Infectious Blushing

In the rolling sugar plantation country around Pahala on the island of Hawaii, Dr. Robert Kaufman noted that his daughter Suzanne, 8, looked "awfully healthy." A week later Dr. Kaufman took a look at his son Philip, 6, and asked his wife: "Is Philip getting unusually healthy or have you been putting rouge on him?" Mrs. Kaufman laughed at the suggestion. Soon Dr. Kaufman realized that all his five children had some malady, and he described its symptoms to Territorial Epidemiologist James Enright in Honolulu.

Dr. Enright decided that it was erythema infectiosum, literally, "infectious blushing," also called fifth disease.* The Kaufmans were not alone. Soon hundreds of fresh cases were reported, most from "the big island" but many also from Oahu.

Of unknown origin, infectious blushing causes nothing worse than a ruddy rash, perhaps a low fever, and some itching as it subsides. The great majority of victims have been children, who were ordered kept out of school for five days.

* Doctors once numbered "primary specific fevers" of childhood (scarlet fever, measles, German measles) and called Duke's disease (no longer recognized) the "fourth disease." They made infectious blushing the fifth. It is not to be confused with "erythema of the ninth day," a reaction to arsenical drugs.

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