Fifth Disease (Erythema Infectiosum)

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Fifth disease is a mild illness caused by a virus called parvovirus B19. It is rarely serious. Its most obvious symptom is the bright red rash or “slapped cheek” look of the face.

The disease occurs most often during the late winter and early spring in children between the ages of 4 and 10. However, older children and adults, especially females, can get it.

Fifth disease is contagious (spread from person to person) in the early stages before symptoms appear. Once the rash appears, it is no longer contagious. It is spread by coughing, sneezing or by touching secretions from the nose and mouth of an infected person. After your child has fifth disease he or she will not get it again.


Fifth disease has 3 stages:

The first stage (incubation period) lasts 7 to 14 days. This is when the child can spread the disease to others without knowing.

Second stage starts 2 to 3 weeks after exposure. This is when the child is no longer contagious.

  • Bright red, “slapped cheek” rash on face
  • Rash fades after 5 to 10 days

Third stage may last 1 to 3 weeks.

  • Rash spreads to chest, arms and thighs
  • Looks blotchy and like lace
  • May be itchy but is painless

The rash may come back after several weeks. It can be triggered by sunlight, exercise, extremes of heat or cold or emotional stress.


There is no treatment for fifth disease. Most children get well without treatment.

If your child has a fever or joint discomfort, you may give acetaminophen (Tylenol®) or ibuprofen (Motrin® or Advil®). Read the label to know the right dose for the age of your child.

Do not give ibuprofen to children younger than 6 months. For children younger than 6 years, do not give over-the-counter (OTC) cold or cough medicine without asking your child’s doctor. Do not give aspirin or products that contain aspirin.


There is no vaccine to prevent fifth disease.

To prevent the spread of infection:

  • Wash hands often (Picture 1)
  • Cover the mouth and nose when coughing or sneezing
  • Avoid touching the mouth or nose

Pregnant women should avoid being near children with fifth disease. If exposed, they should call their health provider. Fifth disease may harm an unborn child.

When to Call the Doctor

Call the doctor if your child has:

  • Fever more than 102° F after treating for 3 days
  • Severe joint pain or swelling
  • A condition that weakens the immune system (like sickle cell disease, cancer, or hemolytic anemia)

Return to School

Your child can return to school after the rash disappears and he has no fever.

Fifth Disease (PDF)

HH-I-212 12/01, Revised 11/17 Copyright 2001, Nationwide Children’s Hospital