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10 February, 2010

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Slapped face disease

The 'slapped face' infection mainly affects primary school aged children. It causes a bright red rash on the cheeks that looks as though they have been slapped, hence the name. Other names for the illness include fifth disease and erythema infectiosum. Like many viral infections, it is spread by mucous from an infected person sneezing or coughing. This mucous is carried by hand to the mouth or nose of another person. The incubation period is usually between four and 14 days after contact (in rare cases, up to 21 days). For most children, the slapped face infection causes little more than 'cold' symptoms. These generally improve after a few days, when the rash starts to show. The infection can be more serious for pregnant women. Their unborn baby may be harmed by the infection (although this is rare).

Symptoms
The first symptoms seem like a 'cold' and can include:

Fever
Tiredness
Aching muscles
Headache
Sore throat
Runny nose, coughing and sneezing.

As these cold-like symptoms start to improve, the rash on the face appears. This rash is bright red, 'lacey'(with patches of normal coloured skin within the red areas) and often itchy. The person may also develop a pink blotchy rash on the limbs or torso after a few days. Many people (up to 20 per cent) do not have any symptoms at all when they have the infection.

Arthritis-like symptoms
Arthritis-like symptoms are common for teenagers and adults. This can involve swollen joints (usually the ankles, knees and wrists). This complication is more common in female teenagers and adults, and is sometimes the only symptom of infection. Normally, it takes around two to four weeks for the joints to get better. However, in some people, the swelling can last for months. Unlike true arthritis, there is no danger of permanent damage, even if the joints are affected for a long time.

The parvovirus B19
The slapped face virus is caused by the human parvovirus B19. It can only infect humans and is different from dog or cat parvoviruses. Children between the ages of five and 15 years are prone to contracting the disease. Adults who have regular contact with children, such as teachers and child health care workers, are also at increased risk. However, over half of all adults are immune to the virus because they had the infection in childhood. People are infectious during the incubation period, which is usually about a week before the rash appears. Once the characteristic rash has appeared, the person is no longer contagious. This pink, lace-patterned rash tends to last for around one to three weeks, and is made more obvious by exercise, sunlight or hot weather.

High risk groups
Generally, the slapped face virus is a mild illness that doesn’t pose any health risks to the sufferer. However, contracting the virus is serious for people with specific conditions, including:

Pregnancy - although most women have had the infection before their pregnancy, some will get it while they are pregnant. Most of their babies will not be harmed by the infection; however, about five per cent may develop severe anaemia, which can cause a miscarriage or still birth. The risk of harm to the baby is greatest in the first six months of pregnancy.
Weakened immunity - people with compromised immune systems (for example, people being treated for cancer or severe asthma, or those with HIV/AIDS) can develop chronic and severe anaemia.
Haemolytic blood disorders those with disorders such as sickle cell anaemia, thalassaemia and hereditary spherocytosis can experience a sudden drop in haemoglobin, the protein that transports oxygen around the blood. In severe cases, this can lead to heart failure.

Treatment options
Most people with slapped face infection need little if any treatment. Rest and analgesics (such as paracetamol) may help. If a woman who is pregnant gets the infection, her baby’s development will need to be monitored (ultrasound may help with this). A few unborn babies with severe anaemia have been treated for this before birth. Immunodeficient patients and those with chronic anaemia may require a transfusion of red blood cells to ensure an adequate level of haemoglobin.

Where to get help

Your doctor
Nurse on Call Tel. 1300 606 024 – for expert health information and advice (24 hours, 7 days)
Child health care workers
The Maternal and Child Health Line is available 24 hours a day Tel. 132 229.

Things to remember

The slapped face virus infection is characterised by bright red cheeks, a cold-like illness and, sometimes, an itchy rash on the torso and limbs.
It commonly affects primary school children and is not dangerous for most people.
Pregnant women, people with haemolytic blood disorders and those with compromised immune systems need medical assessment if exposure to the slapped face virus is suspected.

You might also be interested in:
Infections - bacterial and viral.

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