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
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
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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