What is Fifth's Disease?

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  • Written By: O. Wallace
  • Edited By: Niki Foster
  • Last Modified Date: 19 October 2019
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Fifth's disease, also commonly known as “slapped cheek disease,” is a viral infection caused by the parvovirus and characterized by bright, red cheeks and a pale mouth, hence the nickname. The disease got its official name because it was the fifth fever/rash illness to be identified after others such as chickenpox and measles. It is a harmless, common illness that the majority of people have been exposed to by the time they reach adulthood, although it can also affect adults.

Fifth's disease is usually diagnosed by the presence of the signature red cheeks and pale skin around the mouth. A lacy and/or bumpy red rash may also spread to the chest, back and abdomen. Heat and sunlight can exacerbate the rash, which can disappear and reappear over several months. In 25% of cases, fever can also occur, along with mild flu symptoms. Headache, body aches and muscle aches are not uncommon with fifth's disease.

In some people, fifth's disease begins with aches and fevers that end, then the rash breaks out one to three weeks later. Sometimes, the rash appears with no prior symptoms at all. Many affected children never show any symptom of fifth's disease, and it goes unnoticed and undiagnosed.


Fifth’s disease is highly contagious, as most viruses tend to be. It is spread through human to human contact, via a cough, saliva or a runny nose. It is most contagious before the rash erupts, the day before the fever starts and while the fever is ongoing. The contagious period ends 24 hours after the fever breaks and after the rash has erupted. The incubation period lasts approximately four to 14 days, but can last up to 21 days.

Although fifth's disease is generally a harmless illness, pregnant women experiencing their first exposure can exhibit complications. Exposure is most dangerous in the first 20 weeks of pregnancy, and there is a slight chance of miscarriage. More than likely, most people have been exposed in childhood and carry immunity to fifth's disease.

There is a blood test to diagnose fifth's disease, but it is generally only used to confirm exposure in pregnant women. There is no treatment, but Benadryl is suggested to alleviate the itchiness which occurs as a result of the rash. Some adults experience discomfort and swelling in the joints for a few weeks. Over-the-counter pain medication can help with these symptoms.

In rare cases, those with sickle cell anemia, or other hemolytic anemia or immune deficiency disorder, can experience a sudden, severe anemia from exposure to fifth's disease. This can be life threatening, so a visit to the doctor or emergency room is advised.


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