It looks likely that I have fifth disease. My question is: when was I contagious? Everything I’ve read says that by the time children develop the “slapped cheek” rash they have passed the contagious stage. However, I a) am not a child and b) never developed the rash (just the joint pain, which I understand is more standard in adults with fifth disease).
I’m just curious, really. When was I contagious? Was I already done being contagious by the time the first joint pain appeared?
Try this linK: http://www.aafp.org/afp/991001ap/1455.html to answer some of your questions.
I am gonna have to hop on a plane shortly so might not get through this post.
The short answer is, for the first couple of weeks you might be contagious. At the point at which your acute clinical symptoms resolve–no fever, for instance, you probably stop being very infectious. A few days to a couple weeks for most exposures to Parvovirus 19.
There is a much longer answer, and perhaps you’ll find it interesting.
In a way, you don’t really have “Fifth Disease,” which is a nickname applied to this illness because (if my feeble memory serves) it was the fifth classic rash syndrome. Fifth Disease should really be a term limited to folks with a rash, and of course as you know that’s most commonly but not always, children. When viral illnesses produce such protean clinical syndromes, the fact that we lump all the various expressions into a single term is unnecessarily confusing.
Assuming your acute IgM titers show infection with parvovirus 19 and a few other caveats about how to diagnose illness, it sounds like you have been diagnosed with Parvovirus 19-associated arthropathy: in short you got exposed to a virus that gave you joint pains. You’ve asked a pretty insightful question, which is whether or not the joint pains can be used for a marker for the resolution of viremia the way a rash or fever resolution reflects the same thing in kids.
I am going to say that you are probably no longer contagious once the arthropathy develops. The arthropathy (joint problems) is an immunologic response to the virus and not a direct effect of the virus per se. The virus itself is not attacking your joints. To develop the arthropathy you would have needed to have mounted at least a partial immunologic response (IgM antibodies first and then IgG). Because you developed arthropathy we know your immune system is at least partially working, and it’s a reasonable assumption that you cleared your viremia (viruses running around in your bloodstream).
It’s not a perfect marker. We all have slightly different immune responses and there are many viral illnesses whose clinical expression are markedly different. So different that if you walk around saying (like your Doctor probably did) that you have “Fifth Disease” you might go nuts with Moms telling you how their kid had that, too. But in your case the response to Parvovirus 19 exposure is so different that it’s an entirely different syndrome from the typical childhood illness. Anyway, no one can guarantee you aren’t infectious but you aren’t. Odds are you have cleared the virus.
It’s such a common virus and so easily acquired in close contact that you shouldn’t worry anyway. And of course, as is easily inferred from your own comments, you are the most contagious when you are the least ill. An excellent trick of a lot of viruses, and one of the reasons all children should get a good long exposure to day care and every other urchin with a snotty nose. I can’t figure out why we as a society promote exercising our bodies but not our immune systems. It’s a lot more dangerous to have a naive immune system than a fat ass. How do you think we Europeans bumped off half the populations of the lands we took over? Another thread.
Post back if the article doesn’t help, btw. I may have a chance later today to translate any of the gibberish.
Thank you, that is exactly what I was looking for.
So it seems that my arthropathy indicates I am no longer contagious?
Curiously, my sister has been suffering from an arthritic condition for over a year or so. It may just be that she’s in the unfortunate 20% who have joint pain for awhile caused by this virus and doesn’t actually have arthritis. I thought I’d contracted the virus when I was down to see her, but my joint pain started a day after getting back. So if it takes three weeks to for arthropathy to develop, it sounds like it is just a coincidence that we both have contracted this virus and had similar symptoms. Or, maybe I just cleared it in days instead of weeks.
Ignore me, I’m babbling.
In any case, great article. Thanks again.