Iowa Health Book: Pediatrics

Fifth Disease (Erythema): A Guide for Parents

When your child has fifth disease

Fifth disease is a very mild disease characterized by a bright red or rosy rash on both cheeks for one to three days ("slapped cheek" appearance) followed by a pink "lace-like" or "net-like" rash on the extremities. The "lacey" rash appears primarily on the thighs and upper arms. It comes and goes several times over a period of one to three weeks, especially after warm baths, exercise, and sun exposure. The rash does not itch. Your child may have a low-grade fever (less than 101 degree F or 38.4° C), slight runny nose, and sore throat or no other symptoms besides the rash.

Fifth disease is caused by the human parvovirus B19. It was so named because it was the fifth pink red infectious rash to be described by physicians (the others are scarlet fever, measles, rubella, and roseola). Once your child has had the virus, he is protected from becoming infected again.

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No treatment is necessary. This distinctive rash is harmless and fifth disease causes no symptoms that require treatment. Sometimes the diagnosis can be made by telephone.

Your child can go to school. Over 50% of children exposed to fifth disease will come down with the rash in 10 to 14 days. Because the disease is contagious mainly during the week before the rash appears, a child who has the rash is no longer contagious and does not need to stay home from school or day care. Some schools need a physician's note confirming that the child is not contagious.

When adults get fifth disease

Most adults who get fifth disease develop just a mild pinkness of the cheeks or no rash at all. More adults develop joint pains, especially in the knees, then a rash. These pains may last one to three months. Taking a nonprescription ibuprofen product usually relieves them. An arthritis workup is not necessary for joint pains that occur after exposure to fifth disease.

Precautions for pregnant women

The virus that causes fifth disease doesn't cause birth defects. Recent research has shown, however, that 10% of babies who are infected with fifth disease before birth develop severe anemia and 1% or 2% may even die. If you are pregnant and exposed to a child with fifth disease before the child develops the rash, see your obstetrician. He or she will take a sample of your blood for an antibody test to see if you have already had the disease and are protected from becoming infected again. If you do not have antibodies against fifth disease, your pregnancy will need to be monitored closely.

Call our office during regular hours if:

• The rash becomes itchy.
• Your child develops a fever over 101° F (38.4° C).
• You feel your child is getting worse.
• You have other concerns or questions.

Dr. Schmitt is Director of General Consultative Services, The Children's Hospital of Denver, and Professor of Pediatrics, University of Colorado School of Medicine. He is a member of the Editorial Board of Contemporary Pediatrics

Adapted from Schmitt, BD: Your Child's Health, ed 2. New York, Bantam Books, Inc., 1991.

This parent information aid on fifth disease may be photocopied and distributed to parents without permission of the publisher.

Contemporary Pediatrics, November 1994, p 83.

All contents copyright © 1992-1997 the Author(s) and the University of Iowa. All rights reserved.

This document is copyright the Virtual Hospital and the author and has been reprinted with permission by Med Help International . The original copy of this document in English is maintained on The Virtual Hospital . Please refer to it for the most up-to-date version of the document.