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Fifth Disease

(Erythema Infectiosum; Parvovirus B19; Slapped Cheek Disease)


Fifth disease is a viral infection that most often happens in children. The infection can cause a mild rash on the face, trunk, arms, and legs.


This problem is caused by a virus called parvovirus B19. It is found in saliva, sputum, and mucus. It is spread from person to person through contact with these fluids.

It can also spread through blood. A pregnant woman who is infected can pass the virus to her baby.

Risk Factors

This problem is more common in children. Pregnant women and people with weakened immune systems are at high risk of severe illness.

Other things that may raise the risk are:

  • Contact with an infected person
  • Jobs that require close contact with infected people, such as healthcare workers and teachers
  • Exposure to contaminated blood or blood products


Some people do not have symptoms. Those who do may have mild flu-like symptoms, such as:

  • Fever
  • Headache
  • Stuffy or runny nose

People may also have a bright red rash on their face. It may spread to the face, trunk, arms, and legs. Adults may also have joint pain and swelling.


You will be asked about your symptoms and medical history. A physical exam will be done. You may be asked if you have had contact with anyone who has the infection.

Blood tests may be done to look for signs of parvovirus antibodies.


Most people get better on their own with rest. Pregnant women and people with weakened immune systems will need to be monitored closely for problems.

Supportive care during recovery may include:

  • Over the counter pain relievers
  • Corticosteroids to ease joint pain


The risk of viral infection may be lowered by:

  • Practicing proper handwashing
  • Covering the mouth and nose when coughing or sneezing
  • Not touching the eyes, nose, and mouth
  • Avoiding close contact with people who are infected

Family Doctor—American Academy of Family Physicians

US Centers for Disease Control and Prevention


AboutKidsHealth—The Hospital for Sick Children

HealthLink BC


Fifth disease. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/parent/infections/bacterial_viral/fifth.html. Accessed March 5, 2021.

Fifth disease. US Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/parvovirusB19/fifth-disease.html. Accessed March 5, 2021.

Parvovirus B19 infection. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/parvovirus-b19-infection. Accessed March 5, 2021.

Pregnancy and fifth disease. US Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/parvovirusB19/pregnancy.html. Accessed March 5, 2021.

Qiu J, Söderlund-Venermo M, et al. Human Parvoviruses. Clin Microbiol Rev. 2017 Jan;30(1):43-113.

Last reviewed December 2020 by EBSCO Medical Review Board Kari Kassir, MD  Last Updated: 3/5/2021