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Fifth Disease

What is Fifth Disease?

This is a common skin related disease that can infect children. The medical name for this disease is Erythema Infectiosum. It is also known by the name slapped cheek disease. In other countries worldwide this disease has a variety of names such as in Japan it is referred to as the apple sickness because of the redness of the face and in Hungary it is referred to as the butterfly pox because the redness on the cheeks appear to look like a butterfly’s wing. You will usually find this disease in children between the ages of four to sixteen.

The reason that it is referred to as the “Fifth Disease” is that is number five in a group of skin diseases that cause a child to have a rash. The disease was first described in the 1880’s. Both females and males can get this disease equally. An adult, especially women who are pregnant or those who have an immune system that is damaged, can get Fifth Disease. Most patients with Fifth Disease get it during the spring and winter. Once you have had Fifth Disease and recover from it you will usually develop immunity so that you will not get it again.

Fifth Disease Symptoms

In some patients they may experience in the first phase of the disease:

  • Mild fever
  • Headaches
  • Tiredness
  • Pharyngitis
  • Nausea
  • Pain
  • Diarrhea
  • Arthralgias
  • Runny nose

These symptoms usually disappear by the time the rash starts to appear. These symptoms will usually start to appear within two to three weeks after you have been exposed to the virus and then the rash appears several days later.

First Stage

  • The patient’s skin starts to have a reddish color and gives the look of being slapped. This can appear on any part of the patient’s skin including the arms, legs, and cheeks.
  • The rash appears usually first on the cheeks and then spreads to the rest of the body.
  • The redden marks appear on the skin abruptly.
  • They begin to fade in four to five days.

Second Stage

  • An erythematous eruption starts happening on the skin. It usually targets the exterior surfaces and can last four to six days.
  • Slowly the pattern will convert into a pattern of blotches/patches that resembles lace on the skin and can last three to twenty-two days.

Adult Symptoms

If an adult gets this disease it can have a slight difference in symptoms and different characteristics. If a woman is pregnant and gets Fifth Disease there can be serious risk for the fetus. The symptoms most common in adult cases, especially women, include:

Symmetric pain in their joints which overtime can increase. The joint pain is more predominant in their knees, wrists, and ankles. This pain can last for weeks or even for months but will normally not cause any problems long term. It is sometimes called self-limited arthritis. They may also have trouble bending the joints that are affected or walking.

Other Symptoms

  • Swelling of their glands
  • Reddening of their eyes
  • Problems with their throat such as having a sore throat.

The rash may come back if you get too warm, under a lot of stress, or when you are out in the sun. When people have Fifth Disease they may not even feel sick or get the rash. With the rash it can be itchy at times, especially on the soles of their feet.

Fifth Disease Causes

This disease is caused by the virus Human Parvovirus-B19. It is commonly spread among children in school. Because it is a viral infection it can be spread by droplets from an infected person coughing or sneezing. You can also spread this disease if you have flu-like symptoms. The patient is considered to be infectious during the disease’s incubation period. This incubation period is during the initiation and development of Fifth Disease until the rash appears. It can also be transmitted through blood products or blood transfusions and if a pregnant woman gets this disease she can spread it to her unborn baby.


When you visit your physician he can usually tell if you have Fifth Disease just by looking at the skin rash. If you have an immune system that is compromised or are pregnant your physician may test you to see if you have specific antibodies. The physician will also do a physical exam and ask questions about your medical history. If you have the rash it is easier to diagnose the disease.

Fifth Disease Treatment

Normally this disease will go away on its on without any type of treatments. Because it is caused by a virus antibiotics will not help. You can treat the symptoms by:

  • Getting plenty of rest.
  • Drinking extra fluids to help prevent dehydration.
  • Using over-the-counter medications such as ibuprofen or acetaminophen for joint pain, fever, or headaches.
  • Make sure that you are washing your hands so you do not spread the disease.

The physician will base the treatment that you need according to what their age is, what shape their immune system is in, and if they are pregnant. They may prescribe a lotion to help with the rash if you are suffering from itching. Once the rash appears the child can go back to school because they are no longer contagious.

If you have any form of anemia you do need to see your physician because this disease can stop the body from producing the red blood cells. This can decrease the amount of oxygen that gets to your tissues.

Fifth Disease Pictures

Pictures of Fifth Disease…

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fifth disease pictures

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