Fifth Disease: Symptoms, Causes, and Treatment - Verywell Health

Fifth disease is a common illness that is typically mild and resolves on its own. It is most common in children, who often develop a bright red rash on their cheeks when infected. Fifth disease is so common that most people will be infected by the time they are 15 years old.

Though fifth disease is usually mild and does not require treatment, complications can be very serious in pregnant or immunocompromised people due to conditions like cancer, HIV infection, or organ transplant.

This article explains everything you need to know about fifth disease, including symptoms, causes, diagnosis, and treatment.

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The disease is named because it was the fifth on a chronological list of common childhood rashes. Another name for fifth disease is erythema (skin redness) infectiosum.

Symptoms

Fifth disease is also known as "slapped cheek disease" because of the distinctive red rash it causes on the cheeks. This type of rash is more common in children.

Some patients may also develop a rash on their chest, back, buttocks, arms, or legs. Body rashes from fifth disease can be itchy, especially on the bottoms of the feet. The rash can last up to 10 days and may come and go for weeks afterward.

Other fifth disease symptoms include:

Symptoms usually start around 14 days after infection, and you are the most contagious in the early stages, likely before you realize you have it. When the rash or joint pain appears, the virus usually resolves, and it's safe to return to school, day care, or work.

Adults are more likely to develop painful or swollen joints from fifth disease, and these symptoms can last for several weeks. Joint pain usually resolves without any long-term complications.

Causes

Fifth disease results from becoming infected with parvovirus B19. It spreads by respiratory secretions (saliva or mucus) when someone coughs or sneezes.

It can also be passed along via blood or blood products, which means a pregnant person can pass parvovirus B19 to their fetus.

When someone recovers from fifth disease, they usually have protection against future infection.

Prevention

There is no vaccine that can prevent someone from developing fifth disease. The best way to avoid infection includes standard preventive measures, like:

• Washing hands for at least 20 seconds with warm water and soap
• Covering coughs and sneezes with a tissue or elbow
• Avoiding touching your eyes, mouth, and nose when possible
• Staying away from people who are sick
• Staying home when you are sick

Pregnant individuals or those with weakened immune systems, particularly those working in healthcare or facilities with children (like day care workers or teachers), may want to talk to their healthcare providers about protecting themselves from infection.

Diagnosis

Fifth disease is usually diagnosed based on symptoms. A blood test can detect if someone has immunity to fifth disease or if they have been recently infected, but this is not common. A blood test for parvovirus may be useful for pregnant people who think they might be infected or were recently exposed to the virus.

Treatment

Most individuals who develop fifth disease do not require special treatment. Symptoms usually resolve on their own in several weeks.

When necessary, treatment usually focuses on symptom relief, like over-the-counter pain medications for fever and joint pain. A virus causes fifth disease, so antibiotics won't help.

However, people at higher risk, especially if pregnant, should speak to their healthcare provider immediately if they think they might have fifth disease or if they have recently been exposed to someone sick with symptoms associated with the disease.

Prognosis

Fifth disease is usually a mild illness that resolves on its own with no lasting complications. However, some individuals may experience problems if they contract it.

Infection with parvovirus B19 is known to increase the risk of miscarriage and stillbirth in pregnant people. This occurs in less than 5% of people who develop fifth disease during pregnancy, which is much more common in the first half of pregnancy.

Parvovirus B19 infection can also cause the body to temporarily stop making new red blood cells, which may lead to severe and dangerous anemia. This is much more common in individuals with pre-existing conditions like sickle cell anemia, leukemia, organ transplant, or HIV infection.

Summary

Fifth disease (parvovirus B19) is a common and mild illness for most people. Many people do not even realize they are infected with the virus or only suffer from general cold-like symptoms. It can be difficult to prevent transmission because it is contagious, even in people without symptoms. The best way to protect yourself and others from infection with fifth disease is to follow good hand hygiene, stay home while sick, and speak with a healthcare provider about your health needs.

A Word From Verywell

Pregnant people often wonder how much they should worry about fifth disease or if they should continue working in higher-risk environments like hospitals, day cares, or schools. It can help to know that most pregnant people are immune to parvovirus B19 from previous infections. A simple blood test can confirm if you are already protected from infection. If you have concerns about fifth disease while pregnant or amid other high-risk conditions, it's important to speak with your healthcare provider about your concerns. They can help you understand your risk and ways to protect yourself.

By Elizabeth Morrill, RN
Elizabeth Morrill is a former ER nurse and current nurse writer specializing in health content for businesses, patients, and healthcare providers. Her career has spanned the globe, from Bosnia-Herzegovina to Colombia to Guatemala. You can find her online at www.emfreelancing.com.

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