Fifth disease, also referred to as “slapped cheek syndrome”, is viral illness that commonly affects children from age 5–15. It is characterized by a bright red rash that appears on the cheeks. Fifth disease initially starts out with flu-like symptoms such as fever, headache and sore throat. After a few days, these symptoms fade and a rash on the face appears. The rash then begins to spread across the body, affecting the chest, arms and legs. After a few days, blotchy sections of the rash start to clear up, leaving a net-like pattern on the skin. It usually takes about 7–10 days for the rash to fade away. However, the rash may reoccur if too much time is spent in the sun, or if the person undergoes stress before the rash has completely gone away. Although this virus typically affects children, adults can be affected as well. This illness is especially dangerous for pregnant women, as it may cause anemia and fetal stress.

Common features of fifth disease include:

Flu-like symptoms: Coughing, runny nose, chills, fever, sore throat and headaches are usually the earliest symptoms of fifth disease.

Rash: A bright red rash appears on the face, primarily the cheek area. The rash tends to spread to other parts of the body during the course of the illness.

Itchiness: In some cases, the rash may become itchy.

Joint pain: Some people (usually adults) who have this condition may experience joint pain or stiffness.

Fifth disease is caused by human parvovirus B19. It is usually spread by coughing or sneezing, but can also be transmitted through the blood. It is contagious during the early part of the illness, before the appearance of the rash. By the time the rash has formed on the face, the person is no longer contagious, and can resume contact with others without fear of spreading the virus.

The skin may be very sensitive during the rash phase, so it is important to exercise gentle skin care. Hand washing is important to minimize transmission of the viral infection. Avoid soaps, especially bar soaps, as they can cause dry skin and damage to the skin barrier. Instead, opt for mild soap-free cleansers, preferably in liquid form.These cleansers will gently remove dirt, excess oil, bacteria and cosmetics without damaging the skin barrier. Moisturizers help to restore and maintain the skin’s natural moisture levels. Look for moisturizers specially designed for sensitive skin that are free of fragrances, dyes or other allergens that may irritate the skin. Frequent application of moisturizing creams can help soothe dry and itchy spots.

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Fifth disease is most commonly treated at home with rest, fluids, and pain relievers.

Acetaminophen may be taken to alleviate pain. Ibuprofen or Naproxen may be taken to reduce symptoms of swelling.