Fifth disease, caused by parvovirus B19, is a viral infection that leads to a rash on the face, arms, and legs. This common illness mainly affects children and typically resolves on its own.

In addition to the characteristic rash, symptoms of fifth disease may include a low-grade fever, headache, and runny nose. The rash may appear as bright red cheeks (hence the nickname “slapped cheek disease”) followed by a lacy rash on the torso and limbs.

Fifth disease is most contagious before the rash appears. Once the rash is present, the child is usually no longer contagious. It is important for pregnant women to avoid exposure to fifth disease, as it can cause complications for the baby.

There is no specific treatment for fifth disease, as it typically goes away on its own within a few weeks. However, over-the-counter medications can help manage symptoms such as fever and discomfort.

If you suspect your child has fifth disease, it is important to consult with a healthcare provider for a proper diagnosis and to discuss management of symptoms. In most cases, fifth disease is a mild and self-limited illness that resolves without complications.

What Is Fifth Disease?

The viral infection known as fifth disease is characterized by symptoms like a distinct red rash or a “slapped cheek” appearance. It commonly affects children between 4 and 10 years old but can also impact older children and adults, particularly females.

The disease is contagious even before symptoms show up, but it becomes non-contagious once the rash develops. It spreads through coughing, sneezing, or contact with secretions from the nose and mouth of an infected person. Re-infection is not possible after recovery from fifth disease.

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Other signs and symptoms of fifth disease may include:

• Fever
• Headache
• Sore throat
• Runny nose
• Swollen glands
• Joint pain
• Red, swollen eyes
• Fatigue

It is important to note that fifth disease is most contagious before the rash appears, making it difficult to prevent the spread of the virus. If you suspect that you or your child has fifth disease, it is recommended to see a healthcare provider for proper diagnosis and treatment.

How Is Fifth Disease Treated?

There is no specific cure for fifth disease, and most children recover without medical intervention. Acetaminophen or ibuprofen may be beneficial in managing fever or joint discomfort.

Avoid giving ibuprofen to children under 6 months old and use over-the-counter cold or cough medications cautiously with children under 6 years old.

It is important for children with fifth disease to get plenty of rest and stay hydrated. If symptoms persist or worsen, consult a healthcare provider for further evaluation and guidance.

Preventing the Spread of Infection

Currently, there is no vaccine available to prevent fifth disease. To minimize the spread of the infection, pregnant women should avoid contact with infected children as it could harm an unborn child.

Other ways to prevent the spread of infection include practicing good hand hygiene by washing hands frequently with soap and water, covering the mouth and nose when sneezing or coughing, and avoiding sharing personal items such as utensils and cups.

When To Call the Doctor

If your child experiences a fever above 102°F after treatment, severe joint pain or swelling, or has a condition that weakens the immune system, contact a healthcare provider.

Return to School

Once the rash disappears and there is no fever, your child can safely return to school.

Helping Hands Patient Education Materials

Created by healthcare professionals at Nationwide Children’s Hospital, Helping Hand instructions complement advice from healthcare providers and are periodically reviewed and updated.

A viral rash, also known as exanthem, is a skin rash often associated with viral infections.

Key Symptoms

Common symptoms of viral rashes include itchy, red skin, flat or raised lesions, and fever.

Diagnosis

Viral rashes are diagnosed through physical examinations performed by doctors.

Treatment

Treatment for viral rashes varies depending on the type of rash and the presenting symptoms.

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Types of Viral Rashes

Chickenpox

What is chickenpox?

Chickenpox is a highly contagious disease that primarily affects children and is caused by the varicella-zoster virus. It spreads through direct contact or airborne transmission.

What is the chickenpox vaccine?

Since 1995, a vaccine has been available for children over 12 months old. Health authorities recommend it for disease prevention.

What are the symptoms of chickenpox?

Symptoms can range from mild to severe and vary among individuals, typically including fatigue, rash, fever, and malaise.

How is chickenpox spread?

Chickenpox is contagious before and during the appearance of the rash, and it can be transmitted within families.

How is chickenpox diagnosed?

Diagnosis is typically based on a physical examination due to the unique chickenpox rash.

What is the treatment for chickenpox?

Treatment focuses on symptom relief and preventing complications. Avoid giving aspirin to children.

What is immunity from chickenpox?

Most individuals develop lifelong immunity after a chickenpox infection, although the virus can reactivate years later, causing shingles.

What complications are associated with chickenpox?

Complications can occur, especially in vulnerable populations, leading to secondary infections, pneumonia, or encephalitis.

• Cerebellar ataxia
• Transverse myelitis
• Reye syndrome
• Death

Fifth Disease

What is fifth disease?

Fifth disease, also called erythema infectiosum or “slapped cheek” disease, is a viral illness that causes a rash. It spreads from person to person through direct contact with nasal and throat fluids or infected blood.

What causes fifth disease?

The cause of fifth disease is human parvovirus B19, with most cases occurring in the winter and spring.

Which children are at risk for fifth disease?

Fifth disease is most common in young school-age children who often contract it at school. While adults can also get fifth disease, it mainly affects children.

What are the symptoms of fifth disease?

Children exposed to fifth disease typically develop symptoms within 4 to 14 days. The rash, a primary symptom, starts on the cheeks and spreads to the trunk, arms, and legs, lasting 2 to 4 days with a “lacey” appearance. Early symptoms may include low fever, headache, runny nose, sore throat, itching, nausea, vomiting, or diarrhea.

Warning

Pregnant women exposed to fifth disease should seek immediate medical attention. While the disease is usually mild, severe anemia can occur in individuals with certain conditions, and fetal death is a risk if contracted during pregnancy.

