Fifth disease is a viral illness that causes a rash (exanthem). Fifth disease is also called erythema infectiosum. And it’s known as "slapped cheek" disease. This is because the rash can cause a child's cheeks to become very red. Fifth disease is spread from one child to another through direct contact with fluid from the nose and throat. It can also be spread through contact with infected blood. It is somewhat contagious.
Fifth disease is caused by human parvovirus B19. It occurs most often in the winter and spring.
It is most common in young school-age children. Children often get it at school or other places where children gather. Adults can get fifth disease too, but most infections are in children.
Symptoms usually show up 4 to 14 days after a child is exposed to the disease. About 4 in 5 infected children have very mild symptoms for about a week before getting the rash. About 1 in 5 will have no symptoms at all before the rash appears. Children are most contagious before the rash occurs, before they know they have the disease.
Early symptoms are usually very mild. These may include:
- Low fever
- Runny nose
- Sore throat
- Nausea or vomiting
A rash is usually the main symptom of fifth disease. The rash:
- Starts on the cheeks and is bright red
- Spreads to the trunk, arms, and legs, and lasts 2 to 4 days. It often has a "lacey" appearance.
- May come back when the child is exposed to sunlight, heat or cold, or injury to the skin. This may continue for several days.
The symptoms of fifth disease can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.
The healthcare provider will ask about your child’s symptoms and health history. He or she will give your child a physical exam. The physical exam will include inspecting the rash. The rash is unique to fifth disease, and may be enough to diagnose your child. In some cases, your child may also have blood tests.
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. Because it is caused by a virus, antibiotics will not help your child.
The goal of treatment is to help ease symptoms. Treatment may include:
- Making sure your child drinks plenty of fluids
- Giving acetaminophen or ibuprofen for fever and discomfort
- Giving an antihistamine medicine for itching
Talk with your child’s healthcare providers about the risks, benefits, and possible side effects of all medicines. Don't give ibuprofen to a child younger than 6 months old, unless your healthcare provider tells you to. Don't give aspirin to children. Aspirin can cause a serious health condition called Reye syndrome.
Fifth disease is usually a mild illness. In some cases, it may cause acute severe anemia in a child with sickle-cell disease or a weak immune system. In a pregnant woman with fifth disease, there is a small risk of death of the baby in the womb.
The best ways to keep fifth disease from spreading include:
- Washing hands well with soap and warm water
- Covering the mouth and nose when coughing or sneezing
When to Call a Healthcare Provider
Call the healthcare provider if your child has:
- Symptoms that don’t get better, or get worse
- New symptoms
- Fifth disease is a viral illness that causes a bright red rash on the cheeks. The rash can then spread to the body, arms, and legs. The rash lasts 2 to 4 days.
- Other symptoms can include runny nose, sore throat, and low fever.
- Fifth disease is spread from one child to another through direct contact with fluid from the nose and throat. It can also be spread through contact with infected blood.
- Treatment may include medicine to reduce fever and discomfort.
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
- Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.