Fifth Disease

Fifth disease is a viral illness that causes a rash (exanthem). Fifth disease is also called erythema infectiosum, or 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
• 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 health care provider for a diagnosis.

The health care 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.

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

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 health care 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 health care 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.

Call the health care provider if your child has:

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