Fifth Disease | DrBurke

Definition of Fifth Disease

Fifth disease is a self-limiting type of arthritis. It is medically known as Erythema Infectiosum. It is called the fifth disease because it is part of the 5th childhood rash-like illnesses. The other four diseases in the spectrum include: measles, rubella, varicella and roseola.

Fifth disease affects children, predominantly preschoolers and teenagers. It is not a common disease in adults, but it does occur. People tend to develop fifth disease towards the end of winter or in spring.

Causes of Fifth Disease

Fifth disease is caused by a virus called Parvovirus B19. The virus is spread through respiratory droplets from one infected person to another. The respiratory droplets can be transmitted through sneezing, coughing and spitting. The virus typically causes a benign illness.

HIV has been implicated as a cause of fifth disease in men.

Symptoms of Fifth Disease

Once a person contracts the virus, there’s about 4 – 14 days of an incubation period before symptoms begin to manifest.

Initially, an individual complains of flu-like symptoms

  • Hotness of body
  • Generalized body aches
  • Fatigue
  • Runny nose
  • Coughing

Eventually the disease progresses to:

  • Bright red rash on the face with a distinct pattern. Hence the name slapped cheek rash.
  • The rash is typically found on the trunk, cheek and limbs.
  • Joint pain described as dull and nagging.
  • Joints involved include: knee joint, wrist joint, shoulder joint in symmetry. Any other joint in the body can be affected.
  • Joint swelling is sometimes noted.

In adults, joint involvement tends to be more severe.  At least 10% of adults who get fifth disease end up developing chronic arthritis. The viral infection in fifth disease triggers an immunological reaction which causes deposition of immune complexes in joints and other parts of the body.

These immune complexes often result is structural joint changes causing chronic arthritis. Characteristically, fifth disease arthritis is polyarticular, symmetrical, affects both small and large joints and is accompanied by swelling and reduced joint mobility.

Treatment of Fifth Disease

Symptoms of fifth disease can sometimes resolve spontaneously without medication. However, in some cases, a medical consult is required. Arthritis is one of the most common reasons adults seek treatment. The following treatment plans are offered by Dr. Burke, our orthopedic specialist, exceptionally experienced in managing fifth disease. These include:

  • NSAIDs
  • Acetaminophen
  • Hydroxychloroquine
  • Physiotherapy
  • Joint replacement