Fifth Disease (Slapped Cheek)

What is fifth disease?

Also known as "Slapped Cheek" or "Erythema infectiosum", fifth disease is a common childhood infection characterised by a distinctive red rash on the cheeks (hence the name), and a lacy rash on the limbs. It is caused by a virus known as Parvovirus B19. 

There are six childhood infections that cause a rash. These are known as "exanthems" (Greek for "breaking out"). These are;

• First Disease - Measles

• Second Disease - Scarlet Fever

• Third Disease - Rubella

• Fourth Disease - Duke's disease

• Fifth Disease - Slapped cheek

• Sixth Disease - Roseola

Can my child go to school if they have fifth disease?

Exclusion from school is not necessary unless the patient feels unwell as the disease is no longer contagious once the rash develops.  [1]

Pregnant women and individuals with sickle cell disease should avoid contact with infected children.

Is fifth disease contagious?

Yes it is. Transmission occurs via respiratory secretions (saliva, nasal mucous etc.) or via the blood of an infected individual. The incubation period (the time between the initial infection and the onset of symptoms)  is between 4-14 days. Patients are usually no longer contagious when the rash appears.

Symptoms of fifth disease?

The most common symptoms are a red rash on the cheeks and a fine, with a lacy rash on the limbs developing a few days later. Other symptoms may include;

• Flu like symptoms

• Fever

• Headache

• Itching

• Swollen glands

• Swelling and pain in the joints may develop in teenagers and adults

The disease is usually mild however pregnant women are at risk ad the virus can cause serious complications to the developing fetus or miscarriage (usually if the disease is contracted before 20 weeks gestation). Immunocompromised people and those with sickle cell disease are at greater risk of serious illness. Between 40-60% of adults have had past exposure to the Parvovirus B19. Many will have experienced few, if any symptoms whatsoever.

Diagnosis and Treatment of fifth disease:

In many cases, your doctor will be able to diagnose fifth disease on symptoms alone. However, they may wish to confirm diagnosis with a blood test.

There is no cure for slapped cheek & treatment is aimed supportive care such as rest and the use of over the counter painkillers (Ibuprofen or Paracetamol) to relieve fever.

References:

[1] National Health and Medical Research Council