How is fifth disease diagnosed?

Healthcare providers diagnose fifth disease based on symptoms, physical exams, and occasionally blood tests.

What is the treatment for fifth disease?

As fifth disease is caused by a virus, treatment centers on alleviating symptoms, such as ensuring adequate fluid intake, using acetaminophen or ibuprofen for fever and discomfort, and taking antihistamines for itching.

Possible complications of fifth disease in a child

Fifth disease is typically mild, but severe anemia can occur in cases with underlying conditions. Pregnant women with fifth disease have a small risk of fetal death.

Slapped cheek syndrome, also known as fifth disease, is a viral infection most frequently found in children. It typically results in a red rash on the cheeks.

Slapped cheek syndrome usually has a mild course and resolves spontaneously in 1 to 3 weeks, providing lifelong immunity post-infection.

Symptoms of slapped cheek syndrome

Symptoms of slapped cheek syndrome appear 4 to 14 days after infection, sometimes even up to 21 days later.

First symptoms

Initial symptoms may include low-grade fever, runny nose, sore throat, headache, upset stomach, and general discomfort. Joint pain and stiffness may persist in adults.

Slapped cheek rash

A bright red rash on the cheeks emerges a few days after infection, later spreading to the body before fading within weeks. It may reappear due to sunlight, heat, cold, or skin injury triggers.

When to get medical advice

Most cases of slapped cheek syndrome resolve without medical intervention. Consult a doctor if you have specific risk factors or severe symptoms.

Speak to your GP practice if:

Individuals with certain medical conditions, pregnant women, or severe symptoms should promptly seek medical assistance. A blood test may confirm immunity status or detect severe complications like severe anemia.

What to do if you or your child has slapped cheek syndrome

Treatment for slapped cheek syndrome focuses on symptom relief, including rest, fluids, pain relievers, and antihistamines for itching.

How do you get slapped cheek syndrome?

Slapped cheek syndrome is caused by parvovirus B19 and is transmitted through respiratory droplets and contaminated surfaces. It is most contagious before the rash appears.

Preventing slapped cheek syndrome

The prevention of slapped cheek syndrome is challenging due to its early contagious stage. Practicing good hand hygiene and taking general precautions can help reduce transmission, as there is currently no available vaccine.

Fifth disease, also known as erythema infectiosum or “slapped cheek” disease, is a viral illness that causes a rash. It spreads through direct contact with fluids from the nose and throat or infected blood. Children, especially those of school age, are predominantly affected, with symptoms emerging 4 to 14 days after exposure. The rash typically begins on the cheeks and is a vivid red color before extending to the torso, arms, and legs.

It is important for parents and caregivers to be aware of the symptoms of fifth disease, such as fever, headache, and a “slapped cheek” rash. If a child is suspected of having fifth disease, it is recommended to keep them home from school or daycare until the rash has faded to prevent further spread of the virus.

While there is no specific treatment for fifth disease, most children recover on their own without complications. However, pregnant women and individuals with weakened immune systems should seek medical advice if they suspect they have been exposed to the virus.

What causes fifth disease in a child?

Human parvovirus B19 is the cause of fifth disease, with higher prevalence during the winter and spring.

Which children are at risk for fifth disease?

Although adults can contract fifth disease, infections are primarily seen in children. Early symptoms may consist of low fever, headache, runny nose, sore throat, itching, nausea, vomiting, or diarrhea.

What are the symptoms of fifth disease in a child?

Approximately 4 out of 5 infected children experience mild symptoms for around a week before the rash appears. Most contagious before the rash, initial symptoms are usually very mild. The rash may reappear upon exposure to sunlight, heat, cold, or skin injury.

Other symptoms may include runny nose, sore throat, low fever, nausea, vomiting, and diarrhea.

How is fifth disease diagnosed in a child?

Diagnosis of fifth disease by healthcare providers is based on symptoms, physical examinations, and sometimes blood tests. The main focus of treatment is on relieving symptoms with the help of fluids, acetaminophen, ibuprofen, and antihistamines.

In addition to medication for symptom relief, it is important to ensure that the child gets plenty of rest and stays hydrated. Avoiding contact with pregnant women, newborns, and individuals with weakened immune systems is crucial, as fifth disease can be harmful to these groups. It is also recommended to practice good hygiene, such as washing hands frequently and covering the mouth and nose when sneezing or coughing, to prevent the spread of the virus.

What are possible complications of fifth disease in a child?

While fifth disease is generally mild, it can lead to severe anemia in children with specific conditions. Pregnant women are at risk of fetal death.

How can I help prevent fifth disease in my child?

To prevent the spread of fifth disease, it is important to practice good hygiene by washing hands regularly and covering the mouth when coughing or sneezing.

Additionally, it is recommended to avoid close contact with individuals who have been diagnosed with fifth disease until they are no longer contagious. It is also important to encourage your child to avoid sharing personal items, such as utensils or cups, with others to prevent the spread of the virus.

When should I call my child’s healthcare provider?

If symptoms worsen or new symptoms arise, it is advisable to contact a healthcare provider.

Key points about fifth disease in children

• Fifth disease results in a distinctive bright red rash on the cheeks that can spread to the body, arms, and legs.
• Transmitted through direct contact with nose and throat secretions or infected blood, it can be managed with medications to reduce fever and discomfort.

Next steps

Helpful tips to make the most of your child’s healthcare provider appointment:

• Have a clear purpose for the visit and prepare any questions beforehand.
• Take note of any new diagnoses, treatments, or medications.
• Understand the prescribed treatment and its potential side effects.
• Ask about alternative treatments and grasp the recommended tests or procedures.
• Know how to contact the provider outside regular hours in case of an emergency.