What is the fifth disease called “slapped cheeks” in children?

Last week, several elementary schools in the Bordeaux area sent a similar message to families. “Since Monday, we have reported several cases of transmission of epidemic megalarythema in children, commonly known as fifth disease. Benign, which does not require exclusion from school, manifests itself by redness in the cheeks that spreads to the rest of the body. The period of infection is before the appearance of these red spots. In case of more severe symptoms, consult a doctor…

Last week, several elementary schools in the Bordeaux area sent a similar message to families. “Since Monday, we have reported several cases of transmission of epidemic megalarythema in children, commonly known as fifth disease. Benign, which does not require exclusion from school, manifests itself by redness in the cheeks that spreads to the rest of the body. The period of infection is before the appearance of these red spots. In the event of more severe symptoms, consultation with a doctor is recommended. »

As soon as the message was received, a wave of anxiety spread among the parents, apparently accompanied by vague theories, insurmountable fears and legitimate notions. The Covid pandemic has left some shocking scars. So, what is this megalarythema called?

Laurent Thielet Archives/ “SO”

never mind…

Dr. Jean Sarlangue, a pediatric infectious disease specialist at Bordeaux University Hospital, is not panicking. He has seen several megalarithmus in his career, even photographed them to conduct training, pass on his knowledge to general practitioners and families. “Actually, when you see your child with a bumpy cheek, as this is the main sign of such an infection, it is normal to be surprised and worried,” he begins. Most of the time, it is not serious, and will go away on its own. This is a highly contagious parvovirus. »

But finally what gives parents some stress is this somewhat strange name, “Fifth Disease”. “It is so named because it was the fifth of the explosive diseases described and discovered, after measles in 1627, scarlet fever in the same year, then in 3^E conditions, rubella in 1881, staphylococcal toxin in 1900, and hence, megalarythema in 1905. Regarding this infection, science only brought to light the virus responsible for this famous parvovirus B19 in the 1980s! »

Classic features

A rash on both cheeks, as if a child had received a slight slap. Apart from that we don’t slap children today. A symptom of fifth disease is usually this facial flushing, sometimes accompanied by a low-grade fever and a runny nose. Confronted with the latter, Dr. Sarlangue does not hesitate for a second. “This disease is well known to pediatricians, and it is not a phenomenon. Most children and teenagers have already contracted it without realizing it. And 40% of young people are immunocompromised. So yes, it is contagious, the disease spreads in schools, only in groups. It is safe. However, and this is undoubtedly why educators are warning families, this virus can be annoying for pregnant women and people with compromised immune systems. Infection occurs well before the emergence of pimples. Once the pimples are gone, unless there is fever, megalarythema does not need to be excluded. »

However, epidemic megalarythema in communities should be closely monitored. The virus is transmitted through saliva, through contact with objects that children put in their mouths, and can cause large, cascading epidemics. The problem is that an infected child, contagious, goes unnoticed a few days before the rash begins. And if it is not a primary concern for healthy children, megalarythema can cause problems for the most fragile, but also for professionals working with young people, especially pregnant women.

Wash your hands, throw away tissues

Don’t panic, though, hygiene and prevention rules are essential. Washing hands before meals is not an option. Paper tissues used for minor cold noses should be thrown away regularly. Washing toys lying around with soap and “excessive use” of a hydroalcoholic solution is recommended.

If the diagnosis is made in the direct environment of the child, it is better for pregnant women to ask the attending physician for serology. Most of them are also immune.

A small reminder: this disease first affects children aged 5 to 10 years. A runny nose, a few rashes… especially in late winter and early spring. In 30% of cases, it slips through the cracks.