Fifth Disease

Last Updated October 2023 | This article was created by editorial staff and reviewed by Beth Oller, MD

What is fifth disease?

Fifth disease is a mild viral infection caused by human parvovirus B19. It’s more common in children than adults. The disease got its name because it was fifth on a list of illnesses that caused rashes in children in the past. 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 it, you are unlikely to be at risk of getting it again.


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 their 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. 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’re 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, they are not contagious anymore.


Fifth disease is caused by parvovirus B19. This isn’t the same parvovirus that can infect dogs and cats. It’s spread when you or your child comes 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 this disease could pass it to her baby.


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


There is no vaccine for fifth disease. You can prevent your child from getting it by helping them 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


Most cases of fifth disease are mild. It usually goes away without treatment. You can treat fever and flu symptoms in your child with acetaminophen (brand name: Tylenol).

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

Living with fifth disease

Most children and adults who get fifth disease recover completely and have no complications. But this 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 can develop 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’re pregnant, talk to your doctor about fifth disease. They can tell you if you need to take any special steps to avoid the virus. The infection doesn’t cause birth defects or developmental problems.
  • Weak immune system. People who have immune system problems may need special treatment to help fight fifth disease. 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 this illness. 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?
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