What’s Going Around: Fifth disease, seasonal allergies

UPMC Pinnacle’s Heritage Pediatrics is seeing a common warm-weather virus that causes Fifth disease. Despite the name, this is actually a very mild illness. Many children don’t feel ill but develop a classic rash with very red “slapped cheeks” and a flat, lacy-looking red rash on the arms, trunk, and sometimes legs. The rash can come and go for weeks, often it flares up in the heat.

Fifth disease is caused by a parvovirus. Once the rash develops the child is no longer contagious. However, if your child was in close contact with a pregnant woman before the rash broke out, she should be made aware to contact her provider in case testing needs to be done. Parvovirus can have harmful effects on the baby before it’s born.

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics continued to see high numbers of both viral colds and seasonal allergies. More specifically in the viral category, they have seen an increase in roseola and Fifth disease.

Gastroenteritis, strep throat and pink eye increased. Ear infections continued to be seen in high numbers. They saw a couple of flu-like illnesses, although none were specifically tested.
Dr. Joan Thode offered the following advice about roseola and Fifth disease:

“Roseola is a viral illness that causes high fevers for about three days, along with a body-wide rash. This rash often starts on the torso, then spreads to the extremities and face. The rash appears as red splotches that can feel slightly raised. They blanch, meaning that when pressed, the red color goes away. When pressure is removed, the red color returns. The rash is not itchy, does not have fluid-filled bubbles and typically does not bother the child at all. It will fade over the subsequent two to three days. Once the rash develops, the virus has been killed off, and the child is no longer contagious.
Adults can get roseola, though it is such a common childhood illness that most have already experienced the virus and build secondary immunity by the time they reach adulthood.

Fifth disease, also known as erythema infectiosum, is caused by Parvo Virus B19. This disease typically starts with what appears to be a typical viral cold: fevers, headaches and a runny nose. The rash that often develops is a red rash of the cheeks, known as “slapped cheek” rash because it occurs in very bright red, stark areas on both cheeks. This rash typically fades over a couple days as the viral symptoms also resolve, though sometimes it can come and go over the following one to two weeks. 
Often, after the slapped cheeks improve, the child is done with the disease. However, in some cases, the virus can cause an itchy, widespread rash over the torso, arms and legs that appears a week or two later and looks like spots that can be slightly raised. This will get better within a week on its own, though there are unfortunately no medications to hasten resolution time.

Even more rarely, Parvo Virus B19 can cause significant anemia, a decreased number of red blood cells. This will eventually resolve on its own but requires close monitoring by your child’s doctor. Since red blood cells are responsible for carrying oxygen around the body, a child with significant anemia may appear very fatigued and pale.

Adults also can contract Parvo Virus B19 if they have never before been exposed. It can follow a very similar course, though adults are more likely to get joint pain and swelling.”

The CVS MinuteClinic in Lancaster reported the following this week:

“Allergic Conjunctivitis: Patients are presenting with what they presume is “pink eye”. Allergic conjunctivitis differs in that it is usually bilateral with clear, ropey discharge. A predominant symptom is itching. Over the counter treatments include Zaditor, Naphcon A and natural tears. Seeing a health care provider can help determine if it’s bacterial or allergic. If bacterial conjunctivitis is suspected antibiotic eye drops are dispensed.
Physicals: This time of year is busy with sports camp, camp and summer work physicals. A head to toe exam is performed, review past medical history and medication and a determination is made regarding fitness to participate. School entry physicals for all levels of education are coming due in the next weeks for fall semester classes.
Hordeolum (stye): Symptoms include a bump on the inside or outside lash line with pain and swelling. Effective treatments include compresses. Evaluation to determine the need for topical or oral antibiotics is helpful.”
In York, the MinuteClinic reported mostly upper respiratory infections, allergies, and preventative vaccines, including a few for MMR boosters and Tdap.

This week, pediatricians at Penn State Children’s Hospital and Penn State Health Medical Group are seeing viral upper respiratory illnesses and seasonal allergies. They have also seen some tick bites and gotten questions from parents about tick bites. Remember do to regular tick checks. If you check every night before bed or at bath time, you can decrease the risk of Lyme disease as ticks need to be attached for longer than 24 hours to transmit it.

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