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HomeHealthParvovirus B19: Symptoms, treatment and how 'slapped cheek' disease spreads

Parvovirus B19: Symptoms, treatment and how ‘slapped cheek’ disease spreads

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A highly contagious illness known as “slapped cheek” disease for the facial rashes it causes in children is on the rise, the Centers for Disease Control and Prevention warned in a health alert.

The CDC issued the alert late Tuesday, noting infections caused by human parvovirus B19 – the virus behind “slapped cheek” disease – are increasing at higher levels than usual in the United States. Fourteen countries in Europe also have reported a “substantial increase” in parvovirus B19 infections. 


The seasonal illness, also known as fifth disease, spreads through nasal mucus and saliva – often from coughs and sneezes. In healthy children, its symptoms usually are mild. But “slapped cheek” disease can be serious for pregnant women and people with weakened immune systems, according to the Mayo Clinic.

The CDC does not officially track fifth disease, but the agency has received reports indicating the illness is on the rise, especially among children ages 5 to 9. The proportion of these children with antibodies for the disease – an indicator of a recent illness – rose 40% in June – much higher than the 15% increases seen the past two years. 

Why is it sometimes called fifth disease? 

Parvovirus B19 infections are known as fifth disease because the illness historically ranked fifth on a list of common childhood rashes. The virus can cause a rash that turns children’s cheeks red, lending it its other colloquial name, “slapped cheek” disease, according to the Mayo Clinic.

What are the symptoms?

Many people do not experience symptoms when infected, but a red rash on the cheeks may show up in children after other symptoms, such as fever, upset stomach, headache and runny nose. Over the course of several days, the rash may spread to the trunk, arms, legs and buttocks. Sometimes it has a lacey pattern, and it can reappear when children go out in the sun. The cheek rash is flat and not raised, according to the Children’s Hospital of Philadelphia.

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Adults do not generally get red cheeks from parvovirus B19. Their most common symptom is joint pain, especially in the hands, wrists, knees and ankles. It also can cause joint swelling, according to the Mayo Clinic.

How serious is the illness?

Fifth disease is usually mild in children, but it can cause acute anemia in people with sickle cell disease and weakened immune systems. The virus also can pass through the blood from a pregnant woman to her unborn child. Parvovirus infection during pregnancy may cause miscarriage or stillbirth – although this is rare. The greatest risk to the fetus is during the first half of pregnancy, according to the Mayo Clinic.

How is parvovirus B19 treated?

Fifth disease is a viral, infection, and no medication or cure exists. Treatment usually centers around symptom reduction. People with parvovirus infections should increase their fluid intake. A clinician may recommend an antihistamine if a rash is itchy, or the use of analgesics, such as acetaminophen or ibuprofen, if a person experiences a fever. Children and teenagers should never take aspirin since it can cause a rare but serious health condition called Reye’s syndrome, according to the Children’s Hospital of Philadelphia.

People should seek medical advice if they are pregnant and have been exposed to a person with suspected or confirmed parvovirus B19. People are advised to contact their health care providers if they have weakened immune systems, sickle cell anemia or other blood disorders and are experiencing symptoms of parvovirus B19 infection, the CDC says.

How to prevent parvovirus B19 from spreading

The best way to prevent the spread of fifth disease is through frequent handwashing with warm, soapy water for at least 20 seconds, and by covering your mouth when you cough or sneeze. People should stay home if they are sick and avoid contact with others who may be sick, the Mayo Clinic advises.

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Health care providers should be on heightened alert for people who have symptoms common to parvovirus B19 infection, according to the CDC.



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