Skip to main content
Skip to page content

Skip Navigation LinksPennsylvania Department of Health > My Health > A-Z Health Topics > E-H > Fifth Disease Fact Sheet


Fifth disease is a mild rash illness caused by parvovirus B19. This disease, also called erythema infectiosum, got its name because it was fifth in a list of historical classifications of common skin rash illnesses in children. It is more common in children than adults.
Signs and Symptoms
A person usually gets sick with fifth disease within four to 14 days after getting infected with parvovirus B19. The first symptoms of fifth disease are usually mild and may include:
  • Fever;
  • Runny nose; and
  • Headache.
After several days, you may get a red rash on your face called "slapped cheek" rash. This rash is the most recognized feature of fifth disease. It is more common in children than adults.
Some people may get a second rash a few days later on their chest, back, buttocks, or arms and legs. The rash may be itchy, especially on the soles of the feet. It can vary in intensity and usually goes away in seven to 10 days, but it can come and go for several weeks. As it starts to go away, it may look lacy.
People with fifth disease can also develop pain and swelling in their joints (polyarthropathy syndrome). This is more common in adults, especially women. Some adults with fifth disease may only have painful joints, usually in the hands, feet or knees, with no other symptoms. The joint pain usually lasts one to three weeks, but it can last for months or longer. It usually goes away without any long-term problems.
Causes and Transmission
Parvovirus B19 – which causes fifth disease – spreads through respiratory secretions (such as saliva, sputum or nasal mucus) when an infected person coughs or sneezes. You are most contagious when it seems like you have "just a cold" and before you get the rash or joint pain and swelling. After you get the rash, you are not likely to be contagious, so it is usually safe then for you or your child to go back to work or school.
People with fifth disease who have weakened immune systems may be contagious for a longer amount of time.
Parvovirus B19 can also spread through blood or blood products. A pregnant woman who is infected with parvovirus B19 can pass the virus to her baby.
Once you recover from fifth disease, you develop immunity that generally protects you from parvovirus B19 infection in the future.
Fifth disease is usually mild for children and adults who are otherwise healthy. However, for some people fifth disease cause serious health complications.
People with weakened immune systems caused by leukemia, cancer, organ transplants or HIV infection are at risk for serious complications from fifth disease. It can cause chronic anemia that requires medical treatment.
In a pregnant woman, infection may lead to anemia in the baby, which could result in miscarriage or stillbirth. This is a rare complication, but it is most likely to happen if the woman is infected during the first half of the pregnancy.
Tests and Diagnosis
Health care providers can often diagnose fifth disease just by seeing the "slapped cheek" rash on a patient's face. A blood test can also be done to determine if you are susceptible or immune to parvovirus B19 infection or if you were recently infected. The blood test may be particularly helpful for pregnant women who may have been exposed to parvovirus B19 and are suspected to have fifth disease.
Fifth disease is usually mild and will go away on its own. Children and adults who are otherwise healthy usually recover completely. Treatment usually involves relieving symptoms, such as fever, itching, and joint pain and swelling.
People who have complications from fifth disease should see their health care provider for medical treatment.
There is no vaccine or medicine that can prevent parvovirus B19 infection. You can reduce your chance of being infected or infecting others by:
  • Washing your hands often with soap and water;
  • Covering your mouth and nose when you cough or sneeze;
  • Avoiding touching your eyes, nose or mouth;
  • Avoiding close contact with people who are sick; and
  • Staying home when you are sick.
After you get the rash, you are probably not contagious, so it is usually safe for you to go back to work or for your child to return to school or a child care center.
Health care providers who are pregnant should know about potential risks to their baby and discuss this with their doctor.
All health care providers and patients should follow strict infection control practices to prevent parvovirus B19 from spreading.

Additional Information
Centers for Disease Control and Prevention: 
This fact sheet provides general information. Please contact your physician for specific clinical information.

Last reviewed/updated: June 14, 2016