GeneHealth - Your precision medicine

Erythema Infectiosum

Disease Details

Family Health Simplified

Buy Membership

Description: Erythema infectiosum, also known as fifth disease, is a mild viral infection commonly seen in children, characterized by a distinctive "slapped cheek" facial rash.
Type: Erythema infectiosum, also known as fifth disease, is a viral infection caused by human parvovirus B19. It is not genetically transmitted and is typically spread through respiratory secretions, such as saliva, sputum, or nasal mucus, from an infected person.
Signs And Symptoms: Fifth disease starts with a low-grade fever, headache, rash, and cold-like symptoms, such as a runny or stuffy nose. These symptoms pass, then a few days later, the rash appears. The bright red rash most commonly appears in the face, particularly the cheeks. This is a defining symptom of the infection in children (hence the name "slapped cheek disease"). Occasionally, the rash will extend over the bridge of the nose or around the mouth. In addition to red cheeks, children often develop a red, lacy rash on the rest of the body, with the upper arms, torso, and legs being the most common locations. The rash typically lasts a few days and may itch; some cases have been known to last for several weeks. Patients are usually no longer infectious once the rash has appeared.Teenagers and adults may present with a self-limited arthritis. It manifests in painful swelling of the joints that feels similar to arthritis. Older children and adults with fifth disease may have difficulty in walking and in bending joints such as wrists, knees, ankles, fingers, and shoulders.The disease is usually mild, but in certain risk groups and rare circumstances, it can have serious consequences:

In pregnant women, infection in the first trimester has been linked to hydrops fetalis, causing spontaneous miscarriage.
In people with sickle-cell disease or other forms of chronic hemolytic anemia such as hereditary spherocytosis, infection can precipitate an aplastic crisis.
Those who are immunocompromised (HIV/AIDS, chemotherapy) may be at risk for complications if exposed.
In less than 5% of women with parvovirus B19 infection, a baby may develop severe anemia leading to miscarriage. This occurs most often during the first half of pregnancy.
Prognosis: Erythema infectiosum, also known as fifth disease, typically has an excellent prognosis. Most individuals recover completely without complications. However, in people with weakened immune systems, certain blood disorders, or pregnancy, complications such as severe anemia or fetal complications can occur. Proper medical monitoring and supportive care generally lead to a good outcome.
Onset: The onset of erythema infectiosum, also known as fifth disease, is characterized by mild flu-like symptoms such as fever, headache, and runny nose. These symptoms are followed by the appearance of a distinctive facial rash that gives a "slapped-cheek" appearance, typically 4 to 14 days after exposure to the causative agent, parvovirus B19.
Prevalence: The prevalence of erythema infectiosum (also known as fifth disease) is not well documented with precise numbers, but it is considered a common childhood illness. It primarily affects children between the ages of 5 and 15. Outbreaks are more likely to occur in late winter and early spring. Adults can also contract the disease, though it is less common in this population.
Epidemiology: Fifth disease is a viral illness caused by Parvovirus B19. The illness is very common and self-limiting. The modes of transmission include respiratory droplets, blood, or mother to fetus. As with all respiratory pathogens once presumed to transmit via respiratory droplets, it is highly likely to be carried by the aerosols generated during routine breathing, talking, and even singing. Fifth Disease is most prevalent in children aged 5 to 15 years old. Fifth disease occurs at lower rates in adults. The virus spreads easily and once contracted, the body will begin developing lasting immunity to reinfection. The prevalence of antibodies is 50% in children and 70% to 85% in adults. The virus affects both men and women equally. During the spring and winter, epidemic outbreaks are most likely to occur. In the summer and fall, sporadic cases and outbreaks occur. The outbreaks most commonly occur in daycares and schools. The periodicity of the outbreak cycle is three-to-seven years. The risk of acquiring the viral illness increases when exposed to an infected person or contaminated blood. Individuals who have an occupation that requires close contact with infected people such as healthcare workers and teachers are at an increased risk of acquiring the viral illness. Another risk factor of fifth disease are immunocompromised individuals, those with anemia are at a higher risk of developing complications. Pregnant women are at risk for acquiring viral illness, especially during the first half of pregnancy. Though, complications are very rare and less than 5% of these cases will experience serious complications. The most common complication among pregnant women is anemia. In rare cases, severe anemia can occur, and a buildup of fluid can develop. A buildup of fluid can cause congestive heart failure or death. A blood infusion or induction may be necessary. No vaccine is available for human parvovirus B19, though attempts have been made to develop one.
Intractability: Erythema infectiosum, also known as Fifth disease, is generally not considered intractable. It is a self-limiting viral infection caused by parvovirus B19, typically resolving on its own without the need for extensive medical intervention. Most individuals recover fully with symptomatic treatment, such as rest, fluids, and over-the-counter medications for fever and pain. However, in certain populations, such as those with weakened immune systems or certain hematologic conditions, the illness can be more severe and may require medical attention.
Disease Severity: Erythema infectiosum, also known as Fifth disease, is generally a mild illness. Most individuals, especially children, recover without complications. However, in people with weakened immune systems, chronic anemia, or pregnant women, the disease can be more severe and may require medical attention.
Healthcare Professionals: Disease Ontology ID - DOID:8743
Pathophysiology: **Erythema infectiosum**, also known as **fifth disease**, is caused primarily by parvovirus B19.

