What are the symptoms of fifth disease?
A parvovirus B19 infection often starts with flu-like symptoms, which are usually mild. During this time, the virus is most contagious. These symptoms include:
About 20% of children who have a parvovirus B19 infection don’t have these symptoms. Still, they can pass the virus to others.
It can take several days after the onset of flu-like symptoms for the raised, bright red rash (fifth disease) to show up on your child’s face. The rash may be itchy. Children typically no longer have flu-like symptoms once the rash appears.
In some cases, you may see a second rash that develops after the cheek rash. It usually looks “lacey” and may appear on your child’s:
- Arms.
- Legs.
- Trunk (chest and back).
- Buttocks.
About 10% of children with fifth disease also experience joint pain and swelling.
Fifth disease symptoms in adults
Adults who are infected with parvovirus B19 often develop flu-like symptoms without the rash. Along with those symptoms, about 80% of adults also develop joint pain in their wrists, hands and knees.
What causes fifth disease?
Human parvovirus, also called parvovirus B19, causes fifth disease. This is different from the parvovirus that affects dogs and cats. Fifth disease (a red rash) typically appears four to 14 days after your child is infected with parvovirus B19.
Is fifth disease contagious?
Parvovirus B19 is very contagious. It mainly spreads through respiratory droplets in your mouth and nose. If an infected person talks, coughs or sneezes near your child, your child could become infected with the virus.
Parvovirus B19 can also spread through blood exposure from a pregnant person to a fetus, but this is rare.
However, fifth disease — the red rash caused by parvovirus B19 — isn’t contagious. In fact, once a person infected with parvovirus B19 gets the red rash, they’re no longer contagious (they can’t spread parvovirus B19 to other people).
What are the complications of fifth disease?
In healthy children and adults, fifth disease very rarely causes complications.
But the condition can cause problems for people who have a blood disorder or weakened immune system. This is because the virus can affect the way your body makes red blood cells. It can cause your child’s red blood cell count to drop so low that they need a blood transfusion.
Children (and adults) with the following conditions are at increased risk of complications:
If your child has any of these conditions, contact their healthcare provider as soon as the fifth disease rash appears or if they’re having flu-like symptoms, which usually come before the rash.
Fifth disease complications in adults
About 10% of adults who get a parvovirus B19 infection develop chronic (long-term) parvovirus-associated arthritis in several joints, or polyarthritis. People assigned female at birth (AFAB) are more at risk for this complication than people assigned male at birth (AMAB).
Fifth disease and pregnancy
If you’re pregnant and develop fifth disease (parvovirus B19 infection), it can spread to the fetus and cause complications, including:
- Miscarriage.
- Stillbirth (intrauterine fetal demise).
- Hydrops fetalis (when large amounts of fluid build up in a fetus’s tissues and organs).
These complications are rare, however. Most adults and pregnant people have already been infected with parvovirus B19, so they’re protected. The risk of fetal loss when you get a parvovirus B19 infection while pregnant is approximately 2%. Pregnant people in their second trimester are at the greatest risk of developing complications from parvovirus B19, but complications can happen at all points of pregnancy.
If you’re pregnant and have been exposed to someone with fifth disease, contact your healthcare provider.
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