Treatment

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Treatment for Fifth Disease is primarily symptomatic and supportive,[1] as the infection is frequently self-limiting. A self-limiting infection is one that typically does not require treatment, such as medication, and will heal on its own. While there is currently no specific therapy recommendation for Fifth Disease, symptom management can be attempted with over-the-counter medications. Antipyretics, such as acetaminophen are commonly used to reduce fevers. In the cases with joint disease; such as those with arthritis or arthralgia, treatment options can include medications that reduce inflammation like non-steroidal anti-inflammatories (NSAID); or other anti-inflammatories can be used.[2] It is important to never give children aspirin for any of their symptoms due to the risk of Reye's syndrome. Conservative treatment targeted to relieve people with symptoms of joint disease as a symptom of Fifth Disease have also utilized acupuncture, physical therapy exercises, and chiropractic care along with pharmacologic management of any joint disease. [3]

Other forms of treatment include plenty of rest, increase in daily fluids, nutritious daily meal intake, medication adherence and overall wellbeing.

The rash usually does not itch, but can be mildly painful. The rash itself is not considered contagious.[4] The infection generally lasts about 5 to 10 days. Stress, hot temperatures, exercise, and exposure to sunlight can contribute to recurrence within months of the initial infection. Upon resolution, immunity is considered life-long.[5] 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.[6]

Treatment of Vulnerable Populations/High-Risk Patients

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Treatment of B19 in Pregnant People

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Treatment of B19 in People with HIV

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Primary Treatment of people with HIV/AIDS infected with virus responsible for Fifth Disease include:

  • ART compliance [7]

Treatment of a Fetus with B19

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Treatment of fetus infected with the virus that cause Fifth Disease includes:

  • delivery of fetus first-line followed with he use of steroids to speed the maturation of the fetus's lungs. [8]
  • Severe anemia in the fetus is addressed by intrauterine red blood cell transfusions. [8]
  • Intravenous Immunoglobulin.[8]

Prevention

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Since there is no specific treatment for Fifth Disease, prevention is an important factor. Although fifth disease primarily occurs in children and will typically resolve on its own, similar to the cold, vulnerable populations such as those who are immunocompromised, pregnant, or anemic are more at risk of developing complications from the disease due to their bodies compromised state making it harder for the body to fight off the virus[9]. Therefore, prevention of fifth disease is an important factor in decreasing the amount of people who become sick from the B19 virus resulting in Fifth Disease[8].

Primary prevention aims to prevent the virus from infecting the host's body and completely stop the disease from happening while secondary prevention aims to detect the disease early on in its course and stop its progression. [10] An example of a primary prevention strategy is through the use of vaccines. There currently is no approved vaccinations for Fifth Disease. More research needs to be done for the development of a safe and efficacious vaccine, however, clinical studies have shown that vaccinations for B19 carry possible additional benefits to high-risk people such as pregnant, immunocompromised, organ transplant, and children with anemia.[11]

The abbreviation NPI stands for non-pharmaceutical interventions. As discussed in the 'Transmission' content above, Fifth Disease can be spread from human to human through blood respiratory particles, and from mother to baby during pregnancy. Since Fifth Disease can be spread through respiratory particles, which is similar to the transmission of COVID-19, the CDC recommends to follow the general recommendations for respiratory viruses.[12] Thus, much of the same NPI utilized during the COVID-19 pandemic can be used as preventive strategies for Fifth Disease, such as practice go. [13]

High risk/vulnerable population prevention

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One of the populations that is at high-risk for severe complications from contracting Fifth Disease, as discussed in the complications section, is pregnant people and their fetus. The primary prevention for pregnant people is to reduce the exposure, or contact, with Fifth Disease.[8] Prevention strategies for pregnant people, due to the increased risk of severe complications both for them and the fetus, include; increased awareness about the virus/disease to provide them with the knowledge and resources they need to take care of their health effectively, those who are at high-risk for complications should also be advised on the transmission of the virus and educated on what other safety measures they could practice to avoid areas where transmission of the disease is typically high such as childcare centers, close contact with school-age children or even close contact with someone who works with school-aged children such as teachers, and healthcare settings such as hospitals,. [14][15]

