5th disease? Everyone’s always talking about it. Your child gets a viral rash at preschool, and everyone is in a panic. But it’s just a virus! Who does it hurt, and how can I remember is what you’re asking, I know. Lose your patience for the truth no longer. There’re only a few sorts of people that it could really hurt.

The standard disclaimer applies. If your child has a rash, make sure your pediatrician is consulted. If someone else’s child has a rash, do your best to not get what he or she has! Just kidding. Sort of. In other words, do not give any medical advice please.

Fifth disease has three names. Fifth disease = erythema infectiosum = arbovirus B19.

What Causes Fifth Disease?

Fifth disease is caused by a virus in children. So it’s spreads quite quickly in day care centers. There are really only five major groups of people that it affects.

One, the child who gets it. That child will display slapped cheeks, kind of dry, almost chapped, fever, diarrhea, and muscle aches. It’s contagious, so other children will get it quite quickly because of the excessive contact that occurs between children. And this occurs especially in the day care setting.

Two, hemolytic anemia patients. Hemolytic anemia patients are subject to crises that occur when they’re red blood cells clog up there blood vessels producing ischemia or lack of oxygen eventually possibly leading to infarction of parts of your body, so, tissue death. Every step of this process which is fairly gradual is severely painful. And dangerous. Probably the most famous example of a hemolytic anemia is sickle cell disease. African Americans are subject to this disorder, demonstrating a partial version of it in the heterozygous form (I.e., one gene locus has it, the other gene locus that could carry it doesn’t have it); and as you may know, others that have do so demonstrating the more full blown version if they have two allotments of the gene. Anyway, if these unfortunate patients have a crisis, it’s called an aplastic crisis, and it really hurts. Those patients need to avoid exposure to fifth disease to make sure they don’t get it.

Three, adults. In adults, it is a fairly self-limited seronegative arthritis. The adult may show signs of myocarditis. That’s a much worse situation. So all adults should obviously do their best to avoid fifth disease exposure.

Number four, pregnant women. The first 20 weeks, fifth disease could lead to big problems for their baby about 10% of the time. Those babies have a 10% chance of hydrops.

And the fifth and last group of patients that are susceptible to having problems with fifth disease that you should be aware of and should learn about this and certainly make every effort to avoid exposure when they hear it is going around — HIV or AIDS patients. They can experience a drug reaction secondary to their anti-retroviral therapy. It is a severe inflammatory reaction that occurs. These folks are also susceptible to a chronic anemia with fifth disease.

And so in summary, here’s the pneumonic that will let you save the day on Intel when your child’s daycare goes into a panic because one of the kids looks like he or she has a viral facial rash that someone has suggested is fifth disease, that will help you to remember the important facts about fifth disease and who it hurts.

“5“ Groups Affected by “5”th Disease “CHAPD” 

  1. Child: slapped cheeks, F, D, myalgia
  2. Hemolytic anemia e.g. sickle cell anemia
  3. Adults self-ltd sero(-)arthritis, Myocarditis
  4. Pregnant 1st 20 weeks-> 10% hydrops
  5. Drug RXN in HIV pt: severe inflammatory RXN 2° antiretroviral Tx (&chronic anemia)

Stay well!

Dr. Dave