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December 15, 2025
Background
The fifth disease, also known as erythema infectiosum, is a mild viral illness caused by parvovirus B19. It is most commonly seen in children but can affect people of any age. The name “fifth disease” comes from its historical classification as the fifth of six childhood diseases characterized by a rash. The virus is spread through respiratory secretions such as coughing or sneezing and can also be transmitted through contact with infected blood. The incubation period is usually 4-14 days, and symptoms may appear within this time frame.
The fifth disease is generally a mild illness with symptoms similar to those of a common cold, including fever, headache, and sore throat. However, the characteristic rash that appears on the face and body is the most distinguishing feature of the disease. The rash begins as red, raised areas on the cheeks that give the appearance of slapped cheeks. This is followed by a lacy, red rash on the arms, legs, and trunk, which may be itchy. In most cases, the fifth disease resolves on its own within a few weeks without any specific treatment.
However, in rare cases, the virus can cause complications, particularly in individuals with weakened immune systems or pregnant women. These complications may include anemia, arthritis, and fetal loss in pregnant women. Prevention of the fifth disease involves practicing good hygiene, such as washing hands frequently and avoiding close contact with infected individuals. It is also important to stay home from work or school when experiencing symptoms of illness to avoid spreading the virus to others.
Epidemiology
The fifth disease is a common viral illness that occurs worldwide. It is most common in children between the ages of 5 and 15 years but can affect people of any age. The virus is highly contagious and can be easily spread through respiratory secretions such as coughing or sneezing. It can also be spread through contact with infected blood, although this is less common.
The fifth disease is most commonly seen in the late winter and early spring but can occur at any time of the year. Outbreaks of the disease may occur in schools, daycares, and other crowded settings. Although the fifth disease can affect people of any age, it is more common in children because they have not yet developed immunity to the virus. Once a person has been infected with the virus, they typically develop lifelong immunity.
While the fifth disease is generally a mild illness, it can cause complications in certain populations. These include individuals with weakened immune systems and pregnant women. In pregnant women, the virus can cause fetal loss or other complications, particularly during the first half of pregnancy. Overall, the fifth disease is a common viral illness with a high rate of transmission. While it is generally a mild illness, it is important to take precautions to prevent its spread and to seek medical attention if complications are suspected.
Anatomy
Pathophysiology
The fifth disease is caused by parvovirus B19, which is a single-stranded DNA virus that primarily infects human erythroid progenitor cells in the bone marrow. The virus enters the body through the respiratory tract and spreads to other parts of the body through the bloodstream. Once the virus enters the erythroid progenitor cells, it replicates and causes cell lysis, leading to a decrease in red blood cell production. This can result in anemia, particularly in individuals with pre-existing conditions that affect red blood cell production, such as sickle cell disease or thalassemia.
In addition to the effects on the bone marrow, the virus can also cause inflammation and damage to blood vessels, particularly in the skin. This can result in the characteristic rash seen in the fifth disease, which begins as red, raised areas on the cheeks that give the appearance of “slapped cheeks.” This is followed by a lacy, red rash on the arms, legs, and trunk, which may be itchy. In most cases, the symptoms of the fifth disease resolve on their own within a few weeks without any specific treatment.
However, in rare cases, the virus can cause complications, particularly in individuals with weakened immune systems or pregnant women. These complications may include anemia, arthritis, and fetal loss in pregnant women. Overall, the fifth disease is a relatively mild viral illness that primarily affects the bone marrow and blood vessels, resulting in anemia and a characteristic rash. While it is generally a self-limited illness, it is important to be aware of the potential complications and to seek medical attention if they are suspected.
Etiology
The fifth disease is caused by a virus called parvovirus B19. This virus is a small, single-stranded DNA virus that is highly contagious and can be easily transmitted through respiratory secretions such as coughing or sneezing. Parvovirus B19 is most commonly transmitted in school or daycare settings, where it can easily spread from child to child through close contact.
