Fifth Disease-Viral Rash

Is this your child's symptom?

• 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.

When to Call for Fifth Disease-Viral Rash

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
• High Risk child (such as those with a chronic medical problem or weak immune system)
• 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 higher than 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

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.

Fever Medicine:

• For fevers higher than 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.

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.

What to Expect:

• The lace-like rash can come and go for 1 to 3 weeks.

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.

Call Your Doctor If:

• Fever higher than 102° F (39° C) occurs
• You think your child needs to be seen
• Your child becomes worse

Remember! Contact your doctor if you or your child develop any "Contact Your Doctor" symptoms.

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

Last Reviewed: 05/05/2025

Last Revised: 01/25/2025

Copyright 2000-2025 Schmitt Pediatric Guidelines LLC.