Fifth Disease in Children

What is fifth disease in children?

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.

What causes fifth disease in a child?

Fifth disease is caused by human parvovirus B19. It occurs most often in the winter and spring.

Which children are at risk for fifth disease?

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. 

What are the symptoms of fifth disease in a child?

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

  • Headache

  • Runny nose

  • Sore throat

  • Itching

  • Nausea or vomiting

  • Diarrhea

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.

How is fifth disease diagnosed in a child?

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.

How is fifth disease treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. The illness is caused by a virus. Antibiotics won't help your child.

The goal of treatment is to help ease symptoms. Treatment may include:

  • Having your child drink 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.

What are possible complications of fifth disease in a child?

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.

How can I help prevent fifth disease in my child?

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 should I call my child’s healthcare provider?

Call the healthcare provider if your child has:

  • Symptoms that don’t get better, or get worse

  • New symptoms

Key points about fifth disease in children

  • 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.

Next steps

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.