It can also be spread through blood transfusions or exposure to contaminated blood products. Once a person is infected with the virus, it takes between 4 and 14 days for symptoms to appear. During this time, the person is contagious and can spread the virus to others. While the fifth disease is generally a mild illness, it can cause complications in certain populations.
These include individuals with weakened immune systems, pregnant women, and individuals with pre-existing conditions that affect red blood cell production, such as sickle cell disease or thalassemia. In these populations, the virus can cause more severe symptoms and may require medical treatment.
Genetics
Prognostic Factors
The prognosis for most individuals with the fifth disease is excellent. The illness is generally mild and self-limited, and most people recover fully without any complications. Symptoms typically last for one to three weeks and gradually improve over time. However, in rare cases, the fifth disease can cause more severe symptoms, particularly in individuals with weakened immune systems or pregnant women.
In these cases, complications can include anemia, miscarriage, stillbirth in pregnant women or chronic joint pain in adults. It is important to seek medical attention if these complications are suspected. Overall, the prognosis for the fifth disease is good, and most people recover fully without any long-term effects. Good hygiene practices and avoidance of contact with others can help prevent the spread of the virus and reduce the risk of complications.
Clinical History
Clinical history
The clinical history of the fifth disease typically includes the following:
Most people with the fifth disease recover without any complications, although joint pain may persist for some time. However, in rare cases, the virus can cause more severe symptoms, particularly in individuals with weakened immune systems or pregnant women. It is important to seek medical attention if these complications are suspected.
Physical Examination
Physical examination
During a physical examination for the fifth disease, a healthcare provider will typically look for the characteristic “slapped cheek” appearance and the lacy, red rash on the arms, legs, and trunk. They may also look for signs of joint pain or swelling. The healthcare provider may also take the patient’s temperature, blood pressure, and other vital signs.
They may ask about other symptoms, such as sore throat, fatigue, or gastrointestinal symptoms, and may perform additional tests or blood work to help confirm a diagnosis. In some cases, a healthcare provider may also recommend additional testing or monitoring for individuals who are at higher risk of complications, such as pregnant women or individuals with weakened immune systems.
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Differential Diagnoses
Differential diagnosis
The characteristic “slapped cheek” appearance of the fifth disease is often distinctive, but other viral exanthems can also cause similar rashes, including:
Other conditions that can cause a rash include drug reactions, allergic reactions, and autoimmune disorders. A healthcare provider will take a detailed medical history, perform a physical examination, and may order laboratory tests to help make a diagnosis.
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
There is no specific treatment for the fifth disease, as it is caused by a viral infection that typically resolves on its own. However, there are a few steps that can be taken to help manage symptoms and prevent the spread of the virus:
by Stage
by Modality
Chemotherapy
Radiation Therapy
Surgical Interventions
Hormone Therapy
Immunotherapy
Hyperthermia
Photodynamic Therapy
Stem Cell Transplant
Targeted Therapy
Palliative Care
Medication
Future Trends
References
https://my.clevelandclinic.org/health/diseases/15774-fifth-disease
The fifth disease, also known as erythema infectiosum, is a mild viral illness caused by parvovirus B19. It is most commonly seen in children but can affect people of any age. The name “fifth disease” comes from its historical classification as the fifth of six childhood diseases characterized by a rash. The virus is spread through respiratory secretions such as coughing or sneezing and can also be transmitted through contact with infected blood. The incubation period is usually 4-14 days, and symptoms may appear within this time frame.
The fifth disease is generally a mild illness with symptoms similar to those of a common cold, including fever, headache, and sore throat. However, the characteristic rash that appears on the face and body is the most distinguishing feature of the disease. The rash begins as red, raised areas on the cheeks that give the appearance of slapped cheeks. This is followed by a lacy, red rash on the arms, legs, and trunk, which may be itchy. In most cases, the fifth disease resolves on its own within a few weeks without any specific treatment.
