Fifth Disease

What is fifth disease?

Fifth disease is a viral illness that causes rash. Fifth disease is also known as "slapped cheek" disease because the rash can cause a child's cheeks to become quite red as if they were slapped. Fifth disease is spread from one child to another through direct contact with mucus from the nose and saliva. It can also be spread through contact with infected blood. The disease is spread before the rash appears. Once the rash appears, your child is no longer contagious.

What causes fifth disease?

Fifth disease is caused by the germ “human parvovirus B19.” The germ spreads most often in the winter and spring. It is most common in school-age children. Once you have fifth disease, you are immune — you cannot get it again. Adults can get fifth disease too, but most infections are in children because many adults are already immune. 

What are the symptoms of fifth disease?

  • A rash is usually the primary symptom of fifth disease. The rash:
    • Starts on the cheeks and is bright red. It often looks like "slapped" cheeks.
    • Over the next two to four days, the rash spreads to the trunk, arms and legs, and can last several weeks. It often has a "lacey" appearance. 
    • May come back when the child is exposed to sunlight, very hot or cold temperature, or trauma to the skin.
    • The rash is flat; you can see it but not feel it.

Fifth disease is usually a mild illness. Sometimes after the rash appears, parents recall that their child might have had some mild symptoms such as low grade fever, headache, runny nose, sore throat, itching, nausea or diarrhea in the week leading up to the rash.

However, fifth disease may cause an acute severe anemia in people with sickle cell disease or immune deficiencies. There is a small risk of fetal death if fifth disease is acquired during pregnancy, so be sure to tell any pregnant women who were with your child prior to the rash. They should let their obstetrician know they were exposed to fifth disease.

How is fifth disease diagnosed?

Your child's healthcare provider will take a history and perform a physical examination of your child. The disease is easiest to diagnose while the rash is present.

Treatment of fifth disease

The goal of treatment is to help reduce symptoms. Since it is a viral infection, there is no cure for fifth disease. Treatment may include:

  • Drinking more fluids
  • Taking acetaminophen or ibuprofen for fever or headache if present (DO NOT GIVE ASPIRIN to children. Aspirin can cause a serious health condition called Reye syndrome.)
  • Using an antihistamine for itching 

The best ways to keep fifth disease and other illnesses from spreading include handwashing with soapy water and covering the mouth and nose when coughing or sneezing (cough or sneeze in your elbow is a tissue is not available).


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