Skip Ribbon Commands
Skip to main content
Skip Navigation LinksBoys Town Pediatrics > Knowledge Center > Health Articles > Fifth Disease (Erythema Infectiosum) in Children

Fifth Disease (Erythema Infectiosum) in Children

By Melinda Winterscheid, M.D.

Toddler with Rosy Cheeks

​Fifth disease (erythema infectiosum) is a mild viral infection that is most common in children ages 5 to 15. It is sometimes referred to as "slapped cheek syndrome" because of the telltale rash it causes on the infected child's face.​

What Causes Fifth Disease?

Fifth disease is caused by parvovirus B19. It spreads from person to person via fluid from the nose, mouth or throat. A child can contract the virus by sharing a drink with an infected individual or coming into contact with droplets in the sneeze or cough of someone who has fifth disease.

Symptoms of Fifth Disease

Symptoms of fifth disease manifest in two distinct stages. Fifth disease is contagious during stage one. The infected child may have mild flu-like symptoms that can include:

  • Low-grade fever
  • Headache
  • Nasal congestion
  • Upset stomach

In stage two, the child is no longer contagious. At this point in the virus, a bright red rash will develop. The rash often begins on the face and spreads to the torso, buttocks, arms and legs. The appearance of the rash may vary from person to person. For many, the rash begins as a cluster of red spots and takes on a "lacy" appearance as the rash heals and the spots lighten.

It may take one to three weeks for the rash to completely heal, and it is not uncommon for it to become temporarily worse during the healing process.

Less common symptoms of fifth disease include:

  • Diarrhea
  • Swollen glands
  • Red eyes
  • Sore throat
  • Swollen joints (more common in older children and adults)

Fifth Disease Treatments

Because fifth disease is a virus, it cannot be treated with antibiotics. Infected individuals are encouraged to get plenty of rest.

Treatment can be provided to make the symptoms of fifth disease more manageable. If your child is experiencing troublesome itching or joint pain, consult your physician for a treatment plan.

​Fifth Disease Prevention

There is no vaccine protecting against fifth disease. As with most viruses, the best defense is to practice proper hand hygiene. This is especially important because by the time the distinctive rash is visible, the contagious stage of the illness has already passed.​