However, in rare cases, the virus can cause complications, particularly in individuals with weakened immune systems or pregnant women. These complications may include anemia, arthritis, and fetal loss in pregnant women. Prevention of the fifth disease involves practicing good hygiene, such as washing hands frequently and avoiding close contact with infected individuals. It is also important to stay home from work or school when experiencing symptoms of illness to avoid spreading the virus to others.
The fifth disease is a common viral illness that occurs worldwide. It is most common in children between the ages of 5 and 15 years but can affect people of any age. The virus is highly contagious and can be easily spread through respiratory secretions such as coughing or sneezing. It can also be spread through contact with infected blood, although this is less common.
The fifth disease is most commonly seen in the late winter and early spring but can occur at any time of the year. Outbreaks of the disease may occur in schools, daycares, and other crowded settings. Although the fifth disease can affect people of any age, it is more common in children because they have not yet developed immunity to the virus. Once a person has been infected with the virus, they typically develop lifelong immunity.
While the fifth disease is generally a mild illness, it can cause complications in certain populations. These include individuals with weakened immune systems and pregnant women. In pregnant women, the virus can cause fetal loss or other complications, particularly during the first half of pregnancy. Overall, the fifth disease is a common viral illness with a high rate of transmission. While it is generally a mild illness, it is important to take precautions to prevent its spread and to seek medical attention if complications are suspected.
The fifth disease is caused by parvovirus B19, which is a single-stranded DNA virus that primarily infects human erythroid progenitor cells in the bone marrow. The virus enters the body through the respiratory tract and spreads to other parts of the body through the bloodstream. Once the virus enters the erythroid progenitor cells, it replicates and causes cell lysis, leading to a decrease in red blood cell production. This can result in anemia, particularly in individuals with pre-existing conditions that affect red blood cell production, such as sickle cell disease or thalassemia.
In addition to the effects on the bone marrow, the virus can also cause inflammation and damage to blood vessels, particularly in the skin. This can result in the characteristic rash seen in the fifth disease, which begins as red, raised areas on the cheeks that give the appearance of “slapped cheeks.” This is followed by a lacy, red rash on the arms, legs, and trunk, which may be itchy. In most cases, the symptoms of the fifth disease resolve on their own within a few weeks without any specific treatment.
However, in rare cases, the virus can cause complications, particularly in individuals with weakened immune systems or pregnant women. These complications may include anemia, arthritis, and fetal loss in pregnant women. Overall, the fifth disease is a relatively mild viral illness that primarily affects the bone marrow and blood vessels, resulting in anemia and a characteristic rash. While it is generally a self-limited illness, it is important to be aware of the potential complications and to seek medical attention if they are suspected.
The fifth disease is caused by a virus called parvovirus B19. This virus is a small, single-stranded DNA virus that is highly contagious and can be easily transmitted through respiratory secretions such as coughing or sneezing. Parvovirus B19 is most commonly transmitted in school or daycare settings, where it can easily spread from child to child through close contact.
It can also be spread through blood transfusions or exposure to contaminated blood products. Once a person is infected with the virus, it takes between 4 and 14 days for symptoms to appear. During this time, the person is contagious and can spread the virus to others. While the fifth disease is generally a mild illness, it can cause complications in certain populations.
These include individuals with weakened immune systems, pregnant women, and individuals with pre-existing conditions that affect red blood cell production, such as sickle cell disease or thalassemia. In these populations, the virus can cause more severe symptoms and may require medical treatment.
The prognosis for most individuals with the fifth disease is excellent. The illness is generally mild and self-limited, and most people recover fully without any complications. Symptoms typically last for one to three weeks and gradually improve over time. However, in rare cases, the fifth disease can cause more severe symptoms, particularly in individuals with weakened immune systems or pregnant women.
In these cases, complications can include anemia, miscarriage, stillbirth in pregnant women or chronic joint pain in adults. It is important to seek medical attention if these complications are suspected. Overall, the prognosis for the fifth disease is good, and most people recover fully without any long-term effects. Good hygiene practices and avoidance of contact with others can help prevent the spread of the virus and reduce the risk of complications.
