Fifth disease is a contagious viral disease that results in the appearance of a bright red rash on the face and mild, flu-like symptoms. The rash makes a person appear to have “slapped cheeks” or sunburn. The disease usually affects children ages 4 to 10, though adults may become infected as well. It is caused by a virus called parvovirus B19, and is spread by direct contact with the bodily fluids (e.g., saliva, nasal and throat discharges) of an infected individual or through contact with contaminated objects or surfaces.

This viral infection most often occurs in late winter and early spring. Fifth disease is generally mild and does not cause any lasting complications, though it may be serious or fatal for certain patients. Pregnant women who are exposed to the disease during the first trimester may experience a miscarriage (spontaneous termination of pregnancy). In addition, people with a compromised or weakened immune system may develop a very severe type of anemia (red blood cell deficiency) that can become life threatening if left untreated.

The disease usually begins with the appearance of mild, flu-like symptoms, often including a low-grade fever, sore throat and fatigue. Two or four days later, the characteristic blotchy rash usually appears. The rash spreads to the torso area, legs and arms. In these areas, the rash has a lacy and net-like appearance. Sometimes, patients may experience itching (pruritus) in the affected regions. In some cases, especially adults and older teenagers, severe joint pain and inflammation may occur.

Fifth disease is usually diagnosed by taking a patient’s complete medical history and performing a physical examination. In most cases, no other testing is needed. Mild cases of the disease typically require treatment of symptoms.Most patients experience complete recovery with no long-lasting damage to the body, including the joints. However, severe cases resulting in acute anemia may require emergency medical treatment.