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

  • Fifth disease is a rash that starts with red cheeks
  • Then it spreads to the shoulders and upper thighs
  • Caused by a virus

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 Now or Go to ER

  • 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

Call Doctor Within 24 Hours

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

Call Doctor During Office Hours

  • Sore throat present 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.

Disclaimer

The information contained in these topics is not intended nor implied to be a substitute for professional medical advice, it is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition. Nothing contained in these topics is intended to be used for medical diagnosis or treatment.

  • Not a Substitute - The information and materials in Pediatric HouseCalls Symptom Checker should not be used as a substitute for the care and knowledge that your physician can provide to you.
  • Supplement - The information and materials presented here in Pediatric HouseCalls Symptom Checker are meant to supplement the information that you obtain from your physician. If there is a disagreement between the information presented herein and what your physician has told you -- it is more likely that your physician is correct. He or she has the benefit of knowing your child's medical problems.
  • Limitations - You should recognize that the information and materials presented here in Pediatric HouseCalls Symptom Checker have the following limitations, in comparison to being examined by your own physician:
    • You can have a conversation with your child's doctor.
    • Your child's doctor can perform a physical examination and any necessary tests.
    • Your child could have an underlying medical problem that requires a physician to detect.
    • If your child is taking medications, they could influence how he experiences various symptoms.

If you think that your child is having a medical emergency, call 911 or the number for the local emergency ambulance service NOW!

And when in doubt, call your child's doctor NOW or go to the closest emergency department.

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