Erythema infectiosum, often referred to as fifth disease, is caused by human parvovirus B19 and occurs most often during the spring months, often in geographically limited outbreaks among children, particularly school age children. Infection is spread mainly by breathing in small droplets that have been breathed out by an infected person, so infection tends to spread within a household. The infection can also be transmitted from mother to fetus during pregnancy, rarely resulting in stillbirth Stillbirth Stillbirth is death of a fetus after 20 weeks of pregnancy. Pregnancy complications are problems that occur only during pregnancy. They may affect the woman, the fetus, or both and may occur... read more or severe anemia and excess fluid and swelling (edema) in the fetus (hydrops fetalis).
Erythema infectiosum symptoms begin about 4 to 14 days after infection. Many children have no symptoms. However, some children have a low fever and feel mildly ill with a headache and a runny nose for a few days. Several days later, children develop red cheeks that often look like they have been slapped as well as a rash, especially on the arms, legs, and trunk but not usually on the palms or soles. The rash can be itchy and consists of raised, blotchy red areas and lacy patterns, particularly on areas of the arms not covered by clothing, because the rash may be worsened by exposure to sunlight.
The rash and the entire illness usually last 5 to 10 days. Over the next several weeks, the rash may temporarily reappear in response to sunlight, exercise, heat, fever, or emotional stress. In adolescents, mild joint pain and swelling may remain or come and go for weeks to months.
Erythema infectiosum can also manifest in a different way, particularly in children with sickle cell disease Sickle Cell Disease Sickle cell disease is an inherited genetic abnormality of hemoglobin (the oxygen-carrying protein found in red blood cells) characterized by sickle (crescent)-shaped red blood cells and chronic... read more or other disorders of the red blood cells or in children with diseases that impair the immune system's ability to fight infection (such as acquired immunodeficiency syndrome [AIDS]—see Human Immunodeficiency Virus (HIV) Infection in Children Human Immunodeficiency Virus (HIV) Infection in Children Human immunodeficiency virus (HIV) infection is a viral infection that progressively destroys certain white blood cells and causes acquired immunodeficiency syndrome (AIDS). Human immunodeficiency... read more ). In these children, parvovirus B19 can affect the bone marrow and cause severe anemia Overview of Anemia Anemia is a condition in which the number of red blood cells is low. Red blood cells contain hemoglobin, a protein that enables them to carry oxygen from the lungs and deliver it to all parts... read more (low blood count).