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Fifth Disease

Fifth disease is a highly contagious, very common childhood illness, caused by a virus, the most distinguishing characteristic of which is very red or “slapped cheek” rash. The name of the virus causing this syndrome is parvovirus B19 (no, it is not the same parvovirus dogs are vaccinated for) medical provider


Early fifth disease begins with mild cold like symptoms, including a low-grade fever, headache and a runny nose that generally last for several days. A few days after these symptoms resolve, the characteristic rash emerges due to an immune response to the infection. The rash typically begins on the face with very red cheeks and extends to the rest of the body, in a way some describe as "lacy."  Sometimes aches and pains can last for several weeks after fifth disease symptoms begin; however, the characteristic rash is more common in children.  Adults with fifth disease are less likely to develop the rash but more likely to develop joint pain. 

As this virus is transmitted through respiratory secretions, this illness is contagious during the early phase of symptoms (runny nose and low-grade fever) prior to the development of rash. The best way to avoid contracting this virus, as with most viruses, is to wash your hands frequently and avoid contact people who are sick, though this may be easier said than done, as most are unaware that they have fifth disease until they are no longer contagious.  

Since fifth disease is a virus, there are no magic medicines that will stop it in its tracks.  The best we can do is to prevent spread through hand washing and treatment of the symptoms.  We usually recommend acetaminophen (Tylenol) or ibuprofen (Advil) for fever and headache. For older children and adults, over-the-counter cold medications may be used, but younger children should not use these medications. Nasal saline is appropriate for all ages.  

Other than making one feel badly, fifth disease is not typically a serious illness for otherwise healthy patients. It can, however, be harmful for those with certain types of anemia and for unborn babies. Those with sickle cell anemia or other diseases that cause difficulty with production of red blood cells may have sudden worsening in anemia. If a pregnant woman contracts fifth disease, there is a risk the fetus may become severely anemic, which may even lead to miscarriage.

Laura Ekka, MD, is a physician board certified in both Pediatrics and adult Internal Medicine practicing with WakeMed Physician Practices – Garner Primary Care.