Fifth Disease (Erythema Infectiosum)

CAUSE:

The virus belongs to the family of the parvovirus.

SIGNS AND SYMPTOMS:

3 to 4 days of low-grade fever and symptoms of a mild cold, followed by 7 to 10 days of bright red rash that has the appearance of a slapped cheek, a reddening of the skin which fades and recurs. After another 1 to 3 days, a pink lacy rash appears on the cheeks, then spreads to upper arms and legs, trunk, hands, buttocks and feet. Rash is exaggerated by sunlight, heat and nerves. Rash may be accompanied by low-grade fever, headache, mild joint pains or swelling and gastrointestinal symptoms. Discomfort can last for a few days to a few months, usually with no permanent joint damage. Students who are immune compromised can develop severe anemia, and not exhibit a rash. Infection in pregnant women can cause spontaneous abortion or anemia in the unborn baby.

INCUBATION PERIOD:

Incubation period is 4 to 18 days, but usually 12 to 14 days.

MODE OF TRANSMISSION:

Caused by parvovirus B 19. It is spread by direct contact with infected mucus from the nose or mouth or by inhaling droplets coughed or sneezed into the air.

PERIOD OF COMMUNICABILITY:

The disease is contagious from 3 days to 2 weeks before appearance of the rash. Therefore, little can be done to stop the spread of infection. Students are no longer contagious and do not need to be excluded from school once the rash occurs. Pregnant women, in contact with an infected student between 3 days and 2 weeks before the rash develops, should contact their physician. Blood tests to check for immunity or infection are available. Most adults have had a parvovirus infection during childhood and are no longer at risk of catching the illness.

IMPLICATIONS FOR SCHOOL:

Report to School Nurse. Although no strict criteria for exclusion from school can be established, it is recommended that students stay at home during the period when fever and tiredness are present. Students may return to school while the rash (“slapped cheek”) is still present as they are no longer contagious.