About slapped cheek disease or fifth disease

Slapped cheek disease is a mild viral 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 parvovirus that causes slapped cheek disease usually infects children around two weeks before any symptoms appear.

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

Once these symptoms start to ease, a distinctive red rash comes up 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 lacy.

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

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

Older children might complain of joint swelling or pain too.

Some children are at higher risk of complications from slapped cheek disease. They include children who have:

  • red blood cell problems like severe anaemia
  • a weakened immune system because of a medical condition or medical treatment.

Parvovirus is most contagious two weeks before symptoms appear. Your child isn’t usually contagious once the rash has appeared.

Does your child need to see a doctor about slapped cheek disease?

You should take your child to the GP if:

  • your child develops a rash and you’re not sure what’s causing it or the rash doesn’t temporarily disappear with pressure
  • your child’s fever doesn’t settle after 48 hours
  • your child has sore or swollen joints
  • your child develops a rash and has red blood cell problems or a weakened immune system
  • you’re worried your child is unwell.

The virus can be dangerous for unborn babies. 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.

Rest at home might be all your child needs.

Your GP might suggest treatment for itch caused by the rash or paracetamol in recommended doses to help with discomfort.

Prevention of slapped cheek disease

There’s no immunisation 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.

If your child has slapped cheek disease, try to keep your child away from pregnant women and high-risk children. If your child comes into contact with these people, make sure they know about your child’s condition and encourage them to see their doctors.