First Aid

Slapped cheek (fifth disease)

Slapped cheek is a viral infection caused by the human parvovirus B19. It is also called fifth disease or erythema infectiosum. Slapped cheek is common and usually affects children between the ages of four and 10 years, but it can happen at any age. Most children who get slapped cheek do not have any symptoms, and if they do the symptoms are usually very mild. A common symptom is cheeks that look like they have been slapped, which is where the virus gets its name.

Slapped cheek is not life threatening and complications are rare.

Signs and symptoms

It may take between four and 14 days after your child is exposed to slapped cheek for any symptoms to show. The symptoms can vary, and are usually so mild that many parents won't realise that their child has had the virus.

• The first symptoms can include fever, headache, stomach upsets, aches and pains.
• After a few days of being unwell, a bright red rash may appear on the cheeks.
• Your child may also have a different rash on their chest, back, arms and legs, which looks like a pink lace pattern on the skin.
• The rashes can come and go for several weeks, or even months, especially if the skin is exposed to sunlight or after exercise.
• Slapped cheek is spread by touching or breathing in the coughed or sneezed fluid drops from an infected person. Children with slapped cheek are contagious until 24 hours after their fever has resolved. They will not be able to spread the infection to other people after this time, even if they have a rash.

• Often parents won’t know their child has slapped cheek. However, if your child is unwell with a fever, keeping them home from child care, kindergarten or school will help prevent them spreading the illness to others.

   

  When to see a doctor

• A few children with slapped cheek develop swelling and pain in the joints of their hands and feet. If this happens, take your child to the GP for advice on how to treat these symptoms.
• If your child has sickle cell anaemia, severe anaemia, is taking long-term steroids or is immunocompromised (has a weakened immune system) due to a medical condition or medical treatment, speak to your child’s GP or medical team if you suspect your child has slapped cheek.
• If you are pregnant and have been exposed to someone with slapped cheek, speak to your GP.

• If your child is unwell with a fever and a skin rash (small bright red spots or purple spots or unexplained bruises) that does not turn to skin-colour (blanch) when you press on it, this may be a sign of meningococcal infection (see our fact sheet Meningococcal infection).

  Key points to remember

• Symptoms can vary between children, and the infection can show very few symptoms.
• Slapped cheek is caused by a virus and antibiotics will not work to treat it.

• 24 hours after the fever goes away, a child with a rash is not able to spread the infection to others.

  For more information

• Kids health info fact sheet: Pain relief for children
• Kids Health Info fact sheet: Stopping the spread of germs
• Better Health Channel: Slapped cheek disease
• See your GP or Maternal and Child Health Nurse.