Erythema infectiosum, or “fifth disease,” is an infection that results in a mild rash on the face, trunk, and limbs. In healthy people, fifth disease usually resolves without medical treatment, but pregnant women and people who have an impaired immune system, sickle cell anemia , or other blood disorders may need to consult a physician.

Erythema Infectiosum (Fifth Disease)

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Fifth disease is caused by a parvovirus B19 infection. This is not the same parvovirus that infects dogs and cats; parvovirus B19 only infects humans. It is estimated that about half of all adults have been infected with parvovirus B19 at some time.

Since parvovirus is found in respiratory secretions (eg, saliva, sputum, nasal mucus), it is usually spread from person-to-person through direct contact with these secretions.

Risk Factors

The following factors increase your chance of developing fifth disease. If you have any of these risk factors, tell your doctor:

  • Age: fifth disease occurs most commonly in children
  • Contact with someone infected with parvovirus B19


If you experience any of these symptoms, do not assume it is due to fifth disease. These symptoms may be caused by other, less serious health conditions. If you experience any one of them, see your physician.

The first signs of fifth disease usually occur within 4 to 14 days after becoming infected with parvovirus B19. These symptoms include:

  • Low-grade fever
  • Headache
  • A stuffy or runny nose

A few days after these symptoms pass, a bright red rash begins to develop on the face (known as a slapped cheek rash). Several days later, this rash spreads as a lighter red, blotchy rash down the trunk and limbs. The rash usually resolves within 7 to 10 days. In previously uninfected adults, there may be no symptoms or development of a typical rash. Some adults may also have joint pain and swelling.


Your doctor will ask about your symptoms and medical history, and perform a physical exam.

Tests may include the following:

  • Examination of the rash
  • Blood test to identify antibodies to parvovirus


Talk with your doctor about the best treatment plan for you. Treatment options include the following:


Since fifth disease is caused by a virus, antibiotics are ineffective in treating it, and there are currently no antiviral medications that will treat fifth disease.

Usually, fifth disease does not require any treatment other than rest. Medications such as acetaminophen may be used to relieve joint pain and reduce fever. Anti-itch medications may be used to relieve itching associated with the rash.

People With Chronic Anemia

In people with sickle cell disease or other types of chronic anemia , parvovirus B19 can sometimes cause acute, severe anemia. In this case, the anemia will require treatment, which may include hospitalization and blood transfusion.

People With Immune Problems

People with immune problems may need special medical care, such as treatment with antibodies, to help cure the infection.

Women Who Are Pregnant

Sometimes, a parvovirus B19 infection in pregnant women will cause severe anemia in the unborn baby or possibly miscarriage. This is infrequent (less than 5% of the time). Usually, there are no serious complications; however, if you are pregnant and believe that you may have parvovirus B19 infection or if you have been exposed to someone with parvovirus B19 infection, then you should be seen by your obstetrician for evaluation.


It is difficult to prevent the spread of fifth disease since the virus is most contagious before the rash appears.

To help reduce your chances of getting fifth disease, practice good hygiene, especially hand washing, which can help prevent the spread of many infections.