Fifth Disease (Slapped Cheek Syndrome) - Basics & Causes - WebMD

What Is Fifth Disease?

Fifth disease, or erythema infectiosum, is a contagious viral infection common among school-age children. It's most common during winter and spring.

Fifth disease got its name many years ago when it was the fifth on a list of the six recognized childhood rash-forming illnesses. The others include rubella, measles, scarlet fever, chickenpox, and roseola infantum.

Fifth Disease Symptoms

The most recognized symptom of fifth disease is a sudden, bright red rash across the cheeks that looks as if the child has been slapped. You might also hear it called slapped-cheek disease. The disease is rare in infants and adults. 

The rash typically appears a week to 10 days after symptoms similar to those of the common cold, such as: 

  • Stuffy or runny nose
  • Sore throat
  • Mild fever
  • Fatigue
  • Headaches
  • Muscle aches
  • Joint pain (more common in adults)

Fifth Disease Causes

Fifth disease is caused by parvovirus B19. This parvovirus only infects humans. Other forms of the virus can infect dogs and cats.

Fifth Disease Transmission

Fifth disease is spread through blood and by respiratory droplets that enter the air when an infected person coughs or sneezes. Adults who work with young children -- such as child care providers, teachers, and health care workers -- are most likely to be exposed.

By the time the rash appears, children are no longer contagious and may attend school or day care. The incubation period (the time between infection and signs or symptoms of illness) is usually 4-14 days, but it can be as long as 21 days.

Fifth Disease Diagnosis

A doctor can often diagnose fifth disease by looking at the rash. They might do a blood test to check for antibodies to the virus that causes the disease. This test isn't routine. It's usually only done in certain situations, for example, if you're pregnant.   

Fifth Disease Treatment

The goal of fifth disease treatment is to ease symptoms and make you or your child more comfortable. There's no specific medicine to treat the virus that causes fifth disease. Your doctor might suggest:

  • Acetaminophen to help lower fever and relieve muscle aches and pains. 
  • Antihistamines to treat itching that may come with the rash.

Fifth Disease Complications

Fifth disease is usually mild for otherwise healthy kids and adults and poses little risk to health. 

But it can cause chronic anemia in some people. You could need a blood transfusion, which would require a hospital stay. If you get the infection during the first half of pregnancy, you have a 10% risk of miscarriage and a small risk of severe anemia for your baby.

You're more likely to have serious complications from fifth disease if you have a weakened immune system. Conditions that can weaken your immune system include leukemia and other cancers, HIV infection, and organ transplants. 


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