Fifth Disease: Are Those “Slapped Cheeks” a Reason to Worry?

by Carla Hahn Clardy on May 8, 2012

in Medical Information

child laying in bed sickThe young mother picked her child up from preschool and was immediately alarmed. It looked as if her son had been slapped across both cheeks. He had a slight fever and was a little grumpy. Her pediatrician said he had a mild viral infection called fifth disease. There was no cause for concern.

Shaili Singh, MD, Pediatrician at Temple Towne Center Pediatric Clinic, discusses fifth disease.

Fifth disease is a viral infection caused by the human parvovirus B19, says Dr. Singh. It’s a very common childhood illness, generally affecting children ages 3 through 12.

Your child is contagious only during the slapped-cheek stage.

Fifth disease is so called because it’s the fifth of a number of common childhood diseases, including measles, scarlet fever and chicken pox.

What Are the Symptoms of Fifth Disease?

Fifth disease follows a particular pattern of progression, Dr. Singh says.

“Slapped cheek.” “When your child first gets fifth disease, he’ll typically develop a rash that starts on the cheeks,” Dr. Singh says,” “in what is commonly referred to as ‘slapped cheek syndrome.’ The red cheeks will last a day or two.”

Occasionally your child may also have:

  • Fever
  • Achiness
  • Irritability

Small red bumps. Next, the red rash on the cheeks fades, but small red patches or bumps appear on the arms and legs, Dr. Singh says. These can last from one to two days to as long as a week

Lacelike pattern. Finally, on about Day 5 or 6 of the illness, the rash will change to a marbled or lace-like pattern, which, Dr. Singh says, lasts from one to two days or as long as three weeks.

Dr. Singh says your child is contagious only during the slapped-cheek stage. Fifth disease spreads through bodily fluids such as the mucus in the nose, expelled during coughing and sneezing.

Once the disease progresses to the red bumps or lacy stages, your child is no longer contagious and can go back to school or play around others, Dr. Singh says.

What Is the Treatment for Fifth Disease?

Because fifth disease is a mild viral infection, the treatment for fifth disease focuses on symptomatic care. Dr. Singh recommends that your child take over-the-counter antipyretics, such as Tylenol or ibuprofen, for the fever and achiness.

“You don’t need any topical ointments or creams because this rash typically doesn’t itch,” says Dr. Singh.

When Is Fifth Disease Dangerous?

Fifth disease is rarely dangerous. The only time a parent needs to have concern is if your child has an autoimmune disorder or:

  • Sickle-cell anemia
  • Aplastic anemia
  • Spherocytocis
  • Problems with their red blood cells

“For these children, fifth disease can cause serious complications, including aplastic crisis. If your child has any of the above conditions and has been exposed to fifth disease, you should notify his or her primary-care physician,” says Dr. Singh.

“Fifth disease, however,” says Dr. Singh, “generally does not affect the red blood cells of normally healthy children. You have no reason to worry.”

Pregnancy and fifth disease, however, pose a small problem, Dr. Singh says. There’s a very slight risk to the fetus if a woman develops fifth disease while pregnant.  Hence, “if a pregnant woman has been exposed to fifth disease, she might consider getting evaluated,” suggests Dr. Singh.

How Is Fifth Disease Prevented?

The best prevention for fifth disease is good hand washing, Dr. Singh says. “Regular hand washing will reduce the risk of getting fifth disease,” says Dr. Singh, “but most children get fifth disease at some point in their lives and it’s really nothing to worry about.”

When Do You Need to See a Doctor?

If you suspect your child has fifth disease based on his symptoms — red, “slapped cheeks,” in particular — you don’t need to take your child to see a doctor, but should stay home to prevent spread to others.

However, Dr. Singh says that if the symptoms don’t improve or you’re concerned the rash may be something else, your child may need to be evaluated.

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