From the Research
Fifth disease, also known as erythema infectiosum, is a common childhood viral infection caused by parvovirus B19 that typically presents with a distinctive "slapped cheek" rash and is usually mild and self-limiting, requiring only symptomatic treatment. The illness usually resolves within 1-3 weeks without complications, and patients are most contagious before the rash appears, with the risk of transmission decreasing once the rash develops 1. While usually mild in children, the infection can cause complications in pregnant women, people with certain blood disorders, or those with weakened immune systems, and these individuals should contact their healthcare provider if exposed 2. The virus works by infecting red blood cell precursors in the bone marrow, temporarily reducing red blood cell production, which is usually insignificant in healthy individuals but can be problematic for those with underlying conditions 3. Some key points to consider in the management of fifth disease include:
- The rate of vertical transmission during maternal parvovirus B19 infection is estimated at 33%, with fetal complications occurring in 3% of infected women 2
- Fetal complications comprising hemolysis, anemia, and nonimmune hydrops fetalis and fetal loss are more frequent when maternal infection occurs before 20 weeks of gestation 2
- Pregnant women exposed to parvovirus B19 should undergo immunoglobulin (Ig) M and IgG titres testing to evaluate if they have had previous immunity against the disease 2
- If results are negative for IgG but positive for IgM, close obstetrical monitoring is necessary, including serial ultrasounds to rule out fetal anemia and hydrops fetalis 2. In terms of treatment, symptomatic treatment with acetaminophen or ibuprofen for fever and discomfort, as well as rest and adequate fluid intake, is usually sufficient 4. However, some patients may require more intensive treatment, such as transfusions or intravenous immune globulin therapy, depending on the severity of their symptoms and underlying health conditions 3. Overall, while fifth disease is usually a mild and self-limiting illness, it is essential to be aware of the potential complications and to take steps to prevent transmission, particularly in high-risk individuals.