Fifth Disease Overview

11 days young baby
The symptoms of fifth disease are usually more serious in adults than they are in children. See more pictures of skin problems.
© Neudert/© 2009 HowStuffWorks Photos

There are probably plenty of diseases you associate with childhood. And whether it's chickenpox, mumps or rubella, you usually know what to expect from them -- some sort of itchy rash and maybe a mild fever. Typically, these illnesses run their course without serious lasting effects.

Similar in many ways to these other rash-causing conditions, parvovirus infection -- sometimes referred to as "fifth disease" or "slapped cheek disease" -- often gets overlooked or misdiagnosed. In fact, people call parvovirus fifth disease because it shares so many traits with four different childhood rashes: measles, scarlet fever, rubella and Dukes' disease. Like the others, most people get it as children -- as many as 40 to 60 percent of people have had parvovirus infection.


Most people don't spend too much time worrying about the long-term effects of fifth disease. Sometimes, symptoms of the disease are so mild that they never even realize they had it [source: Kid's Health]. However, like other infections, it has its own set of dangers: For example, fifth disease can cause more serious symptoms for adults who catch it, and pregnant women who have it can potentially pass on fatal health problems to an unborn child [source: Mayo Clinic: Parvovirus].

With that in mind, it's important to know the basics about fifth disease: its symptoms, its treatments, how it spreads and what you can do to keep from catching it in the first place. You should also know how to avoid the medical complications associated with parvovirus and pregnancy.

First, read on to find out why parvovirus got stuck with the moniker "slapped cheek disease."


Fifth Disease Symptoms

Fifth disease is sometimes difficult to diagnose because it looks like other rash-causing diseases. The most obvious symptom of the infection is a distinctive red rash that appears on the cheeks, causing a person to look freshly slapped. This redness can eventually extend to other parts of the body, including the arms, chest, thighs and buttocks. However, the rash associated with fifth disease doesn't show up until a few days after infection [source: Mayo Clinic: Parvovirus].

Before the rash appears, there are a number of other symptoms that could also point to fifth disease. These include an upset stomach, headaches, fatigue, itching, sore throat, slight fever and other cold-like symptoms [source: Center for Disease Control]. Typically, these symptoms last seven to 10 days without serious problems, although the rash can hang around for up to three weeks [source: Mayo Clinic: Parvovirus].


Though fifth disease is typically mild, it can lead to more severe complications. If a person has sickle cell anemia, for example, fifth disease can lead to serious anemia -- a deficient level of red blood cells. For those who have a weakened immune system, all symptoms of fifth disease can be much more severe. In these cases, people may have to seek medical care or be hospitalized to help treat the infection [source: Mayo Clinic: Parvovirus].

Now that you know how fifth disease affects the body, you'd probably like to know how a person contracts it. Keep reading to find out whether or not fifth disease is contagious.


Is Fifth Disease Contagious?

In a word, yes, fifth disease is contagious. Usually, a person infected with the parvovirus is contagious before the rash itself appears. This makes fifth disease different from the other rashes it's often confused with, since those conditions are infectious while the rash is present. Since the earlier symptoms of parvovirus are similar to those of a common cold, it's often difficult to prevent the infected person from spreading it to others [source: Center for Disease Control].

The parvovirus typically spreads when an infected person exhales airborne droplets containing the virus, then another person comes into contact with the droplets [source: Wisconsin Department of Health Services]. The good news about that is it's possible to prevent spreading infection by practicing good hygiene. When coming down with symptoms of the disease, be sure to frequently wash your hands and throw away used tissues right after use. This may seem like simple advice, but it is an easy way to prevent the spread of disease since your hands come into contact with many shared objects, particularly in public places [source: Mayo Clinic: Parvovirus].


Washing your hands might be easy, but if you've ever tried to get a kid to do it, you won't be surprised to learn how and where fifth disease usually spreads. While you're at it, check out the myths surrounding the rash and animals.

Fifth Disease Spreading

Because fifth disease is most contagious before a person starts showing symptoms of a rash, and because it's most often found in children, the virus tends to spread through outbreaks at schools or in closed communities [source: Wisconsin Department of Health Services]. In the case of school outbreaks, anywhere from 10 to 60 percent of students may get the disease [source: Center for Disease Control].

The disease passes from person to person through secretions such as saliva, sometimes, for example, by drinking from the same cup [source: Center for Disease Control]. This can happen during an outbreak or simply by coming into contact with a single infected person.


Although fifth disease outbreaks can happen at any time of the year, they're most common in late winter or early spring. There's no specific reason for this, though it most likely happens because people don't go outside as often in the colder months and therefore spend more time with others in enclosed areas [source: Kid's Health].

