Fifth disease: common childhood ailment

DEAR DR. DONOHUE: I am writing about fifth disease. I never heard of it when my children were growing up. My grandchildren have had it. What is it? Can they get it more than once? -C.K.

ANSWER: About 100 years ago, a list of illnesses, all of which had similar red rashes, was drawn up. On the list were illnesses like measles, scarlet fever and rubella (German measles). The fifth illness on the list was simply called fifth disease. Not until 1974 was the cause of fifth disease discovered -parvovirus B 19. The illness has another name -erythema infectiosum -but "fifth disease" is the more popular designation.

It's mostly a childhood illness. By age 15, half of all children have been infected. For some, the illness is so mild, no one suspects they have it. Others develop a fever, have a drippy nose, complain of headache and sometimes come down with diarrhea. Two to five days after those symptoms appear, the child's cheeks turn fiery red, as though they had been slapped. A few days later, a rash might break out on the trunk. The rash can last for a week or more.

Usually a child has only one infection of fifth disease. The rash can recur, however, for some weeks after all the original signs have disappeared.

Adults -especially young women -who become infected with the virus most often do not come down with a rash. They can have painful joints, particularly of the hands and feet. The joints hurt for one to three weeks, but the pain can return again and again for months.

DEAR DR. DONOHUE: I have something on my tongue. Many years ago it used to be called thrush. I have taken various medicines, but I have not been able to get rid of it. Do you have any suggestions? -G.Y.

ANSWER: The candida yeast causes thrush. It produces creamy-white, curdlike patches on the tongue, inside the cheeks and in other places within the mouth. If you scrape a patch, it bleeds.

Quite a few medicines are usually successful at eliminating thrush. Among them are nystatin mouthwashes, clotrimazole lozenges, and fluconazole, ketoconazole and itraconazole, all of which come in many forms.

If these medicines aren't successful, the dentist or family doctor should scrape the tongue and examine the scrapings with a microscope to confirm the presence of the candida yeast. Other conditions can give rise to white patches in the mouth that look something like thrush but have entirely different treatments.