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Fifth disease

Fifth disease is a common childhood infection causing a slapped cheek appearance and a rash. It is also known as erythema infectiosum.

Fifth disease is caused by Parvovirus B19. It most commonly affects young children and often occurs in several members of the family or school class. Thirty percent of infected individuals have no symptoms.

Fifth disease
Family affected by parvovirus
Fifth disease
Slap cheeks
Fifth disease
Lace-pattern of rash
Fifth disease

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What are the symptoms of fifth disease?

The first sign of fifth disease is firm red cheeks, which feel burning hot. A rash follows 1 to 4 days later with a lace or network pattern on the limbs and then the trunk.

The child with fifth disease is usually otherwise quite well, but may have a slight fever and headache.

Although most prominent in the first few days, the rash can persist at least intermittently for up to six weeks.


Rarely fifth disease results in complications.


The characteristic slapped cheek and lacy rash in a child who is otherwise well usually make the diagnosis. The parvovirus can cause other rashes such as a glove-and-stocking rash. In case of doubt, a blood test can be done to confirm the presence of current parvovirus infection or immunity to it. If the child is unwell, or has a blood disease, a full blood count should be performed. Ultrasound examination of at-risk pregancies can detect hydrops fetalis (which requires intrauterine transfusion).


Fifth disease is not generally a serious condition. There is no specific treatment. Affected children may remain at school as the infectious stage occurs before the rash is evident The application of an ice-cold flannel can relieve the discomfort of burning hot cheeks.

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