What is 'slapped cheek disease' and should parents be concerned?

Despite its rough name, experts say most cases of 'slapped cheek disease' are mild and not a cause for concern. (Los Muertos Crew/Pexels)

Also known as "slapped cheek disease" for the red rash it can cause on children's faces, fifth disease is a common viral infection that affects the skin, airway and joints. Despite its rough nickname, experts say symptoms are usually mild and not a cause for concern.

"This disease is a very common illness in childhood," pediatrician Dr. Dina Kulik from Kidcrew Medical in Toronto told CP24. "Most kids that get it will have very mild symptoms, sometimes fever or sore throat or runny nose, but the hallmark of it is a red rash on the cheeks that often looks like they were slapped."

Based on information from the Canadian Paediatric Society, Public Health Agency of Canada, the B.C. Centre for Disease Control and the U.S. Centers for Disease Control and Prevention, here's what you need to know about fifth disease.

What is fifth disease?

Fifth disease, or erythema infectiosum, is caused by the virus parvovirus B19. Much like the common cold, it can spread through droplets in the air from coughs or sneezes, or by touching something contaminated with the virus and then touching your mouth, nose or eyes. It is most prevalent in late winter, spring and early summer and mostly affects children. Those who had it as a child usually won't get it again. Minor outbreaks can occur every three to four years.

Kulik says she's personally seen three cases so far this week at her clinic in Toronto.

"Usually I would see a couple per month around this season," Kulik said. "Now we may not see any more for the rest of spring, or it might be the beginning of many more cases, but it is definitely a higher rate than I've seen in previous springs."

What are the symptoms?

Initial symptoms can include low fever, headache and cold-like symptoms, which are later followed by joint pain and rashes that can appear on the faces of children, as well as on the torso, arms, legs and other parts of the body. Rashes can be itchy and last between one and three weeks.

The virus is highly contagious until the rash appears after seven to 10 days. Symptoms may be more severe in adults. Other more severe viral illnesses like measles and rubella can also cause rashes, and a blood test may be needed to rule them out.

How is fifth disease treated?

Cases are usually mild. Rest and fluids are advised, and symptoms like pain, aches and fever can be treated with common drugs like acetaminophen, commonly known as Tylenol, while rashes can be soothed with cream. There is no vaccine. Fifth disease can be avoided with frequent hand washing

Is fifth disease a cause for concern?

For most people and children, no. Fifth disease is not considered a notifiable disease, like hepatitis and measles, and cases are not tracked by public health authorities. Approximately one quarter of adults and children show no symptoms, and more than half of adults have already had it.

Pregnant people, however, can pass the infection to a developing baby, which can result in anemia, miscarriage or stillbirth in some cases. Kulik says it's especially important to be careful in the first and early second trimesters.

"If a pregnant person gets parvovirus during the early time of pregnancy, it can be quite dangerous to the fetus, and up to 10 per cent of babies in utero can actually become infected and die from this," she said. "So if you are a pregnant individual and you've been exposed to parvovirus, or you think you might have parvovirus, it's very important to touch base with your health-care provider and do bloodwork to see if you have been infected."

Those with anemia or a weakened immune system are also at risk of serious complications. Children should see a doctor if their fever persists for two to three days, or if they have ear pain or a sore neck.

Can you go to school or work with fifth disease?

That depends on where you live, as local public health authorities are responsible for school guidelines on communicable diseases. But the general consensus is that kids can still go to school if they don't have a fever.

Ottawa Public Health, for example, says exclusion from school is not required since children are no longer infectious once a rash appears, but they should stay at home with a fever. The B.C. Centre for Disease Control offers a similar recommendation for work and school.

The Canadian Paediatric Society says children can continue to attend child care or school if they feel well enough to partake in activities.

How did fifth disease get its name?

The term "fifth disease" comes from its place on an early 20th century list of rash-causing childhood diseases like measles and rubella. The name "slapped cheek disease" comes from the red rash it can cause on children's faces.

With files from CP24.com Journalist Codi Wilson