Children's Hospital Colorado

Fifth Disease

Urgent or Emergency Care?

If you believe your child needs immediate attention and you have concerns for a life-threatening emergency, call 911. Not sure what counts as urgent and what's an emergency when your child is sick or injured? When it can't wait, know where to take your kids.

Help Me Decide

  • Viral rash that starts with red cheeks and spreads to the shoulders

Symptoms of Fifth Disease

  • Bright red cheeks on both sides for 1 to 3 days. Looks like "slapped cheeks".
  • Followed by pink "lace-like" (net-like) rash of arms and legs.
  • "Lacy" rash mainly is on thighs and upper arms/shoulders.
  • Rash also is on chest and stomach in 50% of children.
  • The rash does not itch or hurt.
  • No fever or low-grade one less than 102° F (39° C).
  • Peak age: 4 -12 years.

Cause of Fifth Disease

  • It is caused by the human parvovirus B19.
  • Not related to the dog parvovirus.

Prevent Spread to Others

  • Good hand washing can prevent spread of this illness.
  • Once the rash occurs, the child can no longer spread the virus.

Call 911 Now

  • You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

  • Only 1 cheek is red and also has fever
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Fever over 102° F (39° C)
  • You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Sore throat lasts more than 48 hours
  • Mother or other caregiver is pregnant
  • You have other questions or concerns

Self Care at Home

  • Fifth disease suspected

Care Advice for Fifth Disease

  1. What You Should Know About Fifth Disease:
    • It is a viral rash that is harmless.
    • It does not itch or hurt.
    • It can be treated at home.
    • Here is some care advice that should help.
  2. Fever Medicine:
    • For fevers above 102° F (39° C), give an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil).
    • Note: Fevers less than 102° F (39° C) are important for fighting infections.
    • For all fevers: Keep your child well hydrated. Give lots of cold fluids.
  3. Pregnant Women - Special Risk:
    • The risk of Fifth disease is to the unborn babies of pregnant women. It is not harmful to the woman herself.
    • A pregnant woman should see her doctor if she is exposed.
    • He will do a test to see if the mother has had the disease. If she has, she is protected.
    • If not, the pregnancy will need to be watched closely. Some babies that get it before birth can have problems. Ten percent can have a very low red blood cell count and 2% may die.
    • But, birth defects are never a result of this virus.
  4. What to Expect:
    • The lace-like rash can come and go for 1 to 3 weeks.
  5. Return to School:
    • Once your child has the "slapped cheeks", they can no longer spread the illness. Also, the lacy rash cannot be spread to others either.
    • Your child does not need to stay home from child care or school.
    • It can be spread during the week before the rash begins.
    • Exposed children should try not to have any contact with pregnant women. This may be hard to know ahead of time.
  6. Call Your Doctor If:
    • Fever above 102° F (39° C) occurs
    • You think your child needs to be seen
    • Your child becomes worse

Care Advice for Fifth Disease

Fifth Disease

There is redness and puffiness of both cheeks; this is the first sign of Fifth's Disease.

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Related departments