Fifth Disease

Fifth disease, also known as erythema infectiosum, is a viral infection characterized by a rash on the face, arms and trunk. It is caused by a virus called human parvovirus B19. It is especially common in children between the ages of 5 and 15 years and outbreaks tend to happen in winter and early spring.


This disease is highly contagious and can be spread in a variety of ways:

  • By coming in contact with the virus in the air after an infected person has coughed or sneezed
  • By touching the hands of someone who has the infection or touching objects that have come into contact with an infected person and on which the virus is present
  • From mother to unborn child
  • Through blood transfusion

Contagion begins 7 days before onset of symptoms and ends at the time the rash appears.

Incubation Period

The incubation period - or time between infection and the onset of symptoms - is usually 4 to 14 days. It can, however, last up to 28 days.


The characteristic rash of fifth disease is preceded by symptoms of generalized malaise. Adults usually feel the effects of the disease, while children are typically asymptomatic. Malaise symptoms last 2 to 3 days and include headache, fever, sore throat, itchiness, abdominal pain and joint pain. Then, a red, lace-like rash appears on the cheeks, making the face look like it has been slapped. The rash then spreads to the forearms and thighs and resolves within 6 to 8 days. The rash may recur for no reason in the month following the infection, triggered by a skin irritant such as a hot bath, friction, sun exposure or physical exercise. Serious complications are rare with fifth disease. It is recommended however, that you speak to your doctor if any of the conditions below apply to you:

  • If you are anaemic
  • If you have a weakened immune system
  • If you are pregnant

Symptoms may be more serious if you have either of the first two conditions. Usually, there are no serious complications for a pregnant women or her baby when exposed to fifth disease. About 50% of women are already immune to the virus which protects both mother and child from infection and illness. Even if a woman becomes infected while pregnant, she usually experiences only a mild illness. Her unborn baby usually does not have any problems. Sometimes, however, the infection will cause the unborn baby to develop severe anemia which may lead to miscarriage. This occurs in less than 5% of all pregnant women who are infected with parvovirus B19 and occurs more commonly during the first half of the pregnancy. There is no evidence that the virus causes birth defects or mental retardation.


There is no vaccine to prevent the infection and no medication to treat it. It is advised that you rest and drink plenty of water. It is preferable that you avoid exposure to sunlight and excessive heat to prevent rash. As for the fever and pain, we recommended the use of an analgesic such as acetaminophen (ex: Tylenol®).

Frequent handwashing is a simple measure that significantly reduces the risk of transmitting most contagious diseases!

For more information :

Canadian Paediatric Society

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