What is it?

Fifth disease is caused by a virus, human parvovirus B19. It is sometimes called “slapped cheek” disease because of the appearance of the rash.

Signs and Symptoms

  • Flu-like symptoms (e.g., runny nose, sore throat, mild body weakness and joint pain, fever) may be present about 7 days before onset of rash.

  • Raised, red rash that first appears on child’s cheeks. The lace-like rash spreads to the rest of the body after 1 – 4 days, first on torso and arms, and then on to the rest of the child’s body. After the rash fades, it may continue to re-appear for 1 – 3 weeks when child is exposed to sunlight or heat (e.g., bathing).

  • At least 50% of adults had fifth disease as a child and won’t get it again.

The disease is usually mild, but in certain risk groups it can have serious consequences:

  • In pregnant women, infection in the first trimester has been linked to hydrops fetalis, causing spontaneous miscarriage.

  • Fifth disease can be transmitted from a pregnant woman to her unborn baby.

  • The baby can get severe anemia that leads to congestive heart failure.

  • In people with sickle-cell disease or other forms of chronic hemolytic anemia such as hereditary spherocytosis, infection can precipitate an aplastic crisis.

Incubation Period

Usually 4 – 20 days from contact with infected person.

When is the person contagious?

Usually for 7 – 10 days before onset of rash. Once the rash appears, the child can no longer pass it on to anyone else.