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    Maryland Department of Health
    Prevention and Health Promotion Administration

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    Fifth Disease (Erythema Infectiosum) Fact Sheet

    PDF Version of this Fact Sheet

    Fifth disease is a mild rash illness

    It is caused by a human virus called parvovirus B19 and primarily affects school age children.

    Many people already have had fifth disease

    Most people get infected between 5 and 14 years of age. It is estimated that about half the adults in the United States have been infected with parvovirus B19 and therefore can not get it again.

    A red, patchy, "slapped cheek" rash on the face is common during infection

    The rash may appear on other parts of the body (such as the arms, trunk, buttocks, and thighs). Other symptoms such as fever, headache, body ache, sore throat, congestion, runny nose, cough, nausea, or diarrhea may come before the rash. In adults, joint pains or arthritis may occur. Symptoms usually start 4 to 20 days after a person has been exposed. About 25% of all cases have no symptoms. In both children and adults, the disease is usually mild and recovery occurs without problems.
                    
    A person with fifth disease usually spreads the virus before the rash starts

    The virus is spread by exposure to airborne droplets from the nose and throat of infected people. The virus can also be transmitted by blood or blood products.

    There is a blood test, but it is not widely available

    A blood test for antibodies is used to see if a person is currently infected or was infected in the past. The blood test is used primarily for pregnant women exposed to fifth disease. In most cases, the disease is diagnosed based on the appearance of a typical rash.

    There is no specific treatment or vaccine for fifth disease at this time

    Some people are at higher risk of complications or serious illness if they get fifth disease:

    • Unborn fetuses of pregnant women who develop fifth disease. Miscarriages and stillbirths are uncommonly associated with parvovirus infection, but are more frequent when infection occurs during the first half of pregnancy. Parvovirus infection later during pregnancy can lead to severe anemia in the fetus, prematurity, or stillbirth.
    • People with immunodeficiency or chronic red blood cell disorders (such as sickle cell anemia) may get severe anemia if they catch fifth disease.

    Those at risk should check with their doctor

    Those at increased risk for serious illness or complications should realize that they might catch fifth disease from family members, others in the community, and in child care, school, or other occupational settings. Pregnant women and others at risk should consult with their physicians if they have been in contact with a case of fifth disease. The doctor may want to check the blood to see if they have already been exposed to parvovirus. Routine exclusion of those at risk from settings where fifth disease is occurring is not recommended since the risk depends on whether the person is already immune. Each exposure needs to be individually evaluated.

    Exclusion of children with fifth disease from school or day care is not recommended

    Since the greatest risk of viral spread is before symptoms begin, few control measures are necessary.