Clinical history
The clinical history of the fifth disease typically includes the following:
Most people with the fifth disease recover without any complications, although joint pain may persist for some time. However, in rare cases, the virus can cause more severe symptoms, particularly in individuals with weakened immune systems or pregnant women. It is important to seek medical attention if these complications are suspected.
Physical examination
During a physical examination for the fifth disease, a healthcare provider will typically look for the characteristic “slapped cheek” appearance and the lacy, red rash on the arms, legs, and trunk. They may also look for signs of joint pain or swelling. The healthcare provider may also take the patient’s temperature, blood pressure, and other vital signs.
They may ask about other symptoms, such as sore throat, fatigue, or gastrointestinal symptoms, and may perform additional tests or blood work to help confirm a diagnosis. In some cases, a healthcare provider may also recommend additional testing or monitoring for individuals who are at higher risk of complications, such as pregnant women or individuals with weakened immune systems.
Differential diagnosis
The characteristic “slapped cheek” appearance of the fifth disease is often distinctive, but other viral exanthems can also cause similar rashes, including:
Other conditions that can cause a rash include drug reactions, allergic reactions, and autoimmune disorders. A healthcare provider will take a detailed medical history, perform a physical examination, and may order laboratory tests to help make a diagnosis.
There is no specific treatment for the fifth disease, as it is caused by a viral infection that typically resolves on its own. However, there are a few steps that can be taken to help manage symptoms and prevent the spread of the virus:
https://my.clevelandclinic.org/health/diseases/15774-fifth-disease
The fifth disease, also known as erythema infectiosum, is a mild viral illness caused by parvovirus B19. It is most commonly seen in children but can affect people of any age. The name “fifth disease” comes from its historical classification as the fifth of six childhood diseases characterized by a rash. The virus is spread through respiratory secretions such as coughing or sneezing and can also be transmitted through contact with infected blood. The incubation period is usually 4-14 days, and symptoms may appear within this time frame.
The fifth disease is generally a mild illness with symptoms similar to those of a common cold, including fever, headache, and sore throat. However, the characteristic rash that appears on the face and body is the most distinguishing feature of the disease. The rash begins as red, raised areas on the cheeks that give the appearance of slapped cheeks. This is followed by a lacy, red rash on the arms, legs, and trunk, which may be itchy. In most cases, the fifth disease resolves on its own within a few weeks without any specific treatment.
However, in rare cases, the virus can cause complications, particularly in individuals with weakened immune systems or pregnant women. These complications may include anemia, arthritis, and fetal loss in pregnant women. Prevention of the fifth disease involves practicing good hygiene, such as washing hands frequently and avoiding close contact with infected individuals. It is also important to stay home from work or school when experiencing symptoms of illness to avoid spreading the virus to others.
The fifth disease is a common viral illness that occurs worldwide. It is most common in children between the ages of 5 and 15 years but can affect people of any age. The virus is highly contagious and can be easily spread through respiratory secretions such as coughing or sneezing. It can also be spread through contact with infected blood, although this is less common.
The fifth disease is most commonly seen in the late winter and early spring but can occur at any time of the year. Outbreaks of the disease may occur in schools, daycares, and other crowded settings. Although the fifth disease can affect people of any age, it is more common in children because they have not yet developed immunity to the virus. Once a person has been infected with the virus, they typically develop lifelong immunity.
While the fifth disease is generally a mild illness, it can cause complications in certain populations. These include individuals with weakened immune systems and pregnant women. In pregnant women, the virus can cause fetal loss or other complications, particularly during the first half of pregnancy. Overall, the fifth disease is a common viral illness with a high rate of transmission. While it is generally a mild illness, it is important to take precautions to prevent its spread and to seek medical attention if complications are suspected.
The fifth disease is caused by parvovirus B19, which is a single-stranded DNA virus that primarily infects human erythroid progenitor cells in the bone marrow. The virus enters the body through the respiratory tract and spreads to other parts of the body through the bloodstream. Once the virus enters the erythroid progenitor cells, it replicates and causes cell lysis, leading to a decrease in red blood cell production. This can result in anemia, particularly in individuals with pre-existing conditions that affect red blood cell production, such as sickle cell disease or thalassemia.
