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Fifth disease (Erythema Infectiosum)

Highlights
  • Fifth disease is usually very mild. Your child may not even feel sick.
  • Fifth disease can spread from a pregnant woman to her unborn child.
  • There is no vaccine to prevent the infection and no medication to treat it.

What is fifth disease?

Fifth disease is sometimes called “slapped cheek" syndrome because of the red rash it causes. It is an infection of the airway and lungs. Parvovirus B19 causes fifth disease. It’s most common in late winter to early spring.

How does fifth disease spread?

This virus spreads the same as a cold virus:

  • By touching the hands of someone who has the infection and then putting your hands in your mouth.
  • By touching an object (such as a toy) that has been touched by someone who has the infection and then putting your hands in your mouth.
  • By coming in contact with the virus in the air, after an infected person has coughed or sneezed.

The virus is most contagious a few days before the rash starts. Once the rash appears, your child can no longer pass it to anyone else.

This virus can spread from a pregnant woman to her unborn child.

What are the symptoms of fifth disease?

  • There may be no symptoms or only mild symptoms.  Fifth disease begins with a low-grade fever (102°F (38.9°C)), headache, and mild cold-like symptoms (a stuffy or runny nose).  There also be stomach upset (nausea and diarrhea.)
  • It starts as a very red rash on the cheeks that looks like the face has been slapped.
  • After 1 to 4 days, a red, lace-like rash appears, first on the trunk and arms, and then on the rest of the body.

The rash may last from 1 to 3 weeks. During that time, the rash may come and go.  It can be worse with changes in temperature, exposure to sunlight, and exercise.

Can fifth disease be dangerous?

Fifth disease is usually very mild. Your child may not even feel sick. It’s usually more severe in adults. Most people who had fifth disease as a child will not get it again.

  • If a child with certain forms of chronic anemia (such as sickle cell) gets fifth disease, their condition may get worse.
  • There is a very small risk that an unborn child can develop anemia before birth. If you are pregnant you can have a blood test done to determine whether you had fifth disease in the past. If you did, you would be immune to it now.
  • Fifth disease can also be dangerous to people who are having chemotherapy treatment.

What should I do if I’m pregnant and not immune to fifth disease? 

Pregnant women who are not immune usually do not have serious complications after being exposed to others with fifth disease. In most cases, these babies will not have any problems. However, sometimes a baby will develop severe anemia.

If you're pregnant and develop a rash or have sore joints and have been exposed to someone with fifth disease (or to anyone with an unusual rash), call your health care professional.

What can parents do?

  • There is no vaccine to prevent the infection and no medication to treat it.
  • The best way to prevent the spread of any infection is to wash your hands often.
  • Children can continue to attend child care or school if they feel well enough to take part in the activities.

When should I call the doctor?

• If your child becomes ill with fifth disease and you are pregnant.

Source: Well Beings: A Guide to Health in Child Care (3rd edition)


Reviewed by the following CPS committees:
Public Education Advisory Committee

Last Updated: December 2012

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