  

Signs and Symptoms of Fifth Disease

The illness appears 14 days after exposure to an infected individual (incubation period). In children and healthy adults, there may be a flu-like illness with cold symptoms and a fever.  Adults may get polyarthropathy or pain in a number of joints.  People with a weakened immune system may also get a more prolonged and severe illness. 

The hallmark rash of fifth disease is called the “slapped cheek “ rash, or very red cheeks.  I prefer the less violent “kissed cheek rash by an aunt with red lipstick”.  There may also be a red spotty rash on the torso.  As with many viral illnesses, it is simply a rite of passage for children without any dire consequences.

When Should I Be Worried About Fifth Disease?

The real worry about the fifth disease is its impact on women in their first trimester of pregnancy.  Exposure at this time can have consequences for the baby with some birth defects and an increased risk of miscarriage.  If you are a health care worker or work with young children as a teacher or early childhood educator, your primary care practitioner may check to make sure that you have immunity to parvovirus 19 by ordering a blood test in early pregnancy.  There is no vaccine for fifth disease.

Prevention is still the key and the precautions are similar to those for COVID-19.  Avoid touching your face, nose, and mouth, wash hands frequently, and stay home if you are ill.

Our newfound respect for viral illnesses will, hopefully, help us to stay safe in the future.

Dr. Bhooma Bhayana is a family physician in London and the mother of two young men and grandmother of one lovely princess! She continues to find wonder and enjoyment in family practice despite more than 30 years on the job!


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