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Fifth Disease - Pictures, Symptoms, Treatment, Causes, Diagnosis

Updated on December 22, 2013

Fifth Disease Pictures

What is Fifth disease?

Fifth disease is also known as Erythema infectiosum characterized by a facial rash that appears similarly to a marked left by a slap on the face that the disease is also referred to as slapped cheek syndrome or slap-cheek. It is listed fifth among the six classical rashes or exanthems affecting pre-school children between the ages of 3 to 15 years old. It is a disease believed to be the normal response of the body from an infection from a virus known as human parvovirus B19.

Erythema infectiosum can occur sporadically throughout the year although it can occur as an outbreak which is prevalent during early spring or late winter. It commonly affects children aged 3 to 15 years old although it can also affect people from different age levels. It is however, a self-limited disease that resolves without resulting to further complications much less debilitating condition. Fifth disease in children can be mild and may require no treatment but disease in adults may be serious such as in a parvovirus B19 infected pregnant women have higher risk for passing the infection to the developing fetus inside the womb. The disease can also be serious for people with compromised immune system including those with condition of anemia.


Fifth disease has its incubation period which is from infection to onset of symptoms. Symptoms of the disease usually start on the 4th to 14th day from infection or it may also take 20 days before the symptoms appear.

People infected with parvovirus may show signs and symptoms while it may also be asymptomatic to others. Manifestations of the disease on the other hand when it occurs greatly vary and depending on the age of the person infected.

The disease may begin with nonspecific symptoms and vague illness while the disease usually starts with the onset of low grade fever. Slight fever is associated with headache, fatigue, muscle aches, sore throat and nasal congestion and drainage while these symptoms usually last for several days before the onset of facial rash that normally appears after 7 to 10 days from onset of symptoms. Bright red facial rash will appear after earl symptoms have ceased while this rash usually appears on both cheeks with the rash that looks like a slap across the face of the child. The rash may extend to the arms, buttocks, legs and trunks after several days. The rash that extended to the other parts of the body will later fade into pinkish color in lacy pattern then subsequently clears.

Adults suffering from fifth disease may experience pain and swelling of the joints especially in women. The symptoms of pain and swelling in joints are often not associated with other symptoms of fifth disease and it usually recedes in a week or longer although it does not usually leave any medical complications. Pregnant women on the other hand, afflicted with parvovirus B19 may have the risk of passing the infection to the unborn child and leave a fetal problem.


Fifth disease was first recognized in 1799 by Robert Willan and was called Ruebeola, sine catarrho and was later on identified as rubella variant by Anton Tschmer. It was in 1896 when T. Escherich clearly separated the identity of fifth disease and was then given the name erythema infectiosum.

Human parvovirus B19 is the causative agent for fifth disease which was identified in the year 1975. Parvovirus B19 is a single stranded DNA that commonly infect humans and a different parvovirus that can infect animals especially dogs. Yvone Cossart, an Australian virologist was the first to identify the existence of PV-B19 in 1975.

The transmission of parvovirus B19 is through respiratory droplets such as in sneezing or coughing of people infected with the virus. The condition of fifth disease however, is contagious during the stage of nasal congestion symptom and not until the rash has come out. Transmission of the virus through blood is also possible especially in infected pregnant women who can pass the virus to the unborn child and can later on result to fetal problem. Parvovirus B19 infection in pregnant women during the third trimester can also result to miscarriage. The spread of the virus can also be transmitted through exposure to an infected blood.

Parvovirus B19 can however cause numbers of illnesses and not just the fifth disease alone. It is because parvovirus B19 can lead to deficiency in the bone marrow. The virus commonly infects children that school children, teachers and other school personnel are at high risk for being infected. Virus infection from parvovirus B19 not only can cause fifth disease but can also bring medical complications especially to adults and pregnant women.


Fifth disease is marked by slapped cheek that presentation of which can confirm the condition. Medical history on the other hand is being taken to further confirm the suspicion while it is beneficial for adults to undergo laboratory screening to identify and confirm infection from parvovirus B19. Blood test is useful to determine immunity of an individual from parvovirus or if they have recently acquired the infection. Specialized tests are utilized for patients with fifth disease associated with other symptoms and to pregnant women.


Fifth disease or erythema infectiosum is a self-limited disease and is usually mild and resolves on its own without leaving debilitating or any other serious complications. Both children and adults in healthy condition usually do not require treatment except relief of symptoms which is the aim in treating and managing fifth disease. It is advisable though for patients of fifth disease with serious complications that should require medical intervention and seek the help of professional health workers.

The occurrence of fifth disease need not isolate the patient during the outburst of the rash and self-care or home treatment can help the patient in relief of the symptoms. Acetaminophen can be given to children and adults to address the fever although it is not advisable to give aspirin. Acetaminophen can also relieve the symptoms of itchiness and joint pains. Increased fluid intake is also advisable including plenty of rest while recuperating from symptoms.


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