Fifth Disease (Erythema Infectiosum) Fact Sheet

Erythema infectiosum, or fifth disease, is typically a mild rash illness

Fifth disease is caused by a virus called parvovirus B19, which primarily affects school-age children. Fifth disease is usually a mild illness for people who are otherwise healthy.

For some people, fifth disease can cause serious health complications, affecting the nerves, joints, or blood system. Parvovirus B19 has been shown to cause a severe drop in blood count (anemia) in some patients with certain blood disorders or with a weakened immune system. Complications are more common for:

Unborn fetuses of pregnant women who develop fifth disease
People with weakened immune systems
People with blood disorders such as sickle cell disease and thalassemia

Fifth disease is spread from person to person

People who have fifth disease can spread the illness to others by coughing or sneezing, which creates respiratory droplets that contain the virus. You can get sick if you breathe in those droplets or touch something that has droplets on it and then touch your nose or mouth before washing your hands.

Someone with fifth disease is contagious starting a few days before their symptoms start until the rash fades away, which typically takes 7 to 10 days.

Symptoms of fifth disease include:

Red, patchy, “slapped cheek” rash on face
Rash (on arms, trunk, buttocks, and thighs)
Fever
Headache
Sore throat, congestion, cough, or runny nose
Nausea or diarrhea
Joint pain

Symptoms usually appear within 4 to 20 days after exposure to the virus; however, about 1 in 4 infected people will have no symptoms.

Talk to your healthcare provider if you think you have fifth disease

Fifth disease is often diagnosed based on the appearance of the rash. A blood test for antibodies can be used to see if a person is currently infected or was infected in the past, but this test is mainly used for pregnant women exposed to fifth disease.

It’s important to talk to your healthcare provider right away if you are at high risk for complications and think you have fifth disease or were exposed to someone with fifth disease.

There is no specific treatment or vaccine for fifth disease

Fifth disease is usually mild, and symptoms will go away on their own for most people. Treatment usually involves relieving symptoms such as fever and joint pain. For those who develop a low blood count, supportive care, blood products, and other specialized therapies may be needed.