Information: Fifth Disease

Department of Public Health

What is fifth disease?
Fifth disease is a viral infection which often affects red blood cells. It is caused by a human parvovirus (B-19). For many years, fifth disease was viewed as an unimportant rash illness of children. Recently, studies have shown that the virus may be responsible for serious complications in certain individuals.

How is the virus spread?
The virus is spread by exposure to airborne droplets from the nose and throat of infected people.

Who gets fifth disease?
Anyone can become infected, but the disease seems to occur more often in elementary school-aged children.

What are the symptoms and when do they appear?
One to two weeks after exposure, some children will experience a low grade fever and tiredness. By the third week, a red rash generally appears on the cheeks giving a slapped face appearance. The rash may then extend to the body and tends to fade and reappear. Sometimes, the rash is lacy in appearance and may be itchy. Some children may have vague signs of illness or no symptoms at all.

When and for how long is a person able to spread the disease?
People with fifth disease appear to be contagious during the week prior to the appearance of the rash. By the time the rash is evident, the person is probably beyond the contagious period.

How is fifth disease diagnosed?
In most cases, the disease is diagnosed based on the appearance of typical symptoms. A specific blood test to confirm the diagnosis has recently been made available.

Does past infection with the virus make a person immune?
It is thought that people who have been previously infected acquire long-term or lifelong immunity. Studies have shown that approximately 50 percent of adults are immune to parvovirus B19.

What is the treatment?
At this time, there is no specific treatment.

What are the complications associated with fifth disease?
While most women infected during pregnancy will not be affected, some studies have shown that parvovirus B19 may infect the fetus and increase the risk of miscarriage within the first 18 weeks of pregnancy. In people with chronic red blood cell disorders, such as sickle-cell disease, infection may result in severe anemia. Infection has also been associated with arthritis in adults.

What can be done to prevent the spread of fifth disease?
Measures to effectively control fifth disease have not been developed yet. During outbreaks in schools, pregnant school employees and people with chronic red blood cell disorders should consult their physician for advice.

Where can I call for additional information regarding fifth disease and pregnancy?
In addition to your doctor, information can be obtained from your local health department.

This fact sheet is for informational purposes only. It should not be used for self-diagnosis or as a substitute for consultation with a health care provider. If you think that you may have this infection, or have questions about the disease described above, you should consult your health care provider.

For additional information on this disease, visit the Centers for Disease Control and Prevention website.