Academy rash. A probable epidemic of erythema infectiosum ('fifth disease')

Over a few weeks, 69 children (13%) enrolled in a private school manifested an erythematous and migratory rash, most commonly on the extremities, along with fever or other systemic or respiratory symptoms. Fever lasted for a mean of four days, and rash, 11 days. Cases appeared in every grade from kindergarten through ninth, and the incidence peaked in the fifth through seventh grades. More boarding students were affected than day students. Secondary cases in households of affected children and among adults from the school were noted. Eighty-eight attempts at virus isolation were unsuccessful. The illnesses were consistent with erythema infectiosum, a disease of unknown etiology, which has occurred in epidemic form in schools and also in sporadic cases.