Fifth disease (erythema infectiosum) is a viral illness associated with a rash caused by the human parvovirus B19. The disease is most prevalent in late winter and spring, and about 70 percent of the recognized infections occur in children between the ages of 5 and 15.

“Outbreaks of this moderately contagious disease frequently occur in school settings,” says Dr. Joel Steinberg, a pediatrician on the medical staff at Children’s Medical Center Dallas. “The disease is spread through direct contact from nasal and respiratory secretions.”

• A brief mild non-specific illness consisting of fever, mild body aches and headache precedes the characteristic rash by about seven to 10 days. It is during the initial phase that the child is contagious.
• The rash, which is usually the primary symptom parents notice, is characterized by bright red cheeks, described as slapped cheeks, with paleness around the mouth.
• The rash is then noted on the arms, legs and trunk.
• It is very typical for the rash to come and go, especially in relation to sunlight, overheating or hot temperatures.
• The rash may come and go for weeks.
• During the rash phase, the child usually is not contagious and does not have other symptoms.
• Human parvovirus B19 also can cause manifestations other than a rash, such as mild respiratory tract infections and joint pains, which are more commonly seen in adults when the symptoms may be more severe.

While fifth disease usually is a mild illness, parvovirus B19 infection may cause acute severe anemia in persons with sickle cell disease or other hemolytic anemias. Symptoms of fifth disease may resemble other conditions or medical problems. Always consult your child’s physician for a diagnosis. Diagnosis usually is made by your physician on observation of the typical rash.