Fifth Disease-Viral Rash
Is this your child's symptom?
- Viral rash that starts with red cheeks and spreads to the shoulders
Symptoms of Fifth Disease
- Bright red cheeks on both sides for 1 to 3 days. Looks like "slapped cheeks".
- Followed by pink "lace-like" (net-like) rash of arms and legs.
- "Lacy" rash mainly is on thighs and upper arms/shoulders.
- Rash also is on chest and stomach in 50% of children.
- The rash does not itch or hurt.
- No fever or low-grade one less than 102° F (39° C).
- Peak age: 4 -12 years.
Cause of Fifth Disease
- It is caused by the human parvovirus B19.
- Not related to the dog parvovirus.
Prevent Spread to Others
- Good hand washing can prevent spread of this illness.
- Once the rash occurs, the child can no longer spread the virus.
When to Call for Fifth Disease-Viral Rash
Call 911 Now
- You think your child has a life-threatening emergency
Call Doctor or Seek Care Now
- Only 1 cheek is red and also has fever
- High Risk child (such as those with a chronic medical problem or weak immune system)
- Your child looks or acts very sick
- You think your child needs to be seen, and the problem is urgent
Contact Doctor Within 24 Hours
- Fever over 102° F (39° C)
- You think your child needs to be seen, but the problem is not urgent
Contact Doctor During Office Hours
- Sore throat lasts more than 48 hours
- Mother or other caregiver is pregnant
- You have other questions or concerns
Self Care at Home
- Fifth disease suspected
Seattle Children's Urgent Care Locations
If your child’s illness or injury is life-threatening, call 911.
Care Advice for Fifth Disease
- What You Should Know About Fifth Disease:
- It is a viral rash that is harmless.
- It does not itch or hurt.
- It can be treated at home.
- Here is some care advice that should help.
- Fever Medicine:
- For fevers above 102° F (39° C), give an acetaminophen product (such as Tylenol).
- Another choice is an ibuprofen product (such as Advil).
- Note: Fevers less than 102° F (39° C) are important for fighting infections.
- For all fevers: Keep your child well hydrated. Give lots of cold fluids.
- Pregnant Women - Special Risk:
- The risk of Fifth disease is to the unborn babies of pregnant women. It is not harmful to the woman herself.
- A pregnant woman should see her doctor if she is exposed.
- He will do a test to see if the mother has had the disease. If she has, she is protected.
- If not, the pregnancy will need to be watched closely. Some babies that get it before birth can have problems. Ten percent can have a very low red blood cell count and 2% may die.
- But, birth defects are never a result of this virus.
- What to Expect:
- The lace-like rash can come and go for 1 to 3 weeks.
- Return to School:
- Once your child has the "slapped cheeks", they can no longer spread the illness. Also, the lacy rash cannot be spread to others either.
- Your child does not need to stay home from child care or school.
- It can be spread during the week before the rash begins.
- Exposed children should try not to have any contact with pregnant women. This may be hard to know ahead of time.
- Call Your Doctor If:
- Fever above 102° F (39° C) occurs
- You think your child needs to be seen
- Your child becomes worse
And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
Last Reviewed: 04/01/2023
Last Revised: 12/30/2022
Copyright 2000-2023. Schmitt Pediatric Guidelines LLC.