FAQ: What Is Fifth Disease?

A child's rosy cheeks are usually adorable. Sometimes, though, rosy cheeks are the result of a rash and are a sign of illness. Fifth disease, which is sometimes referred to as slapped cheek disease, is a viral infection that shows up on your child’s face as a rash that can be mistaken for rosy cheeks. Although the illness is not typically serious, it’s worth knowing about in case your child becomes infected.

Read on to find out more about fifth disease in kids, including why it is called fifth disease, the signs and symptoms to watch for, how it can be prevented, and when to pay a visit to your child’s healthcare provider.

What Is Fifth Disease?

Fifth disease (also known as slapped cheek disease) is a viral illness caused by parvovirus B19 that is spread from person to person. The illness is most common in children aged 5 to 15. It’s considered a mild disease because most children feel fine even when the rash is present. Children who have sickle cell anemia are at risk for complications if they contract fifth disease.

You’re probably wondering, “Why is it called fifth disease?” Officially the disease is called erythema infectiosum, but it got the name “fifth disease” because it was fifth in line in a historical list of common childhood illnesses that involved a rash. The other four are

• measles

• rubella

• chicken pox

• roseola.

Luckily, once your child has had fifth disease, they will be immune to it in the future.

How Long Does Fifth Disease Last?

Overall, fifth disease may last around 1 to 3 weeks, generally starting with cold-like symptoms followed by the characteristic rash. So, how long does the rash from fifth disease last? This might last between 5 and 10 days. The rash may come and go for several weeks beyond that initial period.

Fifth Disease Incubation Period

Once someone is infected, it can take 4 to 14 days for the first cold-like symptoms of fifth disease to appear.

Is Fifth Disease Contagious and For How Long?

Fifth disease is contagious during the time before the rash appears, when your child may experience cold-like symptoms. Your child is no longer contagious when the rash appears. Ideally, however, even during the period when your little one has the rash, and especially if they have a fever, you should keep your child away from others so as not to spread the virus.

If your child has fifth disease, it’s especially important to keep them away from pregnant people, as it can cause serious problems in the unborn baby if the parent gets infected with the virus during pregnancy (but luckily most adults have been exposed to Fifth Disease and have antibodies to protect them).

How Is Fifth Disease Diagnosed?

If you believe your child might have fifth disease, it’s a good idea to call their healthcare provider. The rash may resemble a rash from another more serious disease, so it’s safest to have your child’s provider check on your little one to determine the cause of the rash.

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Fifth Disease Stages

Fifth disease can sometimes be divided into three stages or phases which may overlap. These stages are:

1. Incubation Period. No symptoms are usually present during this time, and it typically lasts 4 to 14 days after exposure to the virus before symptoms appear.

2. Initial Stage (Prodromal Phase). This is when early cold-like symptoms appear and last for a few days. This phase is often mild and may go unnoticed.

3. Rash Stage. The characteristic “slapped cheek” rash appears and can last for several days to a few weeks. The rash will often spread over the rest of the body and appears lace- or net-like in appearance.

What Causes Fifth Disease?

As with many other viral illnesses, fifth disease is spread through the respiratory secretions (saliva, sputum, and mucus) of infected individuals when they sneeze or cough. Those with fifth disease are most contagious during this phase when the infection resembles the common cold. Fifth disease can also be spread through blood, which is why it’s important for those who are pregnant to stay away from infected individuals, as fifth disease can be passed onto the unborn baby during pregnancy. If you are pregnant and exposed to fifth disease, contact your healthcare provider.

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Can Fifth Disease Be Prevented?

There is no vaccine that protects against fifth disease, but there are some things you, your family, and your children can do to lessen the chance of anyone in your household getting the infection:

• Wash your hands often with soap and water for a minimum of 20 seconds

• When sneezing or coughing, cover your nose and mouth

• Avoid touching your face, especially your nose, eyes, and mouth

• Avoid people who may be sick with the virus

• If you are sick with fifth disease, stay home and avoid contact with others to help prevent its spread to others.

Fifth Disease Symptoms

The main symptom of fifth disease is a red rash that typically starts on your child’s cheeks, which is why it’s sometimes called slapped cheek disease. Within a few days, the rash, which can be itchy, may spread to your child’s arms, trunk, thighs, bottom, and feet. Adults usually don’t get the rash. The rash is slightly raised, starts out blotchy, and then appears with a lace- or net-like pattern. After 5 to 10 days, the rash usually fades. However, it can sometimes reappear weeks or months later, often showing up when a child is spending time in the sun or is exposed to extreme temperatures.

Fifth disease causes cold-like symptoms that precede the rash, such as

• sore throat

• headache

• stuffy or runny nose

• pinkeye

• fatigue

• mild fever

• diarrhea

• upset stomach

• itching

• swollen glands

• painful or swollen joints (hands, wrists, knees, or ankles), although this is more common in older children and adults.

Fifth Disease or Roseola?

Both fifth disease and roseola are common viral infections in children, but they have distinct characteristics that may help differentiate them.

Fifth disease is characterized by the distinctive “slapped cheek” rash that starts on the face before spreading to the body with a lace-like pattern. It’s less likely to have a high fever, while roseola generally begins with a high fever followed by a widespread rash starting from the trunk. The roseola rash consists of many small, flat pink spots or patches. If you’re unsure whether your little one has fifth disease, roseola, or something else, contact your healthcare provider for a diagnosis.

Fifth Disease Treatment

There is no specific treatment for fifth disease, though experts may recommend ways to relieve the symptoms. Fifth disease usually goes away on its own, and in most cases, your child will feel better after lots of rest and drinking plenty of fluids. If your child has a mild fever or aches and pains, their healthcare provider may recommend giving acetaminophen to help relieve these symptoms. If you have any questions about treatment, be sure to ask the provider.

When Should You Contact Your Child’s Healthcare Provider?

If your child’s condition worsens—for example, their fever spikes—or their symptoms don’t improve, contact the healthcare provider right away. In children who have a weakened immune system, fifth disease can be more severe. If this applies to your child, it’s best to see their healthcare provider at the first sign of fifth disease.

The Bottom Line

Fifth disease can leave your little one feeling under the weather. Offering a lot of comfort and TLC will help them feel better within a few days or weeks. The good news is that fifth disease will eventually pass, and things can get back to normal.