In addition to the effects on the bone marrow, the virus can also cause inflammation and damage to blood vessels, particularly in the skin. This can result in the characteristic rash seen in the fifth disease, which begins as red, raised areas on the cheeks that give the appearance of “slapped cheeks.” This is followed by a lacy, red rash on the arms, legs, and trunk, which may be itchy. In most cases, the symptoms of the fifth disease resolve on their own within a few weeks without any specific treatment.
However, in rare cases, the virus can cause complications, particularly in individuals with weakened immune systems or pregnant women. These complications may include anemia, arthritis, and fetal loss in pregnant women. Overall, the fifth disease is a relatively mild viral illness that primarily affects the bone marrow and blood vessels, resulting in anemia and a characteristic rash. While it is generally a self-limited illness, it is important to be aware of the potential complications and to seek medical attention if they are suspected.
The fifth disease is caused by a virus called parvovirus B19. This virus is a small, single-stranded DNA virus that is highly contagious and can be easily transmitted through respiratory secretions such as coughing or sneezing. Parvovirus B19 is most commonly transmitted in school or daycare settings, where it can easily spread from child to child through close contact.
It can also be spread through blood transfusions or exposure to contaminated blood products. Once a person is infected with the virus, it takes between 4 and 14 days for symptoms to appear. During this time, the person is contagious and can spread the virus to others. While the fifth disease is generally a mild illness, it can cause complications in certain populations.
These include individuals with weakened immune systems, pregnant women, and individuals with pre-existing conditions that affect red blood cell production, such as sickle cell disease or thalassemia. In these populations, the virus can cause more severe symptoms and may require medical treatment.
The prognosis for most individuals with the fifth disease is excellent. The illness is generally mild and self-limited, and most people recover fully without any complications. Symptoms typically last for one to three weeks and gradually improve over time. However, in rare cases, the fifth disease can cause more severe symptoms, particularly in individuals with weakened immune systems or pregnant women.
In these cases, complications can include anemia, miscarriage, stillbirth in pregnant women or chronic joint pain in adults. It is important to seek medical attention if these complications are suspected. Overall, the prognosis for the fifth disease is good, and most people recover fully without any long-term effects. Good hygiene practices and avoidance of contact with others can help prevent the spread of the virus and reduce the risk of complications.
Clinical history
The clinical history of the fifth disease typically includes the following:
Most people with the fifth disease recover without any complications, although joint pain may persist for some time. However, in rare cases, the virus can cause more severe symptoms, particularly in individuals with weakened immune systems or pregnant women. It is important to seek medical attention if these complications are suspected.
Physical examination
During a physical examination for the fifth disease, a healthcare provider will typically look for the characteristic “slapped cheek” appearance and the lacy, red rash on the arms, legs, and trunk. They may also look for signs of joint pain or swelling. The healthcare provider may also take the patient’s temperature, blood pressure, and other vital signs.
They may ask about other symptoms, such as sore throat, fatigue, or gastrointestinal symptoms, and may perform additional tests or blood work to help confirm a diagnosis. In some cases, a healthcare provider may also recommend additional testing or monitoring for individuals who are at higher risk of complications, such as pregnant women or individuals with weakened immune systems.
Differential diagnosis
The characteristic “slapped cheek” appearance of the fifth disease is often distinctive, but other viral exanthems can also cause similar rashes, including:
Other conditions that can cause a rash include drug reactions, allergic reactions, and autoimmune disorders. A healthcare provider will take a detailed medical history, perform a physical examination, and may order laboratory tests to help make a diagnosis.
There is no specific treatment for the fifth disease, as it is caused by a viral infection that typically resolves on its own. However, there are a few steps that can be taken to help manage symptoms and prevent the spread of the virus:
https://my.clevelandclinic.org/health/diseases/15774-fifth-disease

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