Fifth Disease: Are You Susceptible? Is Your child?

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The "slapped cheeks" of Fifth Disease. Photo from WebMD.

First came the email from my school, and then the notice home–“cases of Fifth Disease have been reported.” Fifth Disease?  Huh? I had no idea what Fifth Disease was, and didn’t know why I should be worried about it. Thinking others may be in the same boat, Breezy Mama turned to Pediatrician Anatoly Belilovsky, M.D. for answers.

What is Fifth Disease?

It is a visually distinctive, but clinically mild, viral illness caused by Parvovirus B19 and transmitted by droplet (cough/sneeze) spread.

How do we know if we have it?

Mainly by its distinctive rash – usually red “slapped cheeks” to start, then a “lacy” extremity rash extending to the rest of the body. The order of appearance is sometimes reversed; when “slapped cheeks” appear later, diagnosis is usually delayed. Besides the rash, there may or may not be a low grade fever, mild aches and pains, and mild cough.

Is it seasonal?

Somewhat; more common winter/spring, but can occur at any time.

Can people and kids of all ages get it?

Peak incidence is school age, but, again, it is rare but possible at any age.

Is it contagious?


If our child contracts it, should we alert school officials?

The disease is not on the list of reportable conditions in New York, but I would recommend informing the school so that other parents know what to expect, as a courtesy.

What kind of precautions should we take to avoid getting Fifth Disease?

Only people at high risk for complications should take any precautions, but as the most contagious period is before the rash appears, and most persons with this infection are not significantly symptomatic, the illness is very difficult to avoid except by complete isolation.

Why does it have such a funny name?

I think it’s a sign of how mild it is, and the contempt in which it was once held – we have the “real” diseases with rashes, measles, scarlet fever, rubella, roseola, and then there’s this one, whatchamacallit, fifth disease that no one particularly cares about. By the time we found reasons we should care about it, the name had stuck.

Anything you’d like to add?

Yes. In addition to the symptoms listed, Parvovirus B19 almost always causes the bone marrow to shut down production of red cells, and only red cells, for a short time – a week or so in normal individuals, though that may be longer in people with AIDS or receiving chemotherapy. Since red cells normally live for 120 days, this shutdown is barely noticeable most of the time. However, in people with hemolytic anemia (such as thalassemia major or sickle cell disease) all red cells may be destroyed within that short time, causing severe anemia; prolonged shutdown in persons with immune deficiencies may also cause severe anemia; and the same can happen in the fetus, usually in the second trimester, when a woman who has never had this disease catches it while pregnant. This is the main reason why healthy children really do not need to be kept out of schools during outbreaks of fifth disease, but pregnant teachers may need to be.

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About The Author: Anatoly Belilovsky, M.D., is a board certified pediatrician, and is listed in America’s Top Pediatricians and is the recipient of the Americhoice Quality of Care Award. He is a Clinical Instructor in Pediatrics at the Weill College of Medicine and serves as the medical director of Belilovsky Pediatrics in Brooklyn, N.Y.



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  1. My son had fifth’s disease when he was 13 months old. It took a while for it to go away, but other than a low fever it didn’t affect him much.

  2. We just got a letter home from Sydney’s school yesterday about this. My husband and I were asking the same questions…thanks!

  3. I wanted to share my story since fifths disease is common amonscore schoolers who have pregnant mommies. My son came down with this when I was 8 weeks pregnant. I did significant research on it because fifth disease can impact pregnancy and the fetus in rare cases. Thankfully I was immune.
    A few facts this author missed…
    *Pregnant women before 20 weeks who do not have immunity are at risk for miscarriage or their fetus can develop fetal anemia or an inflamed heart.
    **If you had fifth disease as a child, you are immune to it. Just like the chicken pox. A simple test at your OB-GYN office can tell you if you have immunity (most do).
    ***There’s no cure for fifths disease in pregnant women who are affected, their pregnancies are just more closely monitored through ultrasounds.

  4. My mother got fifth’s disease when I was in high school. a few days after we knew what she had, we discovered I had it too. In adults it can be a bit more severe. My mother had a headache so bad you could see how much pain she was in.One of the symptoms for adults is a swelling in the lining around the brain … thus the headache. It was awful. I couldn’t hold a pen due to all the swelling in my joints. It took us both nearly 3 weeks to be done with it. I wouldn’t wish it on anyone.


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