**Pathophysiology**:
- Parvovirus B19 primarily targets erythroid progenitor cells in the bone marrow, leading to temporary disruption of red cell production.
- The body's immune response leads to the characteristic symptoms.
- The initial phase is marked by mild flu-like symptoms and viremia (virus present in the blood).
- An immune complex-mediated response follows, accounting for the erythematous rash, which classically appears as a "slapped cheek" rash on the face, spreading to the trunk and extremities.
- Joint involvement (arthropathy) can also occur, particularly in adults.

The infection is usually self-limited, but can cause complications in certain populations, such as pregnant women (risk of fetal hydrops), immunocompromised individuals, and those with underlying hemolytic disorders.
Carrier Status: Carrier status for erythema infectiosum, commonly known as fifth disease, is not applicable. It is an acute viral infection caused by parvovirus B19, and there is no asymptomatic carrier state. Infected individuals typically show symptoms or recover and clear the virus from their system.
Mechanism: Erythema infectiosum, also known as fifth disease, is caused by human parvovirus B19. The mechanism and molecular mechanisms are as follows:

**Mechanism:**
1. **Transmission**: The virus primarily spreads via respiratory droplets, but it can also be transmitted through blood or blood products and from mother to fetus.
2. **Replication**: After entering the body, parvovirus B19 targets erythroid progenitor cells in the bone marrow, hindering their ability to produce red blood cells.
3. **Symptoms**: The infection typically causes a mild rash illness, with a characteristic "slapped cheek" rash on the face, followed by a lacy red rash on the trunk and limbs. Additionally, it may result in joint pain and, in some individuals, can lead to more severe complications like transient aplastic crisis or hydrops fetalis in fetuses.

**Molecular Mechanisms:**
1. **Viral Entry**: Parvovirus B19 binds to the P antigen (globoside) present on erythroid progenitor cells and other cell types, facilitating viral entry.
2. **DNA Replication**: Inside the host cell, the viral single-stranded DNA is converted into double-stranded DNA, which then serves as a template for transcription and replication using the host’s cellular machinery.
3. **Protein Production**: The virus produces nonstructural proteins, notably NS1, which plays a crucial role in viral DNA replication and cellular apoptosis, as well as structural proteins VP1 and VP2, which form the viral capsid.
4. **Immune Response**: The infection triggers an immune response that includes the production of specific antibodies and T cell activation. The characteristic rash and joint symptoms are believed to be immune-mediated, resulting from the deposition of immune complexes in the skin and joints.

