Fifth Disease Overview
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-age 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.
Medically Reviewed by a Doctor on 2/26/2015
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