Updated: 2018, Dec 20

Fifth Disease: Symptoms, Causes, Risk, Treatments and More

By - Reviewed by CHD Team
Fifth Disease


Fifth disease involves having a mild rash illness that is directly caused by parvovirus B19. It is often called erythema infectiosum that is a lot more common in children. A person typically gets sick within 4 to 15 days after he/she is infected with parvovirus B19. Approximately one in five of patients with the disease do not develop any symptoms.

Signs and Symptoms

The symptoms of the disease differ from one person to another and may include any of the following:

  • Low-grade fever
  • Bright red cheeks or rashes
  • A flat or raised reddish rash that usually appears on the arms and legs. It usually lasts from 2 to 39 days and may become itchy. The rash starts to fade from the center outwards thus causing a lacy appearance. It can recur with physical activity, warm baths, and irritation of the skin or emotional upset.
  • Although less common, sore throat, headache and joint pain may also occur.

Not all children develop a rash due to unclear reasons. The rash may last several weeks and fluctuate which are both normal.
The following symptoms are more common and severe in adults who are infected with parvovirus B19 generally preceding the rash that usually doesn’t occur in adults:

  • Headache
  • Sore throat
  • Muscle pain
  • Joint pain
  • Abdominal pain
  • Fever

In most cases, fetuses are not affected when their mothers are infected with the virus, and there is no proof that it can cause birth defects. However, if the fetus becomes infected, the virus may cause a disruption in the fetus’ normal production of red blood cells. This can lead to a severe form of anemia, heart failure and in some cases cause miscarriage or stillbirth. There is about a 10% chance of a miscarriage in pregnant women who are infected with the virus.


Causes and Risk Factors

Most people have the misconception that they can get infected from dogs and cats, but the type of “parvo” is different so there is no risk of catching a fifth disease from pets. Fifth disease is spread by droplet contact or when a person comes into contact with mucus or saliva that carries the virus. It can be spread through coughing, sneezing, kissing and sharing personal items. Frequent hand washing has been shown to help reduce its spread. Unlike other rash illnesses like measles, once symptoms appear, the infected individual is not contagious anymore. Fifth disease usually affects children 5 to 7 years of age, and it is more common during springtime. Adults who have never had fifth disease can catch it, but most adults have already had it and are immune.

Causes and Risk Factors

Tests and Diagnosis

There is no need for tests since doctors can usually tell if a person has fifth disease through the examination of the pattern of the rash. A blood test can confirm by checking for antibody to parvovirus, but this is not really necessary. Blood tests are only conducted when the patient has other conditions that may increase the risk for complications from the fifth disease.

Treatments and Medications

Generally, there is no need for treatment other than taking an antihistamine if the rash is itchy. For those with joint pain, the use of non-steroidal anti-inflammatory medication such as ibuprofen may be used. Treatment is only necessary if the person has chronic anemia, sickle cell anemia or an impaired immune system where immunoglobulin is injected to fight the virus. In some cases, red blood cell transfusion may be needed.

Precautions and Self Care

Home care is primarily for relieving the symptoms of fifth disease that includes the following:

  • Drink plenty of water or other non-diuretic fluids.
  • Eat plenty of fruits, vegetables and nutritious foods that can help strengthen the immune system.
  • Take acetaminophen for controlling the fever. Do not take aspirin since this will increase the risk of developing Reye’s syndrome in children with a fever.
  • Wash your hands if you are infected to prevent spreading the virus. Wash your hands after handling personal items of a child with the fifth disease.

If the symptoms become severe, it would be best to consult your health care provider to make sure that risk for complications is minimized.


Fifth disease only causes mild symptoms that go away on their own. Take note that the risk of developing complications is much higher in people with compromised immune systems so if this is the case, seek the guidance of your health care provider. In most cases, you just need to control the symptoms and prevent the spread of the virus in your household.

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Dr. Ahmed Zayed

Dr. Ahmed Zayed Helmy holds a baccalaureate of Medicine and Surgery. He has completed his degree in 2011 at the University of Alexandri

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