Illness & Symptoms
Fifth Disease-Viral Rash
Is this your child's symptom?
- Viral rash that starts with red cheeks and spreads to the shoulders
 
- If NOT, try one of these: 
 - Rash or Redness - Widespread
 
Symptoms of Fifth Disease
- Bright red cheeks on both sides for 1 to 3 days. Looks like "slapped cheeks".
 - Followed by pink "lace-like" (net-like) rash of arms and legs.
 - "Lacy" rash mainly is on thighs and upper arms/shoulders.
 - Rash also is on chest and stomach in 50% of children.
 - The rash does not itch or hurt.
 - No fever or low-grade one less than 102° F (39° C).
 - Peak age: 4 -12 years.
 
Cause of Fifth Disease
- It is caused by the human parvovirus B19.
 - Not related to the dog parvovirus.
 
Prevent Spread to Others
- Good hand washing can prevent spread of this illness.
 - Once the rash occurs, the child can no longer spread the virus.
 
When to Call for Fifth Disease-Viral Rash
 Call 911 Now
 Call Doctor or Seek Care Now
  |  
  Contact Doctor Within 24 Hours
 Contact Doctor During Office Hours
  |  
  Self Care at Home
  |  
Call 911 Now
- You think your child has a life-threatening emergency
 
Call Doctor or Seek Care Now
- Only 1 cheek is red and also has fever
 - High Risk child (such as those with a chronic medical problem or weak immune system)
 - Your child looks or acts very sick
 - You think your child needs to be seen, and the problem is urgent
 
Contact Doctor Within 24 Hours
- Fever higher than 102° F (39° C)
 - You think your child needs to be seen, but the problem is not urgent
 
Contact Doctor During Office Hours
- Sore throat lasts more than 48 hours
 - Mother or other caregiver is pregnant
 - You have other questions or concerns
 
Self Care at Home
- Fifth disease suspected
 
Care Advice for Fifth Disease
What You Should Know About Fifth Disease:
- It is a viral rash that is harmless.
 - It does not itch or hurt.
 - It can be treated at home.
 - Here is some care advice that should help.
 
Fever Medicine:
- For fevers higher than 102° F (39° C), give an acetaminophen product (such as Tylenol).
 - Another choice is an ibuprofen product (such as Advil).
 - Note: fevers less than 102° F (39° C) are important for fighting infections.
 - For all fevers: keep your child well hydrated. Give lots of cold fluids.
 
Pregnant Women - Special Risk:
- The risk of Fifth disease is to the unborn babies of pregnant women. It is not harmful to the woman herself.
 - A pregnant woman should see her doctor if she is exposed.
 - He will do a test to see if the mother has had the disease. If she has, she is protected.
 - If not, the pregnancy will need to be watched closely. Some babies that get it before birth can have problems. Ten percent can have a very low red blood cell count and 2% may die.
 - But, birth defects are never a result of this virus.
 
What to Expect:
- The lace-like rash can come and go for 1 to 3 weeks.
 
Return to School:
- Once your child has the "slapped cheeks," they can no longer spread the illness. Also, the lacy rash cannot be spread to others either.
 - Your child does not need to stay home from child care or school.
 - It can be spread during the week before the rash begins.
 - Exposed children should try not to have any contact with pregnant women. This may be hard to know ahead of time.
 
Call Your Doctor If:
- Fever higher than 102° F (39° C) occurs
 - You think your child needs to be seen
 - Your child becomes worse
 
Remember! Contact your doctor if you or your child develop any "Contact Your Doctor" symptoms.
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
Copyright 2000-2025 Schmitt Pediatric Guidelines LLC.
Reviewed: 5/5/2025 Updated: 1/25/2025

