Fifth disease is viral illness that most kids recover from quickly and without
complications. Also called erythema infectiosum, it's caused by parvovirus B19. It's
especially common in kids ages 5 to 15.
Fifth disease causes a distinctive red rash on the face that makes a child appear
to have a "slapped cheek." A few days later, the rash spreads down to the trunk, arms,
and legs. It usually lasts 1 to 3 weeks.
In older kids and adults, fifth disease can cause joint swelling and pain that
can last from weeks to months and, very rarely, years.
Signs and Symptoms
Fifth disease begins with a low fever,
headache, and mild cold-like symptoms (like a stuffy or runny nose). These symptoms
pass, and the illness seems to be gone until the rash appears a few days later. Kids
younger than 10 are most likely to get the rash.
The bright red rash usually starts on the face. Then, red blotches (usually lighter
in color) appear on the trunk, arms, and legs. After a few days, the rash, which can
be itchy, takes on a lacy net-like look.
In the time that it takes for the rash to completely clear, it may seem to get
worse before it finally fades away.
Sometimes fifth disease also can cause swollen glands, red eyes, sore throat, diarrhea,
and rarely, rashes that look like blisters or bruises. Joint swelling or pain (often
in the hands, wrists, knees, or ankles) can sometimes happen, especially in adults
and older teens.
Is Fifth Disease Contagious?
Yes. Because the rash is due to an immune system reaction that happens after
the infection has passed, someone with fifth disease is most contagious before
the rash appears. Kids usually don't spread the infection once they have the rash.
Can Fifth Disease Be Prevented?
There is no vaccine to prevent fifth disease, and no real way to prevent spreading
the virus because a person usually isn't contagious by the time the rash appears.
well and often is always a good idea because it can help prevent the spread of many
How Is Fifth Disease Diagnosed?
Doctors can usually diagnose fifth disease by seeing the distinctive rash on the
face and body. If someone doesn't have the rash but does have other symptoms, the
doctor may do blood tests to see if they're caused by fifth disease.
How Is Fifth Disease Treated?
Fifth disease is caused by a virus, so can't be treated with antibiotics (antibiotics
kill bacteria, not viruses). In most cases, this is a mild illness that clears up
on its own, so no medicine is needed.
Usually, kids with fifth disease feel OK and just need to rest. After the fever
and mild cold symptoms are gone, there may be little to treat except any discomfort
from the rash.
If your child's rash is itchy, ask the doctor for advice about easing discomfort.
The doctor may also recommend acetaminophen
for a fever or joint pain. Do not give aspirin to your child, as
it has been linked to a rare but serious illness called Reye
Fifth disease might cause some children with weakened immune systems (such as those
with AIDS or cancer) or
with certain blood disorders (like sickle
cell disease or hemolytic anemia) to become ill. The virus that causes it (parvovirus
B19) can temporarily slow down or stop the body's production of oxygen-carrying red blood cells (RBCs). This
can lead to severe anemia,
which needs to be treated in a hospital.
Parvovirus B19 infection during a woman's pregnancy may cause problems for the
fetus, especially during the first half of the pregnancy.
When to Call the Doctor
Call the doctor if your child develops a rash, especially if the rash is widespread
over the body or accompanied by other symptoms, like fever, cold symptoms, or joint
If you're pregnant and develop a rash or if you've been exposed to someone with
fifth disease (or to anyone with an unusual rash), call your health care provider.