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Indiana State Department of Health

ISDH Home > Public Health Protection & Laboratory Services > Epidemiology Resource Center (ERC) > Surveillance and Investigation > Diseases and Conditions Resource Page > Fifth Disease Fifth Disease

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About... Fifth Disease

What is fifth disease?

Fifth disease is a mild and common rash illness caused by the parvovirus B19.  It is so named because it was the fifth of the childhood rash illnesses to be identified.  It is also called erythema infectiosum. There are no complications of fifth disease for a normal child, but can cause serious problems to an unborn child. If you are pregnant, and suspect that you have or have been exposed to fifth disease, contact your healthcare provider immediately. 

How is fifth disease spread?

Fifth disease is probably spread by very close contact, including direct contact, with infected mucus from the nose or mouth or through the air when a person with fifth disease coughs or sneezes. Children can be contagious one week before the rash appears. Once the rash develops, the child is no longer contagious.

Who is at risk for fifth disease?

Children five to fifteen years of age are at greatest risk for infection, but if an adult has not been exposed previously they can be infected also.  Once a person has had fifth disease they are immune and cannot get it again.  Most cases of fifth disease occur in late winter and early spring, but may occur anytime during the year.

How do I know if someone has fifth disease?

Fifth disease begins with the some of the following symptoms:

  • low-grade fever;
  • symptoms of a mild cold;
  • headache;
  • swollen glands;
  • sore throat;
  • upset stomach or diarrhea

Often these symptoms pass and then the rash appears a few days later.  The rash is bright red and usually becomes visible on the face first.  This distinctive rash makes the child appear to have slapped cheeks.  The rash then spreads to the trunk, arms, and legs.  As the rash clears it may take on a lacy net-like appearance.  After the rash fades it may return if the person is exposed to sunlight, heat, exercise or stress.  In adults, the most common symptom is joint soreness which can last several weeks.

How can fifth disease be treated?

Most children with fifth disease do not need medication. Over-the-counter drugs may be given for joint pain and swelling or to reduce itching. There is no need to change a child's diet or to limit activity.  If you are worried about your child's illness, or if your child develops a fever over 102° F or has severe joint pains, call your doctor.

How is fifth disease prevented?

  • Children are contagious before they have a rash or joint pains. Since they feel well or have only a mild illness, they continue to play with other children. Little can be done to stop the spread of this infection.
  • Once the rash appears, they are no longer infectious and can return to child care or school.
  • Sometimes the rash will return, but the child will not be infectious again.
  • Pregnant women should tell their doctor if they have been in contact with infected children one week before the rash appeared.
  • Most adults have had fifth disease as a child and are no longer at risk for catching the disease.
  • Practice good personal hygiene.  Frequent hand washing, is always a good idea since it can help prevent the spread of infections, many of which are more serious than fifth disease.

For additional information on fifth disease, please visit the Centers for Disease and Control Web site at:

or the Mayo Clinic Web site at:

or the Kids Health Web site at:


This page was last reviewed October 16, 2008

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