Fifth Disease Pediatric Care Plan

By David Shafran, MD
Medically reviewed
January 18, 2021

What is Fifth Disease (Erythema Infectiosum)?

Erythema infectiosum, also known as slapped-cheek rash and fifth disease, is caused by the virus parvovirus B-19. The main symptom of fifth disease is a rash.

Prior to the rash occurring, your child will likely have other viral symptoms such as:

  • fever
  • headache
  • sore throat
  • runny nose
  • upset stomach

The fifth disease rash usually appears as the child is beginning to feel better from the initial viral symptoms. It can include bright red cheeks (known as ‘slapped cheek’) and a lace-pattern (net-like) rash on the chest, arms and legs.

The rash usually doesn’t cause any other symptoms. Parvovirus can be dangerous to children with sickle cell disease and, in rare cases, can be dangerous to a developing fetus. 

Fifth Disease Treatment

Parvovirus is harmless and so is its rash. If the rash is not itchy then you don’t need to apply any cream. 

If the rash is itchy:

  • You can apply an unscented moisturizing cream like Aveno or Eucerin. It’s best to do this after a warm bath while the skin is till damp
  • You can apply an over-the-counter 1% hydrocortisone cream up to 3 times per day to the itchy areas

Pregnant women who come into contact with someone with parvovirus should call their doctors to evaluate the risk to the fetus. Their doctor will usually test them to see if they’ve had parvovirus before and if not, will monitor the fetus closely even though complications are rare.

When can my child return to school?

Once the rash of parvovirus appears – either ‘slapped cheek’ or ‘lace-like’ –  your child can no longer spread the virus and can return to school as long as they do not have a fever.

Check in With K If…

  • You have general questions about your child’s condition
  • You want general followup for your child      
  • You have questions about supportive care      
  • Your child’s symptoms don’t go away but are not alarming

See a Doctor in Person If…

  • If fever last more than 5 days
  • If congestion or runny nose lasts for more than 10 days
  • If your child develops ear pain
  • If your child looks really sick with a concerning decrease in activity level even without a fever
  • If your child isn’t drinking enough and you’re concerned for dehydration
  • If your child has a bad cough, chest pain, or difficulty breathing
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

David Shafran, MD

Dr. Shafran is a board-certified pediatrics physician. He joins K Health from the Cleveland Clinic, where he led a pediatrics practice and completed a fellowship in transplant ethics. He has completed multiple fellowships, including one in pediatric nephrology at Rainbow, Babies & Children's University Hospitals. He received his medical degree from the Sackler School of Medicine in Tel Aviv and completed his medical residency at the Jacobi Medical Center.