Fifth Disease

What is Fifth Disease?

Fifth disease is a mild rash and is also known as Slapped Cheek Syndrome, Slap cheek, Slap face, Slapped face, or Erythema infectiosum and is one of several possible signs of infection by parvovirus B19.

The name of the disease is derived from its place on the list of rash-causing childhood diseases which includes measles (1st), scarlet fever (2nd), rubella (3rd), and Duke’s disease (4th). Fifth disease often affects pre-schoolers and school-aged children during the spring.

The unmistakable sign of this illness is bright-red cheeks.  The disease is transmitted via fluids in the mouth and nose when someone sneezes or coughs but can also be spread by contact with infected blood. 20% of those who get the virus will not have symptoms.

What are the Symptoms of Fifth Disease?

The disease usually starts with  runny nose, low-grade fever, and headache. Later a rash will appear on the cheeks. Sometimes the rash will even cover the bridge of the nose and areas around the mouth. Some individuals also experience joint pain and swelling. The rash may itch and last anywhere from a couple of days to several weeks.

Teenagers and adults may experience self-limited arthritis and have difficulty walking and bending joints like wrists, ankles, knees, shoulders, and fingers. As the rash begins to go away it may have a lacy appearance.

Fifth Disease Causes

Fifth disease (Erythema infectiosum) is a mild viral infection that typically infects children who have been exposed to the Human Parvovirus B19. The disease takes anywhere from four to fourteen days to incubate and then manifests itself in a bright red rash on the cheeks, resembling the appearance of a slapped cheek. Fifth disease is easily spread through human contact and will often spread quickly through environments like an elementary school where children are in close contact. The virus is transmitted through saliva, mucus, coughing or sneezing. Many people who have actually contracted the virus never show any symptoms at all and it goes away on its own.

How is Fifth Disease Treated?

In most cases the disease will go away on its own.

Treatment includes

Drinking plenty of fluids and getting extra rest will help. Treatment focuses primarily on managing symptoms such as fever, itching, joint pain and swelling. Taking acetaminophen (Tylenol) can reduce pain.

Fifth Disease Prevention

In a patient with a normal, healthy immune system, fifth disease is not a serious infection, and once a person has been exposed and gone through the full infection, he or she is immune from getting it again. Fifth disease can be very dangerous for groups with fragile immunity, however, as well as those who suffer from anemia and pregnant women. Standard protocols for limiting infection can be very effective in preventing the spread of fifth disease. Frequent and thorough hand washing with soap and warm water is the single best prevention. Close supervision of young children should also be taken to avoid drinking or eating after each other, particularly if there are already infected children in the environment. Encouraging children to cover their mouths when they cough or sneeze can help prevent the spread of the virus. For people who have been exposed to the virus, it is helpful to avoid touching the eyes and mouth as that can introduce the virus into the bloodstream. Naturally, avoiding people who are already sick is ideal in preventing the spread of fifth disease. However, that can be very difficult because once the symptoms actually present themselves, especially the skin rash, the patient is usually no longer contagious.

Last Reviewed:
October 06, 2016
Last Updated:
December 22, 2017
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