Fifth Disease: How Bad is it?

April 2, 2024

Has your child caught the fifth disease and you don’t know what to do? In this article, we discuss how long the rash of the fifth disease lasts, what the difference is with the sixth disease, how to relieve itching, what the symptoms of scarlet fever are instead, and how to generally tell if it is an exanthematous disease.

What is the fifth disease?

The fifth disease, technically known as Erythema infectiosum, is a common childhood illness.

Also known as “slapped cheek” disease, it is caused by Parvovirus B19.

It is so named because it was the fifth exanthematous disease (i.e., a disease with a rash) to be identified and studied, after measles, scarlet fever, rubella, and the fourth disease or Dukes’ disease.

How long does the rash of the fifth disease last?

Once it starts, the fifth disease rash can last from 1 to 3 weeks.

It usually starts with a red rash on the face, which may resemble the slap mark on the cheeks.

After a couple of days, the rash may spread to the trunk, arms and legs.

However, the duration of the rash can vary from child to child, and in some cases, it can last up to six weeks, especially is under stress or has other underlying conditions.

Here is a small table with the symptoms of the fifth disease and their approximate chronology:

Initial PhaseMild fever, malaise, joint pain1-2 days before rash appears
Eruptive PhaseRed rash on cheeks (“slapped cheek” appearance), then on arms, legs, and trunk1-4 days after cheek rash appears
Remission PhaseRash becomes maculopapular and then fades7-10 days after rash appears

What is the difference between fifth and sixth diseases?

Fifth and sixth diseases are two distinct exanthematous diseases, both of which are common in children.

The fifth disease is caused by Parvovirus B19 and manifests as we mentioned with a red rash on the cheeks, arms and legs.

On the other hand, the sixth disease, also known as Exanthem Subitum or Rubella, is caused by herpes virus type 6B or 7 and manifests with high fever followed by a rash.

fifth disease

How to relieve itchy fifth disease?

If your child is experiencing itching due to fifth disease rash, several remedies can help.

A warm bath with colloidal oatmeal or baking soda can help soothe the itching.

Light, breathable clothes can also help keep the skin cool and prevent further irritation.

In any case, hear from your pediatrician, and he or she will be able to recommend solutions tailored to your child’s specific situation.

How is fifth disease treated?

Fifth disease usually requires no specific treatment.

However, if your child has fever or pain, ibuprofen or acetaminophen may help (of course, your pediatrician will advise which is best and in which cases).

It is important to remember, however, that aspirin should not be used in children or adolescents because of the risk of Reye’s Syndrome, a rare but serious condition.

As with many other childhood diseases, the only things to do are to prevent it when possible, stop the infection, and wait for the natural course.

How to tell if it is a rash disease?

Exanthematous diseases are characterized by a rash or exanthem.

If your child has a rash along with fever or other symptoms, he or she may have a rash disease.

However, the rash can vary greatly among different diseases, so it is important to consult a doctor for proper diagnosis.

Is the fifth disease contagious?

The answer is affirmative: those with the Fifth Disease can actually spread this infection to another healthy individual.

Mode of transmission of the Fifth Disease

An individual can contract the fifth disease, caused by Parvovirus B19, through various modes of transmission from an infected person to a healthy one, including:

  • Inhalation of droplets of saliva from an infected person, which may be released during sneezing, coughing or conversation (this is the case with respiratory secretions).
  • Contact with surfaces that have been touched by an infected person, followed by any touching of one’s own mucous membranes (eyes, mouth, nose).
  • Direct exposure to the blood or tissues of an infected person.
  • It is also important to note the risk of transmission of the disease during pregnancy, from mother to child through the placenta (hematoplacental transmission).

Period of contagiousness of the Fifth Disease.

The phase during which a person with the fifth disease is contagious begins before symptoms occur, that is, during the incubation period of the disease, and extends to the emergence of the first visible signs, such as skin rash.

Thereafter, the risk of infection decreases rapidly until it disappears completely.

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Kostolansky S, Waymack JR. Erythema Infectiosum. [Updated 2023 Jul 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from:

About the Author

Severino Cirillo

Health, Wellness and Education Expert. With a degree in Community Health, he is the CEO of Informed Parent and is responsible for validating the blog's scientific information and coordinating the editorial team of experts, consisting of gynecologists, midwives, psychotherapists, and others in pregnancy, perinatal, and parenting wellness and health.