If a kid develops a red rash that looks like a “slapped cheek” this cold and flu season, a virus called fifth disease may be to blame.
Parents alarmed by the symptoms may not have heard of the illness, but pediatricians see it quite often as respiratory viruses rage during the fall, winter and spring. An outbreak was already reported this month at a school in Allegheny County, Pennsylvania.
The unusual name of the disease came from the fact that it was fifth on a list of common skin rash illnesses in children, the Centers for Disease Control and Prevention said.
What should families know about it and why should pregnant women be concerned? TODAY asked the experts.
What is fifth disease?
It’s a mild, but contagious illness caused by parvovirus B19. Kids can get it at any time of year, but it’s most prevalent during the cold and flu season in the winter up until the early spring.
“This is just one of many, many respiratory viruses that can cause infections in children," Dr. Athena Kourtis, a pediatrician specializing in infectious diseases at the CDC and a member of the American Academy of Pediatrics Committee on Infectious Diseases, said. "What differentiates it a little bit from many other viruses is that the clinical course includes a rash.”
Fifth disease is transmitted through bodily fluids like saliva or a runny nose, or when an infected person coughs or sneezes.
Why is it more common in children?
This is true for many viruses because kids’ immune systems take time to fully develop, so they’ll have many more colds in a year than adults, Kourtis said.
Fifth disease is most common in children 5 to 15 years old, according to Dr. Emily Goodwin, a pediatrician at Children’s Mercy Kansas City Hospital and a clinical assistant professor of pediatrics at the University of Missouri Kansas City School of Medicine.
But grown-ups can get fifth disease, too. It’s estimated about half of adults are immune to it — meaning they had the infection as kids — and half are not, Kourtis noted.
What are the symptoms?
Parents may not always be aware that the facial redness is part of an illness.
“It’s tough because during cold and flu season we also get kids getting rosy cheeks just being outside in the dry air,” Goodwin said. “But it’s very characteristic, this red rash.”
The second rash with a lace-like look is most commonly found on the arms, legs and trunk.
Ironically, kids are no longer contagious by the time they develop the rash, both experts said.
“Their cheeks are quite rosy, but they’re playful and looking good,” Goodwin noted. “If I see a kid with a rash but they’re looking quite ill, then I might start thinking of other things besides this virus.”
Adults who have fifth disease can also experience pain and swelling in their joints.
What are the complications?
Fifth disease is nothing to worry about in healthy children and adults, Kourtis said.
But if a pregnant woman who isn’t immune to it becomes infected, there’s a small risk of damage to the fetus, especially during the first 20 weeks of pregnancy, she added.
“The baby could get a very serious anemia that can lead to swelling of the fetus, heart failure and in some cases, even death of the fetus," Kourtis warned. "The risk is small, but real.”
A simple blood test can reveal whether a person is immune to fifth disease or not. People with weakened immune systems can also experience serious complications.
What is the treatment?
The illness will usually go away on its own. There’s no specific treatment other than supportive care for the fever and symptoms.
Parents should call a doctor if a child isn’t feeling well, doesn’t look right, has a high fever that lasts four days or longer or the rash seems widespread.
“Rashes can be really tricky,” Goodwin noted.
Is it possible to prevent fifth disease?
There’s no vaccine, so the best prevention is good hygiene, both experts said.
- Washing hands with soap and water is the best prevention.
- For pregnant women, avoid close contact with someone who is sick.
- Those who work in healthcare, a daycare or a school, where they could be exposed to sick children, should be especially vigilant.
- Cover the nose and mouth when coughing or sneezing.
- Don’t send kids to school when they’re sick.