5th disease (Slapped Cheek Disease)

This page answers questions on 5th disease which is also known as erythema infectiosum or slapped cheek disease because of the characteristic appearance of the rash. This is a common childhood disease.

What is 5th disease?

Fifth disease is a viral disease that causes a fever and rash in children. It is also known as erythema infectiosum or slapped cheek disease.

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What are the symptoms of slapped cheek disease?

With fifth disease your child will usually be unwell with fever for a few days. He will feel miserable and may complain of a headache. A rash will appear a few days after his symptoms started and it gives the appearance of slapped cheeks.

The cheeks look very red just like someone has slapped them. A few days after the slapped cheek appearance, there may also be a lacy red rash on the arms or legs (see bottom photos).

5th disease cheek rashFifth disease rash
slapped cheek appearanceSlapped Cheek appearance

A few days after the slapped cheek appearance, there may also be a lacy red rash on the arms or legs.

Fifth disease arm rashFifth disease arm rash
Fifth disease leg rashLacy 5th disease leg rash

The rash in 5th disease lasts a few days, but it is not unusual to see the rash reappear, sometimes for weeks after, when your child gets hot or exercises.

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What causes 5th disease?

Fifth disease of children is caused by a virus called parvovirus (human parvovirus B19 to be exact).

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Is parvovirus infection dangerous?

In most cases, it is not dangerous. Some children get infection with parvovirus and don't even have any symptoms.

However, in children with sickle cell anemia or thalassemia, it can cause severe anemia (aplastic crisis).

Pregnant women should avoid contact with parvovirus as it can cause disease in the unborn baby.

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What is the treatment of slapped cheek disease?

There is no specific treatment.

If your child is very miserable, you can keep him comfortable with Paracetamol or Acetaminophen.

Keep him drinking so he doesn't get dehydrated.

See your doctor if:

your child has sickle cell anemia or thalassemia

you are pregnant

your are worried your child is very ill

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Do I need to keep my child away from daycare or school?

The infectious time of slapped cheek disease is usually before the rash appears, so before you know he has the illness. Once the rash is visible, your child is no longer infectious so doesn't have to be excluded from daycare or school.

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References

  • Lissauer T, Clayden G. Illustrated Textbook of Paediatrics. Mosby. 1999

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Last reviewed 14 May 2011

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Dr Maud MD

Dr Maud MD (MBChB, FRACP, FRCPCH), a specialist pediatrician, provides health information and medical advice for parents of babies and toddlers. Read more about Dr Maud.



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