Rumors exist that fifth disease can be contracted from pets, particularly dogs. Although dogs are susceptible to a parvovirus, it is not the same one that affects people. Canine parvovirus attacks the intestines, white blood cells and sometimes the heart of dogs. It cannot be passed to humans, and likewise, the human virus cannot be passed to animals [source: American Veterinary Medical Association].

Read on to find out how this childhood disease becomes more serious when caught by adults, particularly pregnant women.


Fifth Disease in Adults

Like other childhood rashes, the effects of fifth disease can become more severe when an adult becomes infected. In addition to all of the other symptoms, adults often experience soreness in the joints, including the hands, wrists, knees and ankles [source: Mayo Clinic: Parvovirus]. These symptoms can last for several weeks or even months, in some cases [source: Center for Disease Control].

Although the additional symptoms may be problematic, they're nothing compared to the complications associated with fifth disease and pregnancy. In the most severe cases, the mother can pass on parvovirus to her unborn child, causing severe anemia and possibly a miscarriage. These complications are more likely in the earlier stages of pregnancy. If you're pregnant and have become infected with fifth disease, your doctor may want to schedule more frequent checkups and ultrasounds to make sure the baby remains healthy. Although these extra visits with the doctor may help protect the baby, there are no actual medicines or vaccines to prevent the disease or cure it once someone contracts it [source: Center for Disease Control].


Luckily, about 50 percent of women are immune to fifth disease because they've had the illness before, and that immunity protects the fetus from infection. In addition, the most severe complications occur in less than 5 percent of women who contract fifth disease, making the likelihood of harming the child highly unlikely [source: Center for Disease Control].

Read on to find out what types of treatment can help alleviate the symptoms of fifth disease in children, adults and severe cases.


Fifth Disease Treatments

Unfortunately, there are no vaccines or cures for fifth disease. Because it is a virus, antibiotics aren't used to treat the infection [Web MD: Fifth].

For the most part, the effects of fifth disease will go away on their own with plenty of rest, fluids and pain relievers to address any soreness or fever. In children, the disease will usually go away after seven to 10 days, though it may last a couple of weeks for adults or in severe cases. Once a person is showing the rash symptoms of fifth disease, he or she should no longer be contagious. In other words, there's no need to hide or quarantine yourself [source: Center for Disease Control].


When people with severe anemia or immune deficiency contract fifth disease, they might have to go to the hospital so doctors can monitor the infection and prevent it from getting worse. In severe cases, patients may receive blood transfusions or antibodies to help fight the infection [Mayo Clinic: Parvovirus].

For pregnant women who contract fifth disease, the doctor may want to schedule more frequent checkups and ultrasounds to make sure the baby remains healthy [source: Center for Disease Control]. If the doctor is worried about the baby becoming anemic or having any heart-related issues, he may recommend transfusions or other medications at that time [Mayo Clinic: Parvovirus].

To read more about conditions that affect the skin, follow the links on the next page.


Lots More Information

Related HowStuffWorks Articles


  • American Veterinary Medical Association. "Care for Animals: Pet Health." (Accessed 8/19/09)
  • Center for Disease Control. "Parvovirus B19: Fifth Disease." January 21, 2005. (Accessed 8/19/09)
  • Center for Disease Control. "Parvovirus B19 Infection and Pregnancy: Q&A." January 21, 2005. (Accessed 8/19/09)
  • Center for Disease Control. "Scarlet Fever." April 13, 2008. (Accessed 8/19/09)
  • Kids Health. "Infections: Fifth Disease." (Accessed 8/19/09)
  • Mayo Clinic Staff. "Chickenpox: Prevention." September 5, 2008. (Accessed 8/20/09)
  • Mayo Clinic Staff. "Chickenpox: Symptoms." September 5, 2008. (Accessed 8/20/09)
  • Mayo Clinic Staff. "Parvovirus infection: Complications." Jan 12, 2008. (Accessed 8/19/09)
  • Mayo Clinic Staff. "Parvovirus infection: Overview." Jan 12, 2008. (Accessed 8/19/09)
  • Mayo Clinic Staff. "Parvovirus infection: Prevention." Jan 12, 2008. (Accessed 8/19/09)
  • Mayo Clinic Staff. "Parvovirus infection: Symptoms." Jan 12, 2008. (Accessed 8/19/09)
  • Mayo Clinic Staff. "Parvovirus infection: Treatments and drugs." Jan 12, 2008. (Accessed 8/12/09)
  • Morens, David and Alan Katz. "The 'Fourth Disease' of Childhood: Reevaluation of a Nonexistent Disease." Vol 134. No 6. (Accessed 8/20/09)
  • Web MD. "Fifth Disease: Treatment Overview." March 7, 2007. (Accessed 8/20/09)
  • Web MD. "Rubella: Topic Overview." September 11, 2008. (Accessed 8/20/09)
  • Wisconsin Department of Health Services. "Fifth Disease Fact Sheet." November 4, 2008. (Accessed 8/20/09)