Fifth disease is a viral illness that is also referred to 'slapped cheek' syndrome or erythema infectiosum. It's a common childhood virus that's caused by parvovirus B19. It's called 'fifth' disease because it used to be fifth on a list of common childhood rashes. Fifth disease tends to be a mild and short-lived illness in children, but it can cause problems for pregnant people and those with certain health problems. Below, you'll find all you need to know about 'fifth' disease in babies, from how to spot it, to how to treat it and when to pay a visit to your family doctor.
Why have my baby's cheeks turned red or purple?
Your baby could have fifth disease - an illness caused by parvovirus B19. It's more common from late winter to early spring (Caring for Kids 2023).
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It's called 'fifth' disease because it was fifth on a list of illnesses that were known to cause rashes in the past. The others were: scarlet fever, measles, rubella (German measles) and roseola (AAFP nd). The actual name for fifth disease is erythema infectiosum (Caring for Kids 2023).
Fifth disease is also sometimes referred to as "slapped cheek syndrome". This is due to the bright red rash that appears on a child's cheeks (Healthlink BC 2022). The rash may appear purplish on darker skin tones.
Your little one can catch 'fifths' from an infected person coughing or sneezing nearby. Or, they may catch it by touching an object (such as a bottle or toy) that an infected person has handled, then putting their fingers in their mouth (Healthlink BC 2022, Caring for Kids 2023).
What are the symptoms of fifth disease?
You'll notice that your baby has a fever, a runny nose and seems agitated and sleepy (NHS 2018). Your baby may also have a sore throat or an upset tummy (Caring for Kids 2023).
A rash may show up on one or both of their cheeks (NHS 2018). A few days later, a more faint rash that looks lace-patterned may appear on your baby's torso and arms, followed by the rest of their body (Caring for Kids 2023).
The rash can last from one week to three weeks (Caring for Kids 2023). It can be itchy, so you may notice your baby is a bit more restless than usual. (Kids Health 2022).
Your baby's rash will likely start to fade within two weeks (NHS 2018), but in some cases, the rash may come and go for up to a month (NHS 2018). You may notice it again if your baby has been in the sun or becomes hot, perhaps after having a warm bath or being active. This does not mean the infection has come back (My Health Alberta 2022).
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Sometimes, symptoms of fifth disease can be so mild that you don't even notice them (Caring for Kids 2023).
Should I call my healthcare provider if my baby has fifth disease?
In most babies and children, there's no need to call your doctor right away, because fifth disease is a mild illness. Since it's a virus, it just needs to run its course. (Healthlink BC 2022).
However, you should call your doctor if:
- You're not sure if your baby's rash is caused by fifth disease, and the rash has spread to the whole body (Kids Health 2022).
- Your baby has a fever and is under six months old (Caring for Kids 2022). If your baby is under three months and has a fever, take them to the emergency department right away (CHEO 2020).
- Your baby's fever lasts longer than 72 hours. Something else could be causing it (Caring for Kids 2023).
If your baby seems weak, tired and floppy, has very pale skin or is having trouble breathing, take them to the local emergency department immediately or call 911 (My Health Alberta 2022, Kids Health 2022).
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Fifth disease can be more serious for babies with a blood disorder such as sickle cell disease or thalassaemia (Caring for Kids 2023). This is because the virus can affect the production of red blood cells, which help to carry oxygen around your baby's body (Kids Health 2022). Call your doctor if your baby has one of these disorders and you think they may have fifth disease.
How can I treat fifth disease?
Since it's viral, fifth disease will go away on its own. But there are a few things you can do to ease your baby's symptoms:
- Make sure they get plenty of rest (My Health Alberta 2022).
- Keep your baby hydrated with extra breast milk or formula feeds. If your baby is formula-fed, or on solids and over six months of age, they can have extra water, too.
- Give your baby infant acetaminophen, or ibuprofen, to bring down a fever (Healthlink BC 2022). Talk to your healthcare provider first if your baby is under three months (for acetaminophen) and under six months (for ibuprofen) (Caring for Kids 2022).
- Always be sure to check the dosage details on the bottle. If you're unsure how much to give your baby, talk to your healthcare provider or pharmacist. It's safe to switch back and forth between doses of acetaminophen and ibuprofen. Just keep track when you're using both as they have different dose and time recommendations (Caring for Kids 2022).
- If your baby is trying to scratch the rash, try putting a handful of oatmeal (ground to a powder) in their bath water to help soothe them (My Health Alberta 2022).
The virus that causes fifth disease is most likely to spread before the rash starts. The Canadian Paediatric Society says that as long as your baby seems well, they can keep going to daycare once the rash appears (CPS 2017).
Can I catch fifth disease from my baby?
If you've had fifth disease before, it's not likely that you'll catch it from your baby. About 50 per cent of adults are immune because they've had fifth disease during their childhood or teen years (AAFP nd).
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If you do catch it, you may get stiff and painful joints, with pain that can recur for a few months. Or you may not have any symptoms at all. Most adults don't get the 'fifths' rash (AAFP nd).
I'm pregnant. Is my unborn baby at risk if I catch fifth disease?
To be on the safe side, see your healthcare provider right away if you have a rash or sore joints, or if you've had contact with someone who has fifth disease or has a rash. You can have a blood test that will show if you have it now, or if you've had it in the past (CPS 2017, AAFP nd).
Most pregnant people who have fifth disease have healthy babies (CPS 2017). Sadly, there's a small risk of miscarriage if you catch it during the first 20 weeks of pregnancy (Riley and Fernandes 2020).
Very rarely, fifth disease can cause anemia in the fetus, leading to fetal hydrops if you have it when you're between nine weeks and 20 weeks pregnant. This is when excess fluid builds up in an unborn baby's tissues and organs (Riley and Fernandes 2020).
Check out our photo slideshow of childhood rashes.
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