• Fifth Disease

    (Erythema Infectiosum; Parvovirus B19; Slapped Cheek Disease)


    Fifth disease is a viral infection that most often happens in children. The infection can cause a mild rash on the face, trunk, and limbs.
    Fifth Disease
    fifth disease
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    Fifth disease is caused by a virus called parvovirus B19. About half of all adults have been infected with this virus at some time in their life.
    The parvovirus is found in saliva, sputum coughed up from the lungs, and nasal mucus. It is usually spread from person to person through contact with those fluids.

    Risk Factors

    Fifth disease is more common in children.
    Contact with someone infected with parvovirus B19 may increase your chance of developing fifth disease.
    There is a parvovirus that can cause infections in cats and dogs. This is not the same virus that can make humans ill. Contact with an animal with a parvovirus will not make you ill.


    The first signs of fifth disease usually occur within 4-14 days after becoming infected. These symptoms may include:
    • Low-grade fever
    • Headache
    • Stuffy or runny nose
    A bright red rash on the face will begin to show a few days after these first signs. Several days later, this rash spreads down the trunk and limbs and will usually go away within 7-10 days.
    In some adults, there may be no symptoms or rash. Adults are more likely to have joint pain and swelling with this infection.


    You will be asked about your symptoms and medical history. A physical exam will be done.
    Tests may include the following:
    • Examination of the rash
    • Blood test to identify antibodies to parvovirus


    Talk with your doctor about the best treatment plan for you. Usually, fifth disease does not require any treatment other than rest.
    Treatment options include the following:


    Some medications may help relieve some symptoms:
    • Acetaminophen or ibuprofen may help reduce joint pain or fever.
    • Anti-itch medications may be used to relieve itching caused by the rash.
    Antiviral medications can prevent or weaken infections caused by specific viruses. Right now, there are no antiviral medications for fifth disease.

    People With Chronic Anemia

    Fifth disease can cause more severe symptoms if you have sickle cell disease or other types of chronic anemia. You may develop a very low level of red blood cells called severe anemia. The anemia will need immediate care which may include hospitalization and blood transfusions.

    People With Immune Problems

    Weakened immune systems can lead to a more severe infection. If you have immune problems, special medical care may be advised.

    Women Who Are Pregnant

    This type of infection can cause problems in about 5% of pregnant women. A parvovirus B19 infection during pregnancy may cause a miscarriage or severe anemia in the baby. If you are pregnant and believe that you may have this infection or have been exposed to someone with the infection, see your doctor.


    It is difficult to prevent the spread of fifth disease because the virus is most easily passed on before the rash appears. People may not know they are infected.
    To help reduce your chances of getting any virus:
    • Practice good hygiene.
    • Wash your hands often.
    • Try to avoid touching your eyes, mouth, and nose.
    • Avoid close contact with people who are infected. Wash your hands after coming in contact with someone who has a virus.


    Family Doctor—American Academy of Family Physicians http://familydoctor.org

    United States Centers for Disease Control and Prevention http://www.cdc.gov


    AboutKidsHealth—The Hospital for Sick Children http://www.aboutkidshealth.ca

    HealthLink BC http://www.healthlinkbc.ca


    Fifth disease. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/parent/infections/bacterial%5Fviral/fifth.html. Updated January 2014. Accessed October 31, 2014.

    Fifth disease. US Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/parvovirusB19/fifth-disease.html. Updated February 14, 2012. Accessed October 31, 2014.

    Parvovirus B19 infection. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115232/Parvovirus-B19-infection. Updated July 13, 2015. Accessed September 27, 2016.

    Pregnancy and fifth disease. US Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/parvovirusB19/pregnancy.html. Updated February 14, 2012. Accessed October 31, 2014.

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