Need to talk? Call 1800 882 436.
It's a free call with a maternal child health nurse. *call charges may apply from your mobile

Is it an emergency? Dial 000
If you need urgent medical help, call triple zero immediately.

beginning of content

Fifth disease (Slapped cheek disease)

7-minute read

What is fifth disease?

Fifth disease (also known as ‘slapped cheek disease’, erythema infectiosum or Parvovirus B19) is a fairly mild viral illness, usually of childhood. It is a common infection — half of adults have been infected during their childhood.

Why is it called fifth disease?

It is called fifth disease as it was the fifth of the 5 common viral rash illnesses of childhood.

The ‘slapped cheek disease’ name comes from its most obvious symptom — a red rash that makes children’s cheeks look like they’ve been slapped.

What are the symptoms of fifth disease?

In children, the symptoms of fifth disease are often mild and you may not notice them in your child. The symptoms in a child may include a mild fever, headache and cold symptoms, such as a runny nose.

A few days later, a bright red rash, like the mark left by a slap, appears on the cheeks. Over the next 2 – 4 days a pink lacy rash appears on the trunk and limbs. This may be itchy. The rash usually clears up in 7 – 10 days.

Some children may experience the body rash coming and going for a few weeks — generally brought on by heat or sunlight.

Children may get joint pain as a symptom, although this is not common in children.

Children with blood disorders such as spherocytosis or sickle cell disease may become more anaemic. They should seek medical care.

Adults with fifth disease may not have any symptoms at all, or they may have joint pain and stiffness, but they don’t usually get the slapped cheek rash. The joint pain can take 1 – 2 weeks to go away. Sometimes it lasts longer, even months or years.

CHECK YOUR SYMPTOMS — Use the healthdirect Symptom Checker and find out if you need to seek medical help.

What causes fifth disease?

Fifth disease or slapped cheek disease is a viral infection caused by human parvovirus B19. Outbreaks generally happen in winter and spring. The virus is spread through contact with infected respiratory secretions, such as through coughing and sneezing. It may also be passed from mother to unborn baby.

Once a person has been infected they will generally be immune to the disease.

When should I see my doctor?

Certain people should contact their doctor immediately, if they think they have been in contact or may be infected with human parvovirus, including:

  • pregnant women
  • anyone who is immunosuppressed
  • anyone with haemolytic anaemia

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist.

How long is someone with fifth disease infectious?

The infectious period is a few days before the rash appears (children are no longer contagious when the rash appears).

Children are not excluded from school or child care, but they should stay at home if they have a fever, and until they feel well.

Fifth disease will infect around half of all previously uninfected household contacts and up to 60% of school or childcare contacts.

What is the incubation period for fifth disease?

The incubation period for fifth disease varies from 4 to 20 days. This is the time between a person being infected and them developing symptoms.

How is fifth disease diagnosed?

Fifth disease can often be diagnosed by the presence of the characteristic rash, during a physical examination.

Blood tests are usually only done if a person is at risk of complications. The blood tests can detect antibodies to fifth disease, which show previous exposure to the parvovirus, or the genetic material of the virus, showing an active infection.

Amniotic fluid may be tested in a pregnant woman if the fetus is affected by hydrops fetalis (fluid accumulation).

What is the treatment for fifth disease?

Fifth disease is caused by a virus (parvovirus) so antibiotics will not be effective. Treatment is aimed at managing the symptoms, which can usually be done at home.

If your child is infected:

  • make sure they rest and drink plenty of fluids
  • give them paracetamol or ibuprofen, if necessary, to relieve the discomfort and fever

Adults with fifth disease may need to rest, or take ibuprofen if they have joint pain. Your doctor or pharmacist will be able to advise if ibuprofen is suitable for you.

Can fifth disease be prevented?

No vaccine is currently available for fifth disease. It helps to follow good hygiene and careful handwashing, especially in childcare facilities and schools, but there’s nothing else you can do to stop it spreading.

Parvovirus is most contagious during the incubation period, before your child develops the rash or other symptoms. Your child isn’t usually contagious once the rash has appeared and fifth disease is diagnosed, so there’s then no need to keep your child home from childcare or school.

What if I get fifth disease while pregnant?

Pregnant women or women planning to become pregnant should see their doctor or midwife as soon as possible if they come into contact with the infection or develop a rash. Parvovirus can affect the unborn baby, though this is rare.

Half of all women will have had fifth disease previously, and so will be immune to parvovirus. If a pregnant woman who isn’t immune gets fifth disease, usually the illness is mild and doesn’t affect the baby. But rarely, an unborn baby can develop anaemia or fluid accumulation (hydrops fetalis) if the mother gets parvovirus. This can lead to miscarriage.

Are there any complication of fifth disease?

As mentioned, the rash may return in children for a couple of weeks. Adults may have joint pain which lasts for days, weeks or months after infection.

As parvovirus affects the development of red blood cells, certain groups of people are more at risk of complications, including:

  • women in the first half of pregnancy — the fetus may develop anaemia or fluid accumulation (hydrops fetalis), which sometimes leads to miscarriage
  • anyone who is immunosuppressed — chronic (ongoing) anaemia may result and be difficult to treat
  • anyone with haemolytic anaemia — they may develop severe anaemia during the infection

Learn more here about the development and quality assurance of healthdirect content.

This information was originally published on healthdirect - Fifth disease (Slapped cheek disease).

Last reviewed: March 2022

Back To Top

Need more information?

Slapped cheek or fifth disease: children | Raising Children Network

Slapped cheek disease, also called fifth disease, is a mild viral illness. Symptoms include a red rash on the cheeks. You can usually treat it at home.

Read more on website

ACD A-Z of Skin - Erythema Infectiosum

A-Z OF SKIN Erythema Infectiosum BACK TO A-Z SEARCH What is it? Also known as…Parvovirus B19 Infection, Fifth Disease or “Slapped Cheek” Disease What is Erythema Infectiosum? Erythema Infectiosum is usually a harmless childhood viral infection characterised by a classic slapped-cheek appearance or a lacy patterned rash

Read more on Australasian College of Dermatologists website

Fifth disease -

If your child (or you) has been unwell with what you think is the flu and later develops bright red cheeks, fifth disease may be the cause.

Read more on myDr website

Childhood rashes -

Distinguish between the childhood rashes of rubella (German measles), measles, chickenpox and fifth disease ('slapped cheek' disease).

Read more on myDr website

Common childhood rashes

Childhood rashes are common and many disappear without treatment. Learn about symptoms and treatment of childhood rashes, such as eczema, ringworm and impetigo.

Read more on Pregnancy, Birth & Baby website

Infectious diseases: when can my child go back to school or child care? -

Children with certain infections need to stay away from school or child care to recover and to help stop the spread of infection. Use this guide to work out how long your child should stay away.

Read more on myDr website

Call us and speak to a Maternal Child Health Nurse for personal advice and guidance.

Need further advice or guidance from our maternal child health nurses?

Healthdirect Australia acknowledges the Traditional Owners of Country throughout Australia and their continuing connection to land, sea and community. We pay our respects to the Traditional Owners and to Elders both past and present.

This information is for your general information and use only and is not intended to be used as medical advice and should not be used to diagnose, treat, cure or prevent any medical condition, nor should it be used for therapeutic purposes.

The information is not a substitute for independent professional advice and should not be used as an alternative to professional health care. If you have a particular medical problem, please consult a healthcare professional.

Except as permitted under the Copyright Act 1968, this publication or any part of it may not be reproduced, altered, adapted, stored and/or distributed in any form or by any means without the prior written permission of Healthdirect Australia.