Fifth Disease

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Medical Author:

Robert Ferry Jr., MD

Robert Ferry Jr., MD

Robert Ferry Jr., MD, is a U.S. board-certified Pediatric Endocrinologist. After taking his baccalaureate degree from Yale College, receiving his doctoral degree and residency training in pediatrics at University of Texas Health Science Center at San Antonio (UTHSCSA), he completed fellowship training in pediatric endocrinology at The Children's Hospital of Philadelphia.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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• Fifth Disease Overview
• Fifth Disease Causes
• Fifth Disease Symptoms and Signs
• When to Seek Medical Care
• Fifth Disease Diagnosis
• Fifth Disease Treatment
• Self-Care at Home
• Medical Treatment
• Follow-up
• Fifth Disease Prevention
• Fifth Disease Prognosis
• Fifth Disease Picture
• Synonyms and Keywords
• Authors and Editors
• Read more on Fifth Disease from Healthwise
• Viewer Comments: Fifth Disease - Describe Your Experience
• Viewer Comments: Fifth disease - Symptoms

Fifth disease is a mild illness caused by a virus called human parvovirus B19. The medical name for fifth disease is erythema infectiosum (EI). This infection occurs primarily in school-aged children between 5 and 14 years of age during winter and spring. Fifth disease causes a reddish, lacy rash on the child's face, appearing as though the child had been slapped on both cheeks. Sometimes in North America, the disease has been referred to as slapped cheek syndrome or simply slapcheek. The characteristic appearance of the rash gave rise to the names "apple sickness" (or ringo-byou) in Japan and "butterfly pox" in Hungary (since the cheeks resemble the wings of a butterfly).

• The virus is thought to spread via droplets in the air (respiratory secretions transmitted by coughs and sneezes) or by blood from other infected people. Early during the illness, nasal secretions contain the viral DNA. Blood has been found to contain viral particles as well as DNA.
• Cases of fifth disease can occur either sporadically or as part of community outbreaks. Outbreaks occur mainly in elementary schools during the spring. Half of the cases occur from spread of the virus to others in the patient's household. Transmission of the infection in schools is less common.
• At least half of North American adults have been infected by parvovirus B19 and are unlikely to be reinfected. About 10% or fewer of young children are immune.
• People with this illness are contagious before the onset of symptoms and are probably not contagious after they develop the rash. The incubation period (the time from acquiring the infection to the development of symptoms) usually lasts between four and 21 days.
• The name fifth disease comes from a classification system developed in the 1890s but no longer used. It was the fifth in a list of the five most common rashes (or exanthems) of childhood and therefore acquired this name.

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