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Fifth ("Slapped Cheek") Disease


Fifth disease is a very mild disease characterized by a bright red or rosy rash on both cheeks. It begins with a low-grade fever, headache, and mild cold-like symptoms (a stuffy or runny nose.) After these symptoms disappear, the illness seems to be gone until a rash appears a few days later. The bright red rash typically begins on the face. Several days later, the rash spreads, and red blotches (usually lighter in color) extend down to the trunk, arms, and legs. As the centers of the blotches begin to clear, the rash takes on a lacy appearance. It may reappear for one to three weeks, especially after warm baths, exercise, and sun exposure. The rash does not itch.

Fifth disease is caused by the human parvovirus B19. (It was so named because it was the fifth pink-red infection rash to be described by physicians; the others are scarlet fever, measles, rubella, and roseola.)

No treatment is necessary.

A person with parvovirus infection is most contagious before the rash appears — either during the incubation period (the time between infection and the beginning of symptoms) or during the time when he or she has only mild respiratory symptoms. A child is usually not contagious once the rash appears. Parvovirus B19 spreads from person to person in fluids from the nose, mouth, and throat, especially through large droplets from coughs and sneezes.

Children with the rash of fifth disease may attend childcare or school since they are no longer contagious.

There is no real way to prevent spreading the virus. Isolating someone with a fifth disease rash won't prevent the spread of the infection because the person usually isn't contagious by that time. Practicing good hygiene, especially frequent hand washing, is always a good idea since it can help prevent the spread of many infections.

* If you, or someone else who is close to the child with fifth disease, are pregnant and exposed to a child with fifth disease, see your obstetrician. Parvovirus B19 infection during pregnancy may cause problems for the fetus.

* People with compromised immune systems are also at risk for developing serious illness; consult your health care provider.

For more information: KidsHealth page on fifth disease