By understanding these mechanisms, we can better grasp how erythema infectiosum manifests and progresses in the human body, guiding both prevention and treatment strategies.
Treatment: Treatment is supportive, as the infection is frequently self-limiting. No specific therapy is recommended. Antipyretics are commonly used to reduce fevers. In cases of arthropathy, such as those with arthritis or arthralgia, non-steroidal anti-inflammatories (NSAIDs) or other anti-inflammatories can be used. The rash usually does not itch, but can be mildly painful. The rash itself is not considered contagious. The infection generally lasts about 5 to 10 days. Stress, hot temperatures, exercise, and exposure to sunlight can contribute to reoccurrence within months of the initial infection. Upon resolution, immunity is considered life-long. Populations at greater risk of complications (see below) may need referral to a specialist. Anemia is a more severe complication that could result from parvovirus B19 infection and requires a blood transfusion as part of therapy.
Compassionate Use Treatment: Erythema infectiosum, also known as Fifth disease, is caused by parvovirus B19. There are no specific treatments categorized under compassionate use or experimental treatments for this generally mild and self-limiting illness in healthy individuals. The management primarily focuses on symptomatic relief, such as using antipyretics for fever and analgesics for joint pain.

In cases involving immunocompromised individuals or patients with severe complications, such as transient aplastic crisis, intravenous immunoglobulin (IVIG) may be used off-label to help clear the virus. No other recognized experimental treatments are broadly accepted for routine use in erythema infectiosum. Consultation with a healthcare provider is essential for specific cases that may require such interventions.
Lifestyle Recommendations: Erythema infectiosum, also known as fifth disease, is a common viral infection, primarily affecting children. Here are some lifestyle recommendations for managing erythema infectiosum:

1. **Rest:** Ensure adequate rest to help the body recover.
2. **Hydration:** Keep well-hydrated by drinking plenty of fluids.
3. **Good Hygiene:** Practice good hygiene, such as regular handwashing, to prevent the spread of the virus.
4. **Avoid Close Contact:** Stay home from school or work if symptomatic to avoid spreading the infection to others.
5. **Skin Care:** For any associated rash, avoid scratching and use soothing lotions if needed to relieve itching.
6. **Pain Relief:** Over-the-counter pain relievers like acetaminophen or ibuprofen can help alleviate symptoms such as fever, headaches, or joint pain.

If symptoms persist or worsen, consult a healthcare provider.
Medication: Erythema infectiosum, also known as fifth disease, is caused by the parvovirus B19. Treatment is generally supportive, as the infection is usually self-limiting. Management focuses on relieving symptoms:

- **Fever:** Acetaminophen or ibuprofen can be used to reduce fever and alleviate discomfort.
- **Itching or Rash:** Antihistamines or topical anti-itch creams may provide relief.

There's no specific antiviral medication for erythema infectiosum, and antibiotics are not effective since it is a viral infection. Rest, hydration, and maintaining comfort are key aspects of care.
Repurposable Drugs: Erythema infectiosum, also known as fifth disease, is typically a mild viral infection caused by parvovirus B19. Treatment mainly focuses on symptomatic relief. There are no specific medications approved solely for treating erythema infectiosum. However, drugs such as acetaminophen or ibuprofen can be repurposed for managing symptoms like fever and joint pain.
Metabolites: Erythema infectiosum, also known as fifth disease, is caused by parvovirus B19. Currently, there are no specific metabolites uniquely associated with this viral infection for diagnostic or therapeutic purposes. The diagnosis is usually based on clinical presentation and can be confirmed by detecting parvovirus B19 DNA in the blood using PCR or by identifying specific antibodies (IgM and IgG) against the virus.
Nutraceuticals: Currently, there is limited scientific evidence supporting the use of specific nutraceuticals for the prevention or treatment of erythema infectiosum, commonly known as fifth disease. This disease is caused by parvovirus B19. Management primarily focuses on symptomatic relief, including rest, hydration, and medications for fever and pain, such as acetaminophen or ibuprofen. For individuals interested in nutraceuticals, it is always best to consult a healthcare professional.
Peptides: Erythema infectiosum, also known as fifth disease, is caused by parvovirus B19. It is characterized by a "slapped cheek" rash on the face and a lacy red rash on the body. There is no specific peptide treatment currently available for erythema infectiosum. Treatment primarily involves relieving symptoms like fever and pain with medications such as acetaminophen or ibuprofen. Nanotechnology and nanomedicine are not standard treatments for this disease. Standard supportive care is usually sufficient, as the infection is generally mild and self-limiting in healthy individuals.