Springdale Mason Pediatrics

Fifth Disease


  • Fifth disease is a viral rash that starts with red cheeks
  • Then it spreads to the shoulders and upper thighs
  • Average age: 4 to 12 years

Call or Return If

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

About This Topic


  • 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 occurs on thighs and upper arms/shoulders.
  • Rash also occurs on chest and stomach in 50% of children.
  • The rash isn't itchy or painful.
  • No fever or low-grade one less than 102° F (39° C).


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

Prevention of Spread to Others

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

After Care Advice

  • Fifth disease is a unique viral rash that is harmless.
  • It does not cause itching or pain.
  • It can be treated at home.
  • Here is some care advice that should help.
  • For fevers above 102° F (39° C), give acetaminophen (such as Tylenol) or ibuprofen. Note: Lower fevers are important for fighting infections.
  • For ALL fevers: Keep your child well hydrated. Give lots of cold fluids.
Pregnant Women:
  • 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 OB doctor if she is exposed to Fifth disease.
  • He will do a test to see if the mother already had the disease. If she has, she is protected.
  • If not, the pregnancy will need to be watched closely. Some fetuses infected with Fifth disease before birth develop complications. Ten percent develop severe anemia and 2 % may die.
  • Birth defects, however, 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. Likewise, the lacy rash cannot be spread to others either.
  • Your child does not need to stay home from child care or school.
  • The disease can be spread during the week BEFORE the rash begins.
  • Therefore, exposed children should try to avoid contact with pregnant women. This may be hard to know in advance.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2021 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.
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