Introduction

 

Fifth disease has at least three names, and it affects many different population groups differently. And some of the health risks for only some of these folks are pretty bad. So, it all gets fairly complicated pretty quickly.

 

I present a pneumonic below for education purposes only that makes it easier to keep all the facts in line.

 

Disclaimer

 

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 here she has! In other words, do not to give any medical advice.

 

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

 

Fifth disease is caused by a virus in children. So it spreads like wildfire in child care centers. So the pneumonic? 5th disease? “5”... 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 chopped, 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 cloud up there vessels producing ischemia or lack of oxygen eventually possibly leading to infarction of parts of your body, so, tissue death. 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, demonstrating the more full blown version if you have two allotments of the gene. Anyway, if these unfortunate patients have a crisis, it’s called in a plastic 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. 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 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.

 

Conclusion

 

So you were expecting a more clever pneumonic than simply the number 5 for 5 main risk groups for 5th disease. Okay, fair enough.

 

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 here 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” (for the famous slapped cheeks)

 

That’s the pneumonic, best I could do. But you got the “5” thing going for it too. So tell me if you find a better one! Here it is:

 

Child: slapped cheeks, F, D, myalgia

Hemolytic anemia e.g. sickle cell anemia

-> aplastic crisis

Adults self-ltd sero(-)arthritis, Myocarditis Pregnant 1st 20 weeks-> 10% hydrops Drug RXN in HIV pt: severe inflammatory RXN 2° antiretroviral Tx (&chronic anemia)

 

Stay well!

Dr. Dave Allingham