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Treatment

Treatment for Fifth Disease is primarily symptomatic and supportive, 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. 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.

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. 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. 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.

Treatment of Vulnerable Populations/High-Risk Patients

Treatment of B19 in People with HIV

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

• ART compliance

Treatment of a Fetus with B19

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.

• Severe anemia in the fetus is addressed by intrauterine red blood cell transfusions.
• Intravenous Immunoglobulin.

Prevention

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. 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.

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. 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.

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. 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.

High risk/vulnerable population prevention

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. 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,.