Fifth Disease

What is fifth disease?

Fifth disease is a mild viral infection that is more common in children. It is caused by human parvovirus B19. The medical name for fifth disease is erythema infectiosum.  It is called fifth disease because it was fifth on a list of illnesses that caused rashes in children in the past. The others included measles, rubella (German measles), chicken pox, scarlet fever, and roseola. Fifth disease is sometimes called “slapped cheek disease.” The illness’s bright red rash on the face looks like the child has been slapped.

About half of people get fifth disease sometime during childhood or their teens. Once you’ve had fifth disease, you will not be at risk of getting it again.

Symptoms of fifth disease

The first signs of fifth disease are mild flu- or cold-like symptoms, including:

  • low-grade fever
  • sore throat
  • headache
  • stuffy or runny nose
  • fatigue.

After a few days of these symptoms, your child may develop a bright red, raised rash on his or her face. The rash may then spread to the arms, legs, and trunk of the body. After 5 to 10 days, the rash usually fades. It fades from the center outward, making it look blotchy or “lacy.” It could show up again when your child gets hot or is out in the sun. This could go on for several weeks or months after the illness.

Adults who catch the virus usually don’t develop the rash. Instead, they are more likely to experience joint pain or swelling. This usually happens in the hands, wrists, knees, and ankles. It can last several months, but usually gets better after 1 to 2 weeks. Some adults who get fifth disease don’t experience any symptoms.

Symptoms usually show up 4 to 14 days after exposure. The rash may not appear for as long as 3 weeks. Once your child has the rash, he or she is not contagious anymore.

What causes fifth disease?

Fifth disease is caused by parvovirus B19. This is not the same parvovirus that can infect dogs and cats. It is spread when you or your child come into contact with saliva or mucus carrying the virus. It can be spread by coughing, sneezing, or sharing items. It can also be spread through blood. A pregnant woman who has fifth disease could pass it to her baby.

How is fifth disease diagnosed?

Your doctor can usually tell if your child has fifth disease by seeing the “slapped cheek” rash. A blood test can be used, but it is not usually needed.

Can fifth disease be prevented or avoided?

There is no vaccine for fifth disease. You can prevent your child from getting it by helping him or her practice good hygiene habits. These include:

  • Washing hands often with soap and water.
  • Covering the mouth and nose with their elbow when coughing or sneezing.
  • Not touching the eyes, nose, or mouth.
  • Avoiding close contact with anyone who is sick.
  • Keeping them home when they are sick.

Fifth disease treatment

Most cases of fifth disease are mild. They go away without treatment. You can treat fever and flu symptoms in your child with acetaminophen (Tylenol).

Adults who have joint pain or swelling may need to rest and restrict activity. They may want to take medicines like Tylenol or ibuprofen (Advil or Motrin) for the pain.

Living with fifth disease

Most children and adults who get fifth disease experience only mild illness. They recover completely and have no complications. But fifth disease can cause problems in certain cases:

  • Pregnant women who have been exposed to fifth disease should call their doctor. In about 5% of pregnant women, the baby develops severe anemia. When this happens, miscarriage or stillbirth can occur. The mother can take medicines to treat the virus. In some cases, the unborn baby might need a blood transfusion. If you are pregnant, talk to your doctor about fifth disease. He or she can tell you if you need to take any special steps to avoid the virus. The infection does not cause birth defects or developmental problems.
  • Weak immune system. People who have immune system problems may need special treatment to help fight the infection. This includes people who have had organ transplants, or who have cancer or HIV.
  • Chronic anemia. People with sickle-cell disease or other types of chronic anemia could have problems if they get fifth disease. They could develop severe anemia that requires blood transfusions.

Questions to ask your doctor

  • I’m pregnant. What do I need to do to keep my baby safe?
  • What treatment is best for me?
  • How long will I be contagious?
  • How long should I keep my child home from school?
  • What can I do to make my child more comfortable?
  • Should I tell my child’s school that he/she has fifth disease?
  • My rash keeps coming back when I spend time outside. Is that normal?