Parvovirus B19 Skin Infection

Parvovirus infection is the fifth common disease in children that includes measles, rubella, scarlet fever and  Chickenpox.

There are many different disease names for this type of skin infection including slapped-cheek disease, and fifth disease.

An adult who is not immune can be infected with parvovirus B19 and either have no symptoms or develop the typical rash of fifth disease, joint pain or swelling, or both. Usually, joints on both sides of the body are affected. The joints most frequently affected are the hands, wrists, and knees. The joint pain and swelling usually resolve in a week or two, but they may last several months. About 50% of adults, however, have been previously infected with parvovirus B19, have developed immunity to the virus, and cannot get fifth disease.

There is a serious risk involved for pregnant women just as with the measles virus. Pregnant women are at risk for fetal anemia, which can lead to congestive heart failure.

Signs and Symptoms of Parvovirus 

Fatigue, headache, itching, slight fever, and sore throat (try grumpy child with a cold). The rash is bright red. The rash will show up near the end of the illness. Adults may experience soreness in the joints. It can occur at any time and can be managed using over-the-counter meds. A susceptible person usually becomes ill 4 to 14 days after being infected with the virus, but may become ill for as long as 20 days after infection. According to the CDC, during outbreaks of fifth disease, about 20% of adults and children who are infected with parvovirus B19 do not develop any symptoms.

The human parvovirus B19 is not the same infection that dogs and cats get. Pet dogs or cats may be immunized against "parvovirus," but these are animal parvoviruses that do not infect humans. Therefore, a child cannot "catch" parvovirus from a pet dog or cat, and a pet cat or dog cannot catch human parvovirus B19 from an ill child.  

The infection is contagious in the week before the rash. If you suspect parvovirus in your child and he/she is running a fever of 102F or greater, call the pediatrician.

A person infected with parvovirus B19 is contagious during the early part of the illness, before the rash appears. By the time a child has the characteristic "slapped cheek" rash of fifth disease, for example, he or she is probably no longer contagious and may return to school or child care center. This contagious period is different than that for many other rash illnesses, such as measles, for which the child is contagious while he or she has the rash.

If an individual has any chronic infections such as chronic anemia, parvovirus can lead to serious anemia. Those with weakened immune system should be especially careful as well as those with cancer treatment or organ transplant. Complications can also arise if someone has sickle cell anemia or has immune system issues.

Doctor's can usually make a diagnosis by visual inspection. In cases in which it is important to confirm the diagnosis, a blood test may be done to look for antibodies to parvovirus. Antibodies are proteins produced by the immune system in response to parvovirus B19 and other germs. If immunoglobulin M (IgM) antibody to parvovirus B19 is detected, the test result suggests that the person has had a recent infection.

Treatment for Fifth Disease (Parvovirus) 

Normally the parvovirus infection can be treated at home. The rash does not need treatment. Relieving the symptoms is about all you can do. Ibuprofen for any discomforts and fever. Drink lots of fluids.  Do not use aspirin. Once the rash appears, the child is no longer contagious.

Persons infected with the virus develop lasting immunity that protects them against infection in the future.

Those who have severe anemia need to be hospitalized and receive blood. Antibodies are needed when individuals have weakened immune systems and get this infection.

Pregnant women will need to be monitored carefully if they get the infection during pregnancy. They need blood or medications if the baby becomes anemic, suffers edema, or develops heart failure.

Prevention of Parvovirus 

Currently there is no vaccine to prevent parvovirus infection. One way to help prevent the spread of this skin infection is to wash your hands and teach kids to wash their hands properly. Make sure that used tissues are thrown away after use and wash hands after using tissues.

Parvovirus B19 has been found in the respiratory secretions (saliva, sputum, or nasal mucus) of infected persons before the onset of rash, when they appear to "just have a cold." The virus is probably spread from person to person by direct contact with those secretions, such as sharing drinking cups or utensils or toys. In a household, as many as 50% of susceptible persons exposed to a family member who has fifth disease may become infected. During school outbreaks, 10% to 60% of students may get fifth disease. (CDC)

Is it even possible to demand that a small child properly blow their nose and dispose of a tissue?  Most children simply wipe with a hand, arm or sleeve.  Can we really expect teachers and day care workers to be constantly cleaning every surface and toy and child's hands and face? A normally healthy child will suffer no long term effects from Parvovirus so best to get it done early and become immune.

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