Fifth Disease

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Fifth disease is a mild illness caused by a virus. Symptoms include a blotchy rash that begins on the cheeks and spreads to the arms, legs and torso. The bright red cheeks give a “slapped cheek” appearance. The rash fades over a period of one to two weeks.

The disease occurs most often during the late winter and early spring with outbreaks among preschoolers or school-age children and adolescents. It is spread by coughing, sneezing or by touching secretions from the nose and mouth. It takes 4 to 14 days for an infected person to show symptoms. Only 15% to 30% may begin the illness with a mild fever. The rash comes between 2 and 3 weeks after exposure. The infected person is contagious until the rash appears. The bright rash on the cheeks usually lasts a day. The “lacy” rash may last 2 to 39 days, with the average being 11 days. After that, it may come back, brought on by exposure to pressure, sunlight, emotional stress, exercise, fever or extremes of heat or cold.


  • Mild fever
  • Mild headache
  • Mild joint pain
  • Rash, first appearing on the cheeks and spreading to the arms and legs about one day later (rash often looks like lace)


Wash your hands frequently
  • Treatment is not usually required for fifth disease in normally healthy children. Most children recover completely without treatment.
  • If your child has a fever or joint discomfort, you may give acetaminophen (Tylenol). Aspirin should not be used for viral illnesses in children under 12 years of age.


This is a mild, contagious illness for most children. At this time, there is no vaccine to prevent it. Frequent hand washing can help to prevent the spread of the disease (Picture 1). Children in the rash stage may attend school. However, in people with AIDS or low immunity due to cancer treatment, fifth disease can cause serious anemia (disease of the red blood cells). These people should avoid being exposed to children with fifth disease. Pregnant women should also avoid exposure to children who have Fifth Disease. If you are pregnant and have questions about this, please discuss with your doctor.

Fifth Disease (PDF)

HH-I-212 12/01, Revised 9/11 Copyright 2001-2011, Nationwide Children’s Hospital