Fifth disease (Erythema Infectiosum)
Fifth disease is a common infection affecting the skin, upper
airway and joints. It is caused by a virus known as Parvovirus B19 and tends
to spread during the late winter to early spring.
What are the symptoms of fifth disease?
Some children may have no symptoms or only develop mild symptoms.
- Fifth disease usually appears as a very red rash on a child's cheeks, giving a "slapped cheek" look. Because of this, fifth disease is often referred to as “slapped cheek” disease.
- Low-grade fever (102°F [38.9°C]), headache, and mild cold-like symptoms (a stuffy or runny nose). Symptoms may also include an upset stomach (nausea and diarrhea).
- After 1 to 4 days, a red, lace-like rash appears, first on the torso and arms, and then spreads to the rest of the body. It can be quite itchy.
- The rash may last from 1 to 3 weeks. During that time, the rash may come and go. It can be worse with changes in temperature, exposure to sun, and exercise.
How does fifth disease spread?
This virus spreads the same as most cold viruses:
- By touching the hands of someone who has the infection and then touching your mouth, nose or eyes.
- By touching an object (such as a toy or a bottle) that has been touched by someone who has the infection and then touching your mouth, nose or eyes.
- By coming in contact with the virus in the air, after an infected person has coughed or sneezed.
The virus is most contagious a few days before the rash starts. Once the rash appears, it is less likely that your child can pass it to anyone else.
If a pregnant becomes infected, there is a small risk that her unborn child will be infected.
Can fifth disease be dangerous?
Fifth disease is usually very mild. It’s usually more severe in adults. Most people who had fifth disease as a child will not get it again.
- If a child with certain forms of chronic anemia (such as sickle cell) gets fifth disease, their condition may get worse.
- Fifth disease can be dangerous to people who are receiving chemotherapy.
What should I do if I’m pregnant and not immune to fifth disease?
Pregnant women who are not immune usually do not have serious complications after being exposed to others with fifth disease. In most cases, these babies will not have any problems. However, sometimes a baby will develop severe anemia.
If you’re pregnant and develop a rash or have sore joints and have been exposed to someone with fifth disease (or to anyone with an unusual rash), call your health care professional.
What can parents do?
- Encourage your child to rest and stay hydrated.
- To ease pain, aches or a fever, use acetaminophen. Ibuprofen may be used for children over 6 months old.
- There is no vaccine to prevent the infection and no medication to treat it.
- The best way to prevent the spread of any infection is to wash your hands often.
- Children can continue to attend child care or school if they feel well enough to take part in the activities.
When should I call the doctor?
- If your child becomes ill with fifth disease and you are pregnant.
- If your child’s fever does not get better in 2-3 days, or they complain of ear pain or a sore neck.
Source: Well Beings: A Guide to Health in Child Care (3rd edition - Revised)
Reviewed by the following CPS committees
- Public Education Advisory Committee
Last updated: June 2023