Fifth Disease, also known as erythema infectiosum, stems from an infection with Parvovirus B19, a common human virus. While frequently associated with distinctive rashes in children, adults can also contract this infection. When Fifth Disease occurs in adults, its presentation often differs significantly from its childhood counterpart. Understanding these differences is important, as adult cases can pose unique concerns.
How Fifth Disease Appears in Adults
Adults are less likely to experience the characteristic “slapped cheek” rash common in children. The most common symptom in adults is joint pain, medically termed arthralgia or arthritis, which can affect various joints such as the hands, wrists, knees, and ankles. This joint discomfort can sometimes be accompanied by swelling.
Other, less common symptoms in adults may include a low-grade fever, headache, or a general feeling of fatigue, similar to flu-like symptoms. A faint, lace-like rash might appear on the trunk or limbs, but this is not consistently present in adult cases. The incubation period, or the time between exposure to the virus and the onset of symptoms, typically ranges from 4 to 14 days, though it can extend up to 21 days. Adults are most contagious before symptoms, especially the rash, become visible.
How Fifth Disease Spreads
Fifth Disease primarily spreads through respiratory droplets, similar to how a common cold is transmitted. This occurs when an infected person coughs or sneezes, releasing viral particles into the air. Direct contact with saliva or mucus can also facilitate transmission. There is currently no vaccine available to prevent Fifth Disease. General prevention measures include frequent hand washing with soap and water, covering the mouth and nose when coughing or sneezing, and avoiding close contact with individuals who are sick.
Adults at Higher Risk for Complications
While Fifth Disease is often mild in healthy adults, certain populations face a higher risk of complications. Pregnant individuals are one such group, as the virus can be transmitted from the mother to the developing fetus. This can lead to serious outcomes, including severe fetal anemia, and in some cases, hydrops fetalis, a condition where excessive fluid accumulates in the fetus’s tissues and organs. Miscarriage or stillbirth can also occur, with the greatest risk generally observed during the first half of pregnancy.
Individuals with compromised immune systems, such as those with certain cancers, HIV, or organ transplants, are also at increased risk. For these individuals, the virus can lead to a persistent infection and chronic anemia. People with chronic hemolytic anemias, such as sickle cell disease, face a specific and serious complication. Infection with Parvovirus B19 can trigger a transient aplastic crisis, a severe form of anemia where the body temporarily stops producing red blood cells. While joint pain in adults typically resolves without lasting damage, it can sometimes persist for weeks or even months following the initial infection.
Diagnosis and Care
Diagnosis of Fifth Disease in adults is often based on the presence of characteristic symptoms. A blood test, specifically a Parvovirus B19 antibody test, can confirm a recent infection or indicate previous immunity to the virus. This test helps differentiate Fifth Disease from other conditions with similar symptoms.
There is no specific antiviral medication to treat Fifth Disease directly. Care primarily focuses on alleviating symptoms. This typically involves getting ample rest, staying hydrated with fluids, and using over-the-counter pain relievers like acetaminophen or ibuprofen to manage joint pain, fever, or headaches. It is advisable to seek medical attention if symptoms are severe, if pregnancy is a factor, or if there are underlying health conditions that might increase the risk of complications. Medical professionals can provide guidance and monitor for any potential adverse effects.