The fifth disease in children

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What is the fifth disease

Call also infectious erythema or megaloerythema (or infectious megaloerythema), the fifth disease is an infectious disease caused by the parvovirus B19. It is a rather mild viral disease, which generally does not cause particular complications.

It occurs especially in children and young people, without distinction between boys and girls, especially between 5 and 15 years. More frequent in the school environment, the peaks are in late winter and spring.

Why is it called fifth disease?

It is called the fifth disease because, in chronological order, it is the fifth exanthematous disease to have been identified.

The rashes of childhood

According to one of the latest proposed classifications, published in the journal Future Microbiology in 2022, the classics childhood rashes there are six:

  1. scarlet fever (bacterial),
  2. measles,
  3. rubella,
  4. chickenpox,
  5. megaloeritema o infectious erythema (the so-called fifth disease)
  6. critical rash (the sixth disease).

To these six classic diseases we can also add another one, which is syndrome hands-feet-mouth, also of viral origin.

In this article

  • symptoms
  • incubation and contagiousness
  • diagnosis
  • prevention
  • care

Symptoms of fifth disease or infectious erythema

Initial symptoms: bright red cheeks

It can start with one

  • mild fever,
  • headache
  • and flu symptoms

which then vanish to give way to a feature rash which interests you first cheeks, which become colored red accThat, so much so that there is also talk of red or slapped cheek disease.

The rash extends to the rest of the body

In the following days, the rash also extends to:

  • trunk,
  • arm,
  • and legs

and it is more visible if the skin is exposed to the sun, excessive heat or intense cold. This rash is different, less visible, and can also cause itching.

In adults and adolescents

In some cases, especially in adults and adolescents, a fifth disease attack may be followed by swelling or pain, often 

  • to the hands,
  • on the wrists,
  • at the knees
  • or ankles.

Joint pain and stiffness can last for several weeks, or even months, after the first flu-like symptoms disappear. They occur more frequently in women.

Secondary symptoms

There may also be:

  • a runny nose,
  • high body temperature (over 38 ° C).

The course of the disease and the fifth disease contracted in pregnancy

The disease typically is harmless, but if it is contracted during pregnancy it can lead to miscarriage or stillbirth. In addition, people with immune system disorders or blood disorders are more at risk.

Immunity lasts a lifetime

While the rash may be worrying, fifth disease is a mild infection that resolves naturally in 1-3 weeks and makes you immune for life.


Fifth disease in children: how it is recognized (PHOTO)

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What are the symptoms of this disease? It can start with a mild fever, headache and flu symptoms which then fade to give way to a manifestation of ...

How long do incubation and contagion period last?

The incubation for parvovirus infection lasts from one to three weeks, but can last up to 21 days.

The disease is contagious only before the rash appears.

How is it transmitted?

Fifth disease is transmitted as the flu or cold by coming into contact with respiratory secretions (emitted by sneezing and coughing) of an infected person or by touching contaminated surfaces or objects.

It can also be transmitted through contact with infected blood. 

During pregnancy, the virus can pass through the placenta and be transferred from the mother to the unborn child.

When can the child go back to school?

If you feel strong, the child who already has the rash can safely go to school because it is no longer contagious.

The diagnosis

Confirmation of having contracted the fifth disease it can come from the research and dosage, through a blood test, of specific antibodies to parvovirus B19 or, especially for people at risk, from the research of viral DNA.

However, it is not necessary to go to the doctor or consult him to treat fifth disease except in particular conditions, such as in the presence of:

  • sickle cell anemia,
  • immunosoppressione,
  • pregnancy.


The infection occurs before the development of visible symptoms, so it is very difficult to prevent fifth disease.

How the fifth disease is treated

Fifth disease does not require specific therapy or diagnostic tests, given the lack of complications and its absolute benignity. As always in these cases, however, the symptoms can be treated, to relieve the discomfort, for example by taking antifebrile or antihistamines against any itching.

Emollient lotions to reduce itching, rest and increased fluid consumption can also provide relief.

Sources for this article:

  • Information material from the English National Health Service.
  • Mayo Clinic. Parvovirus infection (English)

To learn more


Questions and answers

What is the fifth disease? 

It is an infectious disease caused by parvovirus B19. It is a rather mild viral disease, which generally does not cause particular complications.

What is the sixth disease?

Sixth disease is an infectious disease that usually occurs in children between 6 months and 2 years of age, is mild and short in duration, and generally without significant complications.

What is Scarlet Fever?

Scarlet fever is an exanthematous disease of bacterial origin due to group A beta hemolytic Streptococcus and in particular to the toxins it produces. 

  • exanthematous diseases
  • infectious diseases
  • fifth disease symptoms
  • 3-5 children years
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