Fifth Disease (Erythema Infectiosum)

Fifth disease is a common childhood illness caused by parvovirus B19. It’s best known for a “slapped cheek” facial rash and a lacy pink rash on the body. Most cases are mild.

What causes it and how it spreads

  • Parvovirus B19.
  • Spreads through respiratory droplets (coughs, sneezes) and close contact.
  • People are most contagious before the rash appears; by the time the rash shows, they’re usually not contagious.

Typical symptoms

  • Mild fever, runny nose, headache.
  • Bright red cheeks (“slapped cheek” look), then a lacy, net-like rash on the arms, legs, and trunk that may come and go for weeks, especially with heat or sun.
  • In teens and adults, joint aches (hands, wrists, knees) can occur for days to weeks.

When to seek medical advice

  • If you’re pregnant or have a weakened immune system and were exposed or have symptoms—call your clinician (parvovirus can affect the fetus or cause anemia in certain people).
  • If your child has a blood disorder (like sickle cell disease) or severe anemia—seek care promptly if exposed or symptomatic.
  • High fever lasting more than 3 days, trouble breathing, or your child seems very unwell.

How it’s diagnosed

  • Usually by the look of the rash and story.
  • Blood tests are sometimes used in pregnancy, immune problems, or unclear cases.

Care at home

  • This illness usually goes away on its own.
  • Fever or discomfort: acetaminophen or ibuprofen as directed.
  • Rest and fluids.

School and contagion

  • Because kids are most contagious before the rash, most can attend school once they feel well—follow school guidance.

What to expect

  • Rash may fade and then reappear with heat, exercise, or stress for several weeks—this is normal.
  • Joint pains in adults usually get better; see your clinician if pains last or worsen.

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