  1. ^ Leung, Alexander K. C.; Lam, Joseph M.; Barankin, Benjamin; Leong, Kin Fon; Hon, Kam Lun (2023-04-28). "Erythema Infectiosum: A Narrative Review". Current Pediatric Reviews. doi:10.2174/1573396320666230428104619. ISSN 1875-6336. PMID 37132144.
  2. ^ Macri A, Crane JS (2021). "Parvoviruses". StatPearls. Treasure Island (FL): StatPearls Publishing. PMID 29489222. Retrieved 2021-07-30.
  3. ^ Gryfe, David; Wong, Calvin (2019-04). "Clinical management of an adult with erythema infectiosum: a retrospective case report". The Journal of the Canadian Chiropractic Association. 63 (1): 44–50. ISSN 0008-3194. PMC 6493208. PMID 31057177. {{cite journal}}: Check date values in: |date= (help)
  4. ^ Ralston SL, Lieberthal AS, Meissner HC, Alverson BK, Baley JE, Gadomski AM, Johnson DW, Light MJ, Maraqa NF, Mendonca EA, Phelan KJ, Zorc JJ, Stanko-Lopp D, Brown MA, Nathanson I, Rosenblum E, Sayles S, Hernandez-Cancio S (November 2014). "Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis". Pediatrics. 134 (5): e1474–e1502. doi:10.1007/978-3-030-21267-4_9. PMC 7123921. PMID 25349312.
  5. ^ Ramdass P, Mullick S, Farber HF (December 2015). "Viral Skin Diseases". Primary Care. 42 (4): 517–567. doi:10.1016/j.pop.2015.08.006. PMID 26612372.
  6. ^ Manaresi E, Gallinella G (July 2019). "Advances in the Development of Antiviral Strategies against Parvovirus B19". Viruses. 11 (7): 659. doi:10.3390/v11070659. PMC 6669595. PMID 31323869.
  7. ^ Mendes-de-Almeida, Daniela P.; Bokel, Joanna Paes Barreto; Alves, Arthur Daniel Rocha; Vizzoni, Alexandre G.; Tavares, Isabel Cristina Ferreira; Silva, Mayara Secco Torres; Netto, Juliana dos Santos Barbosa; Grinsztejn, Beatriz Gilda Jegerhorn; Amado Leon, Luciane Almeida (2023-05-08). "Clinical Presentation of Parvovirus B19 Infection in Adults Living with HIV/AIDS: A Case Series". Viruses. 15 (5): 1124. doi:10.3390/v15051124. ISSN 1999-4915. PMID 37243210.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  8. ^ a b c d e Dittmer, Fernanda Parciasepe; Guimarães, Clara de Moura; Peixoto, Alberto Borges; Pontes, Karina Felippe Monezi; Bonasoni, Maria Paola; Tonni, Gabriele; Araujo Júnior, Edward (2024-01-26). "Parvovirus B19 Infection and Pregnancy: Review of the Current Knowledge". Journal of Personalized Medicine. 14 (2): 139. doi:10.3390/jpm14020139. ISSN 2075-4426. PMID 38392573.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  9. ^ Mendes-de-Almeida, Daniela P.; Bokel, Joanna Paes Barreto; Alves, Arthur Daniel Rocha; Vizzoni, Alexandre G.; Tavares, Isabel Cristina Ferreira; Silva, Mayara Secco Torres; Netto, Juliana dos Santos Barbosa; Grinsztejn, Beatriz Gilda Jegerhorn; Amado Leon, Luciane Almeida (2023-05-08). "Clinical Presentation of Parvovirus B19 Infection in Adults Living with HIV/AIDS: A Case Series". Viruses. 15 (5): 1124. doi:10.3390/v15051124. ISSN 1999-4915. PMID 37243210.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  10. ^ Kisling, Lisa A.; Das, Joe M. (2024), "Prevention Strategies", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 30725907, retrieved 2024-07-30
  11. ^ Chandramouli, Sumana; Medina-Selby, Angelica; Coit, Doris; Schaefer, Mary; Spencer, Terika; Brito, Luis A.; Zhang, Pu; Otten, Gillis; Mandl, Christian W.; Mason, Peter W.; Dormitzer, Philip R.; Settembre, Ethan C. (2013-08-20). "Generation of a parvovirus B19 vaccine candidate". Vaccine. 31 (37): 3872–3878. doi:10.1016/j.vaccine.2013.06.062. ISSN 0264-410X.
  12. ^ CDC (2024-06-05). "Preventing Parvovirus B19". Parvovirus B19 and Fifth Disease. Retrieved 2024-07-30.
  13. ^ Messacar, Kevin; Baker, Rachel E; Park, Sang Woo; Nguyen-Tran, Hai; Cataldi, Jessica R; Grenfell, Bryan (2022-11-12). "Preparing for uncertainty: endemic paediatric viral illnesses after COVID-19 pandemic disruption". Lancet (London, England). 400 (10364): 1663–1665. doi:10.1016/S0140-6736(22)01277-6. ISSN 0140-6736. PMC 9282759. PMID 35843260.
  14. ^ Dittmer, Fernanda Parciasepe; Guimarães, Clara de Moura; Peixoto, Alberto Borges; Pontes, Karina Felippe Monezi; Bonasoni, Maria Paola; Tonni, Gabriele; Araujo Júnior, Edward (2024-01-26). "Parvovirus B19 Infection and Pregnancy: Review of the Current Knowledge". Journal of Personalized Medicine. 14 (2): 139. doi:10.3390/jpm14020139. ISSN 2075-4426. PMID 38392573.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  15. ^ Patalon, Tal; Saciuk, Yaki; Trotzky, Daniel; Pachys, Gal; Ben-Tov, Amir; Segal, Yaakov; Gazit, Sivan (2023-11-16). "An Outbreak of Parvovirus B19 in Israel". Viruses. 15 (11): 2261. doi:10.3390/v15112261. ISSN 1999-4915. PMID 38005937.{{cite journal}}: CS1 maint: unflagged free DOI (link)