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Pediatric Fifth Disease

What is fifth disease?

Fifth disease is a moderately contagious viral illness that causes a rash on the skin, but no fever, as with other viral illnesses. It is spread from one child to another through direct contact with discharge from the nose and throat and can also be spread through contact with infected blood.

What causes fifth disease?

Fifth disease is caused by the human parvovirus. It is most prevalent in the winter and spring and is usually seen in children ages 5 to 14. Outbreaks of the disease frequently occur in school settings.

What are the symptoms of fifth disease?

It can take between 4 to 14 days for a child to develop symptoms of fifth disease after being exposed to the disease. Children are most contagious before the rash occurs, meaning they are often contagious before they even know they have the disease. In addition, about 20 percent of people with fifth disease do not have symptoms but can still spread the disease.

The following are the most common symptoms of fifth disease. However, each child may experience symptoms differently.

  • There may be an early phase with the following symptoms, although this is not very common. If this happens, symptoms may include the following:
    • Fever
    • Headache
    • Red eyes
    • Sore throat
  • The rash is usually the primary symptom of fifth disease. The rash:
    • Starts on the cheeks and is bright red. The rash looks like slapped cheeks
    • Spreads to the trunk, arms, and legs, and lasts two to four days
    • May continue to reappear if the child is exposed to sunlight, very hot or cold temperature, or trauma to the skin. This may continue for several days


Pregnant women who have been exposed to fifth disease need to seek immediate medical attention.

Fifth disease is usually a mild illness. However, parvovirus B19 infection can cause an acute severe anemia in persons with sickle-cell disease or immune deficiencies. Also, there is a small risk of fetal death if fifth disease is acquired during pregnancy.

The symptoms of fifth disease may resemble other conditions or medical problems, so consult a physician for proper diagnosis.

How is fifth disease diagnosed?

Fifth disease is usually diagnosed based on a complete medical history and physical examination of the child. The rash and progression of fifth disease is unique, and usually allows for a diagnosis simply on physical examination. The physician may also order blood tests to aid in the diagnosis.

What is the treatment for fifth disease?

The specific treatment for fifth disease will be determined based on:

  • The child's age, overall health, and medical history
  • Extent of the disease
  • The child's tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the disease
  • Child or parent’s opinion or preference

Since it is a viral infection, there is no cure for fifth disease. The goal of treatment for fifth disease is to help decrease the severity of the symptoms. Treatment may include increased fluid intake or acetaminophen for fever (DO NOT GIVE ASPIRIN).

Children's Team

Children's Team





The Division of Dermatology at Children's National Health System continues to expand services as more families seek our expertise in the diagnosis and treatment of disorders of the skin, hair and nails.

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