slapped cheek syndrome/fifth disease
Overview
Slapped cheek syndrome or Fifth disease is a mild rash illness caused by parvovirus B19.It is also known as erythema infectiosum.
It mainly affects children between the ages of 3-10 years. Most cases of parvovirus B19 infection are asymptomatic.
Signs and symptoms
The first symptoms are usually mild and nonspecific and include fever, runny nose and headache. After several days a rash on the face called ‘slapped cheek’ rash can occur. It is more common in children than adults. Some people may get a second rash a few days later, on their chest, back, buttocks or arms and legs. The rash may be itchy especially on the soles. The rash usually disappears in 7 to 10 days but it can last several weeks.
Parvovirus B19 infection can also cause painful or swollen joints. This is more common in adults. It can also cause the body to temporarily stop making new red blood cells. This can lead to a number of complications including: transient aplastic crisis, hydrops fetalis, congenital anemia, pure red cell aplasia, or persistent anemia.
In parts of the world with temperate climates, people tend to get infected with parvovirus B19 more often in late winter, spring, and early summer. Local outbreaks of parvovirus B19 infection occur about every 3 to 4 years.
Incubation
The incubation period (the time between infection and the onset of symptoms) is usually within 4 to 14 days (sometimes up to 20 days).
Transmission
Parvovirus is an airborne virus that is spread in much the same way as the cold or flu viruses. It can be spread through coughs and sneezes that release tiny droplets of contaminated saliva which are then breathed in by another person. It's very difficult to prevent the spread of the virus as people are most contagious before their symptoms begin, so they are unaware that they are infected.
A person with this infection is most contagious before the rash appears.
Parvovirus B19 can spread through blood or blood products.
Prevention
Risk of infection can be reduced by:
- Hand washing with soap and water
- Covering mouth and nose when coughing or sneezing
- Avoiding close contact with people who are sick
- Staying at home when ill
No vaccine or specific treatment exists.
Diagnosis
Doctors can usually diagnose this infection by seeing ‘slapped cheek’ rash
Treatment
Treatment usually involves relieving symptoms such as fever, itching and joint pain and swelling.
People who develop any complications need to be seen by a doctor.
No vaccine exists.
Complications
It is usually mild for children and adults who are otherwise healthy. Once a person is infected with B19 one develops immunity and this protects from further infection in the future.
People with weakened immune systems caused by leukemia, cancer, organ transplants or HIV infection are at risk from serious complications. It can cause chronic anaemia that requires medical treatment.
Pregnancy
Pregnant women who are not immune usually do not have serious complications after they are exposed to others with this infection. They usually have only mild illness. However, Parvovirus B19 infection during pregnancy may cause problems for the fetus. Some fetuses may develop anemia if the mother is infected while pregnant.
Pregnant women should contact their gynaecologists if they:
- have been exposed to someone with this infection
- have an illness that might be caused by parvovirus B19 infection, or
- were recently infected with parvovirus B19.