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Parvovirus B 19 causes an infection known as the "fifth disease"

It is very common in children, but adults can also get it. 

Clinical presentation is usually benign but the infection can be very dangerous if the patient is immunodepressed or has hematologic diseases like sickle cell disease or thalassemia vera .

When symptoms do occur, they include general symptoms that come long with ALL viral infections: fever,headache and joint ache. 
These first symptoms last 2 to 5 days. After that, symptoms can include:
- Rash on the face, often called a “slapped cheek” rash, because it makes a child’s cheek looks bright red, as if someone just slapped it .
- Rash on the chest, back, arms, and legs, it makes a pattern that looks like lace .
- Joint pain

Children often feel better by the time they get a rash. Sometimes, the rash comes back after it goes away. 
It is important to understand that different patients may have different symptoms, symptoms may vary a lot depending on immunity.

Diagnosis is done by examining the patient and when there are any doubts, a blood test can be ordered.
Pregnant women who have been around someone who has it, should tell their doctor. A blood test can be done to see if there is an infection and this is important because this virus can be very dangerous for the fetus.

TRANSMISSION
Parvovirus B19 is transmitted from person to person via the respiratory route. Although there is no association with respiratory symptoms, this is where the virus is found BEFORE the classic symptom of a slapped face appears.
Patients with parvovirus B19 infection are most contagious during the phase of active viral replication, which as explained above, happens BEFORE the slapped cheek appearance . Virus is found in the blood approximately 5 to 10 days after exposure and usually lasts approximately 5 days, During this phase, patients can have no symptoms or present with non-specific symptoms  (fever, muscle aches).
THIS IS WHEN THE PATIENT HAS THE VIRUS IN HIS RESPIRATORY SECRETIONS


Subsequently, patients with a normal immune system and no hematologic disease may present with specific symptoms or signs (eg, joint pain and/or a rash) of parvovirus B19 infection. Individuals are no longer infectious when exhibiting these clinical characteristics.


TREATMENT
Most people with fifth disease get better without treatment. If there is itching or joint pain, we may use common OTC medicines to help the patient feel better. For example, IBUPROFEN (in Brazil: alivium gotas 50 1 drop for each pound of weight every 6 hours) to treat pain.
So far, there is no medicine to treat the virus that causes fifth disease. Antibiotics DO NOT WORK on fifth disease.

PREVENTION
as transmission occurs through respiratory route, general good hygiene rules must always be followed
- Washing hands often with soap and water, or using alcohol pads. Children should be isntructed do the same.
- Not sharing food and drinks with other people

A special warning must be done:
1- pregnant women are at a great risk as the virus can have serious consequences for the unborn baby
2- very serious anemia can develop if a patient does not know he/she a hematologic disorder like sickle cell disease or thalassemia vera
.


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