Causes of slapped cheek disease or fifth disease

Slapped cheek disease is an infection caused by parvovirus B19. This virus is spread through personal contact or through coughing and sneezing.

Outbreaks generally happen in early spring.

Slapped cheek disease most commonly affects children aged 5-15 years.

Slapped cheek disease is also called fifth disease.

Slapped cheek disease symptoms

The incubation period for parvovirus, which causes slapped cheek disease, is around two weeks – that is, the virus infects your child about two weeks before symptoms appear.

The illness starts with fever, headache and a runny nose.

Once these symptoms start to ease, a distinctive red rash appears on the face. It makes children look like their cheeks have been slapped. The rash then spreads to the chest, tummy, back, arms and legs, but not the palms and soles. The rash isn’t usually itchy.

At first the rash looks blotchy, but as the centre clears, it starts to look more lacy.

By the time the rash has appeared, your child is usually no longer sick or contagious. It might take 1-3 weeks for the rash to clear entirely. Overheating or sunlight can make the rash look worse. The rash might come and go for a while.

Other symptoms of slapped cheek disease can include red eyes, swollen glandssore throat and diarrhoea.

Older children might complain of joint swelling or pain too.

When to see your doctor about slapped cheek disease symptoms

You should take your child to the GP if:

  • your child develops a rash and you’re not sure what’s causing it
  • your child’s fever is high or doesn’t settle after 48 hours
  • you’re pregnant and have been exposed to parvovirus
  • you’re worried for any other reason.
The virus can affect an unborn child. If you’re pregnant and you’ve become infected, or you’ve come into contact with someone with the virus, you should see your doctor immediately for blood tests and monitoring of your pregnancy.

Treatment for slapped cheek disease

Slapped cheek disease is caused by a virus, so antibiotics won’t help.

It’s usually a mild disease. Rest at home might be all your child needs.

Your doctor might suggest treatment for any itch caused by the rash, or paracetamol in recommended doses to treat fever or help with discomfort.

Prevention of slapped cheek disease

Parvovirus is most contagious during the incubation period, around two weeks before the onset of the rash or other symptoms. Your child isn’t usually contagious once the rash has appeared.

No vaccine is currently available for slapped cheek disease.

Good daily hygiene and careful handwashing at child care, preschool and school helps prevent spread of the disease, but there’s nothing else you can do to stop it spreading.

There’s no need to keep your child home from child care, preschool or school.