Fifth Disease
(Parovirus, Slap Cheek Diseases)

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What is it?

Fifth disease, also called erythema infectiosum or "slapped cheek disease", is an infection caused by parvovirus B19. Outbreaks most often occur in winter and spring but a person may become ill with fifth disease at any time of the year.

What are the symptoms?

The initial presentation is a reddened area on the cheeks giving a "slapped face" appearance that may be accompanied by a low grade fever. After 1-4 days, a red, lace-like rash appears on the arms, legs and trunk. The rash may come and go over the next 1-3 weeks. Fever, heat, bathing, exercise, and sunlight exposure may lead to reappearance. In adults the rash is often absent but joint pain can last from days to months.

How is it spread?

Fifth disease spreads from person to person through direct contact or by breathing in respiratory secretions from an infected person. After exposure, symptoms may develop 4-20 days later. During pregnancy it can be passed from mother to fetus.

What it the period of infectiousness?

The period of infectiousness is before rash onset. Once the rash appears, a person is no longer contagious.

How is it treated?

There is no treatment for fifth disease and no vaccine is yet available.

Are there complications?

Most people who get fifth disease are not very ill and recover without any serious consequences. The majority of adults had fifth disease in childhood and will not get it again if exposed to a child with the infection; however, children with sickle cell anemia, chronic anemic or an impaired immune system may become seriously ill when infected with parvovirus B19 and will require medical care. Susceptible pregnant women should notify their physicians when in continuous close contact with people infected with fifth disease due to possible fetal complications. Susceptibility can be tested by a blood test.

Are there exclusions?

There are no exclusion guidelines for fifth disease. A child who has been diagnosed with fifth disease does not need to be excluded from school or childcare as long as they are well enough to take part in the activities.