Parvovirus Infection (Fifth Disease)

Overview

By Tina Shahian, PhD

Parvovirus infection, also known as fifth disease or slapped-cheek disease, is a common childhood illness caused by the human parvovirus B19 virus. It is a highly contagious infection that is spread from person to person, with peak transmission during the winter image of slapped cheek rash from parvovirusand spring months. It begins with typical cold symptoms followed by a signature rash on the face, hence the name slapped-cheek disease. Parvovirus infection is one of five most common rash-producing infections during childhood, which is the reason it is also referred to as fifth disease; infection in adults is less common.

Healthy individuals clear parvovirus without treatment. The most serious complication associated with parvovirus is anemia, which is characterized by a lower than normal red blood cell count. Infection in those with compromised immune systems (e.g. HIV, organ transplant and cancer patients) may lead to severe anemia and hospitalization. Pregnant women with parvovirus infection can trigger anemia in their unborn child, with the risk miscarriage or stillbirth.

Causes

Parvovirus infection is caused by the human parvovirus B19. It is transmitted in nasal/oral secretion droplets that are passed between humans through coughing and sneezing. An infected person is considered contagious when he or she shows cold-like symptoms; there is little risk of transmission once the signature rash appears several days later. Preschool- and school-aged children are most likely to contract the virus, especially during the winter and spring seasons. Pregnant women can pass on the virus to their baby via blood.

Symptoms

In children, parvovirus infection causes early cold-like symptoms, followed by a rash on the cheeks (like slapped cheeks), which may spread to the other parts of the body. The rash appears raised and may feel itchy. The most common symptom in adults is joint pain in the hands, wrists, knees and ankles. Symptoms include:

  • Early cold symptoms (runny nose, fever, headache)
  • Rash on cheeks, arms, legs, buttocks and core
  • Itchiness of skin areas with rash
  • Joint pain and swelling.

Diagnosis and Treatment

In most cases, parvovirus infection is diagnosed based on the rash symptom. Specific blood tests me be used to detect the virus or to address the specific risks associated with pregnant or anemic patients.

Parvovirus infection is not treated with medicine and clears over several weeks. Itchiness at the site of rash or joint pain may be alleviated with over the counter medication. Patients with weakened immune systems (cancer, AIDS and organ transplant patients) may receive intravenous immunoglobulin therapy to increase their overall antibody levels. Patients with anemia may benefit from blood infusions to restore blood counts. Many pregnant women have natural immunity to parvovirus infection, while others develop mild disease with little risk to the fetus. Prevention is the best course of action for pregnant women who are not immune to infection. If parvovirus infection is confirmed during pregnancy, the fetus is monitored closely for signs of anemia via sonogram and blood tests. There is less than a 5% chance of miscarriage associated with severe fetal anemia.

Prevention

Hand-washing and limited contact with sick individuals is the best way to prevent parvovirus infection. Currently there is no vaccine, but once people recover from parvovirus, they acquire natural, life-long immunity.

Sources

  • “Fifth disease". Medline Plus. Retrieved Apr 30, 2015. http://www.nlm.nih.gov/medlineplus/ency/article/000977.htm.
  • “Parvovirus infection". Mayo Clinic Foundation. Retrieved Apr 30, 2015. http://www.mayoclinic.org/diseases-conditions/parvovirus-infection/basics/definition/con-20023045.
  • “Fifth disease”. Centers for Disease Control and Prevention (CDC). Retrieved Apr 30, 2015. http://www.cdc.gov/parvovirusb19/fifth-disease.html.
  • “Pregnancy and fifth disease”. Centers for Disease Control and Prevention (CDC). Retrieved May 1, 2015. http://www.cdc.gov/parvovirusB19/pregnancy.html.