Fifth Disease

Fact sheet about Fifth Disease

What is fifth disease?

Fifth disease is a mild childhood illness with a rash. It is called “fifth disease” because it was the fifth of a group of similar rash illnesses to be described. (rubella, measles and scarlet fever are also in this group.) Most cases of fifth disease occur in late winter or early spring. Clusters of cases in schools or day-care centers are not unusual.

How common is fifth disease?

Fifth disease is so common in children that by age 15, 50% of children are immune because they have already had fifth disease.

What are the symptoms of fifth disease?

The first stage of symptoms includes headache, body ache, sore throat, mild fever, and chills. These symptoms last for two or three days. In the second stage, there are no symptoms at all for up to a week. In the third stage, children get a bright red rash on their cheeks that can look like slap marks. This “slapped-cheek” rash is sometimes followed by a lacy rash on their arms and legs. Adults are less likely to have the third-stage rashes but sometimes get swollen and painful joints, especially in the hands and feet.

Fifth disease is usually mild, and most children and adults get better without any problems. Some people have no symptoms and never even feel sick. A few people may get very sick from fifth disease, but this is rare. The people at risk for problems are those with blood disorders (such as sickle cell anemia) or a weakened immune system (from problems such as HIV/AIDS or chemotherapy).

Is fifth disease a problem for pregnant women?

Fifth disease is not known to cause birth defects. However, a few women who got fifth disease while they were pregnant had miscarriages or stillbirths. Recent research suggests that the risk of problems during pregnancy is extremely low. Even so, women who get fifth disease while they are pregnant should be closely watched by their doctors or midwives.

How is fifth disease spread?

The virus that causes fifth disease lives in the nose and throat, and it is sprayed into the air when an infected person sneezes, coughs, or talks. Other people nearby can inhale the virus. However, it seems to take close, prolonged contact (like living in the same household or being in the same classroom) to spread the disease.

How is fifth disease diagnosed?

Children with fifth disease are diagnosed by their symptoms, especially the rash on their cheeks. There is a blood test for fifth disease, but it is usually only used for pregnant women and people who have blood disorders or weakened immune systems.

Can fifth disease be prevented?

There is no vaccine against fifth disease, but so many adults are already immune that there is little need for one. Handwashing and careful disposal of tissues used to wipe noses can help prevent the spread of disease.

How long is someone with fifth disease contagious?

People with fifth disease are most contagious before their symptoms start. By the time they get a rash or joint pains, they are no longer contagious.

Should children with fifth disease be kept home?

Most children are no longer contagious by the time they are diagnosed, so there is no reason to keep them home from school or day care.

Should pregnant women avoid work during an outbreak?

The Department of Public Health does not recommend that employers routinely keep pregnant women out of work during an outbreak of fifth disease. The woman herself should be the one who decides. If you are pregnant and there is an outbreak where you work, talk to your doctor or midwife, health officials, and your employer before you decide whether or not to go to work.

Where can I get more information?

  • Your doctor, nurse or clinic
  • The Centers for Disease Control and Prevention (CDC) website
  • Your local board of health (listed in the telephone directory under “government”)
  • The Massachusetts Department of Public Health (MDPH), Division of Epidemiology and Immunization at (617) 983-6800 or toll-free at (888) 658-2850.

Spanish and Portuguese translations of this fact sheet are available under additional resources.

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