Fifth Disease (Erythema Infectiosum or Slapped Cheek Disease)

What is fifth disease?

Fifth disease is a mild viral illness caused by human parvovirus B19. It is most common in school-aged children, but can occur at any age.

How is fifth disease spread?

Fifth disease is spread through:

• contact with nose and throat secretions (example: dirty tissues, sharing utensils) from an infected person
• mother to fetus  
• rarely: transfusion with infected blood or blood products

What are the symptoms of fifth disease?

Mild symptoms may include:

• tiredness, fever, headache, and muscle aches and pains 
• cold symptoms
• later a bright red rash on the cheeks ("slapped-cheek") 
• lace-like, itchy rash on the trunk, legs and arms that may come and go 
• adults - sore and swollen joints for days or months

People with weak immune systems (example: cancer, HIV) may develop anemia (low iron in the blood). Pregnant women who are infected during the first half of their pregnancy may have problems such as fetal anemia, and rarely miscarriage. Fifth disease is diagnosed through assessing the above symptoms or a blood test.

How long does fifth disease last?

Symptoms appear 4 to 20 days after contact with the virus.  Symptoms can last 1 to 3 weeks or longer. Fifth disease can be spread to others a few days before the rash appears. People with weak immune systems can spread the virus for a longer time (months or years).

How is fifth disease treated?

There is no specific treatment for fifth disease, but to ease mild symptoms:

• take fever or pain medication for fever or sore joints (Aspirin is not recommended for children)
• get plenty of rest and fluids, and eat a well-balanced diet for tiredness and weakness

How is fifth disease prevented?

There is no vaccine for fifth disease.  To prevent fifth disease:

• carefully throw away contaminated objects such as dirty tissues
• do not share eating utensils
• wash your hands often

People with weak immune systems and pregnant women in the first half of their pregnancy should avoid contact with people who have fifth disease.  Pregnant women at higher risk (example: day care workers) should be aware of how fifth disease is spread, prevented, and potential problems for the unborn baby. 

Related Links

Parvovirus B19 (Fifth Disease) (Centre for Disease Control)

Parvovirus B19 Infection and Pregnancy (Centre for Disease Control)

Review Date : January 2004

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