Erythema Infectiosum (Fifth Disease)


Erythema infectiosum or the “Fifth Disease” is an infectious disorder that affects children aging 2-12 years of age. The term “fifth disease” was based on the classification system for childhood rashes decades ago. Generally, the five frequent childhood rashes are the following:

  1. Measles (rubeola)
  2. Chickenpox (vaicella)
  3. German measles (rubella)
  4. Roseola
  5. Erythema Infectiosum (Parvovirus B19)

Because erythema infectiosum is the fifth disease that causes rashes in children, thus, the term has been used by most people. The prevalence of the illness is more commonly seen during spring and winter period and studies show that females are often affected than males.

Parvovirus B19, sometimes called as erythrovirus B19 is a part of the genus Parvoviridae. It was accidentally detected in 1975 by an Australianvirologist Yvonne Cossart.

“Fifth Disease” Related Data

Causative Agent: Parvovirus B19

Incubation period: 6-14 days

Mode of transmission: droplet (respiratory secretions transmitted by cough and sneeze)

Period of communicability: uncertain

Signs and symptoms

Fifth disease produces symptoms that are benign and go away on their own. The following are most likely observed:

  • Fever, headache, coryza, abdominal pain, sore throat and malaise on the first week.

  • Rashes appear a week after, erupting in three sequential phases:


Bright red rash coalesces at the cheeks forms a “slapped face appearance.” (Hallmarksign)


Extensor surface of extremities(outer arm)

Rashes are expected to scatter on the extremities (extensor surface) a day after the facial rash develops.

(Extensor surfaces refers to the part of the skin that do not touch when the joints are bend)

Flexor surfaces of extremities and trunk

Rash invasion in these areas are observed a day after it appeared on the extensor surfaces (inner arm and leg).

  • The eruptions will last for a week or more.
  • Rashes start to fade from the center outward (a lace-like appearance will be observe due to this manner of disappearance)


  • Home care:
  1. Adequate fluid intake
  2. Frequent hand washing.
  3. Acetaminophen (Tylenol) is given to decrease body temperature. Aspirin (acetylsalicylic acid) is not recommended as it is related to the occurrence of Reye’ syndrome.
  • Droplet precautions should be implemented if the child is hospitalized. (wearing mask,gloves, eyewear, spacing client in single room)
  • Avoid contact to pregnant women. Parvovirus B19 is teratogenic. It causes severe anemia with congestive heart failure to the fetus.
  • A child may resume school as soon as the rash appears. (the disease is no longer contagious at this time)

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Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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