If your child has a low-grade fever and looks as though they've been slapped on the cheeks, they might have fifth disease. 

Don't worry. It sounds worse than it is.

Fifth disease 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.​

It's caused by parvovirus B19 and 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 manifest in two distinct stages.

Stage one: It's during this stage children are considered contagious. They may have mild flu-like symptoms that can include a low-grade fever, headache, nasal congestion and upset stomach.

Stage two: During this stage, children are 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.

There are some less common symptoms of fifth disease to look out for. They include diarrhea, swollen glands, red eyes, a sore throat and swollen joints. This last one is more common in older children and adults.

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

However, 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.

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.​


By Dr. Melinda Winterscheid is a pediatrician with Boys Town Pediatrics. Learn more about Dr. Winterscheid on the Boys Town Pediatrics website. Read more advice from Boys Town pediatricians on Momaha's expert advice page.

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