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When Your Child Has Fifth Disease

Fifth disease is a viral infection that is common in children. Fifth disease is also known as erythema infectiosum or “slapped cheek disease.” This is due to the bright red facial rash that is one of the signs of the infection. Fifth disease usually goes away on its own with no lasting problems.

Closeup of skin showing first stage rash. Rash is in large patch.

Closeup of skin showing second stage rash. Rash looks lacy.

Pregnancy and Fifth Disease

Pregnant women should consult their health care provider before having contact with a child with fifth disease. The virus that causes fifth disease may harm an unborn child.

Why Is it Called “Fifth Disease?”

In the past, erythema infectiosum was number five on a list of childhood infections that cause rashes.

What Causes Fifth Disease?

Fifth disease is caused by a virus called parvovirus B19. The virus is spread by droplets in the air when someone who is infected sneezes or coughs. Most children with fifth disease catch it at school or daycare. The virus is contagious in its early stages, before the rash appears. Fifth disease is most common in children from ages 5 to 8.

What Are the Symptoms of Fifth Disease?

Fifth disease has three stages:

  • The “prodrome” stage of fifth disease consists of a low fever, headache, chills, or respiratory symptoms. This often resembles a mild cold. Your child may feel tired, cranky, or rundown. This stage may come and go before you notice it.

  • The first stage of fifth disease is when the facial rash appears. The rash appears bright rosy red on the cheeks. Your child may also look pale around the mouth because the cheeks are so red. This first rash fades in a few days.

  • The second stage of fifth disease is a rash that appears on your child’s limbs and torso. This second rash is flat, purple-red, and “lacy” in appearance. It is painless, but may be slightly itchy. The second rash may take 1-3 weeks to go away entirely, and may wax and wane (get better or worse) during this time.

How Is Fifth Disease Diagnosed?

There are no tests for fifth disease. But it is easily diagnosed by the appearance of the distinctive rash. In some cases, tests may be done to rule out other health problems.

How Is Fifth Disease Treated?

Fifth disease needs no treatment. It will go away on its own. To help your child feel better until it does:

  • Be sure he or she gets plenty of rest and fluids.

  • Your child’s health care provider may suggest giving acetaminophen or ibuprofen to help relieve fever or discomfort. Don’t give your child aspirin to relieve a fever. Using aspirin to treat a fever in children could cause a serious condition called Reye’s syndrome. Do not give ibuprofen to an infant 6 months of age or less.

  • An anti-itch medication called an antihistamine may be recommended if the rash is itchy.

Return to School

Once the fever goes away, your child is no longer contagious. So, even if your child still has the rash, he or she may attend day care or school.

What Are the Long-Term Concerns?

Once your child has had fifth disease, he or she will not have it again. Fifth disease rarely causes problems in children who are otherwise healthy.

Call your child’s health care provider right away if your otherwise healthy child has any of the following:

  • Fever:

    • In an infant under 3 months old, a rectal temperature of 100.4°F (38.0°C) or higher

    • In a child 3 to 36 months, a rectal temperature of 102°F (39.0°C) or higher

    • In a child of any age who has a temperature of 103°F (39.4°C) or higher

    • A fever that lasts more than 24-hours in a child under 2 years old, or for 3 days in a child 2 years or older

    • A seizure caused by the fever

  • Severe muscle or joint aches and pains with the rash or fever

  • Rash that does not clear up after several weeks

 

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