Fifth disease rash

Rosy cheeks may be cute and adorable sometimes, but at others they can be a sign of illness. Slapped cheek syndrome is a name for the parvovirus B19 infection, which shows up on your child’s face as a rash that can look like rosy cheeks. Learn more about slapped cheek syndrome in babies and toddlers including the signs and symptoms, how it can be prevented and when to see your child’s doctor.

What Is Slapped Cheek Syndrome?

Slapped cheek syndrome (also known as fifth disease), is a common childhood illness caused by the parvovirus B19 virus. It’s infectious, meaning it can be spread from person to person. In case you were wondering, human parvovirus (B19) is not the same thing as the parvovirus that can infect some pets, especially dogs. Slapped cheek syndrome can’t be caught from animals, and it can’t be given to your pet. Slapped cheek syndrome is most common in babies and toddlers or older children. Adults are less likely to get it; but if they do, the symptoms may differ and can be more serious. Luckily, if your child has been infected with parvovirus B19 once, he or she will almost certainly be immune to it for life.

What Are the Signs and Symptoms of Slapped Cheek Syndrome?

As its name suggests, the main symptom of slapped cheek syndrome in babies and toddlers is typically a bright red rash on both of your child’s cheeks.

A few days after the rash shows up on the cheeks, a lighter-coloured pink rash of raised spots, which can be itchy, may also appear on your child’s body. These rashes are not usually the first symptom your child will experience, however. In most cases, a child with slapped cheek syndrome will have cold-like symptoms for a few days before the rashes appear. Early symptoms of slapped cheek syndrome can include:

  • High temperature or fever of 38 degrees Celsius or higher

  • Runny nose

  • Sore throat

  • Headache.

Slapped Cheek Syndrome Symptoms in Adults

Although grown-ups are less likely than children to become infected with the parvovirus B19 virus that causes slapped cheek syndrome, the symptoms can be different (and sometimes more serious) than in babies and toddlers. For example, adults don’t always get the ‘slapped cheek’ rash. On the other hand, they may also experience stiff or painful joints that can last up to several weeks after the other symptoms have cleared up. If your child has slapped cheek syndrome, and you yourself (or another adult in your home) haven’t had it before, it may be worth keeping an eye out for these symptoms in case you catch it from your child.

How Long Does Slapped Cheek Syndrome Last?

It usually takes about three weeks for slapped cheek syndrome to clear up after the first cold-like symptoms (if any) appear. The rashes on the cheeks usually clear up within two weeks, and the lighter-coloured body rash also typically takes a couple of weeks to disappear. Sometimes, however, the body rash may come and go for up to a month. In this case, it can be triggered by heat, anxiety or physical exertion.

How Long Is Slapped Cheek Syndrome Infectious?

Slapped cheek syndrome is infectious for about 7 to 10 days before the rash sets in—it’s during this period that your child might experience the cold-like symptoms as well.

When the rash appears, it’s a sign that your child is no longer infectious, so there’s no need to keep him or her home from school or childcare once that happens.

Do let the school know that your child has slapped cheek syndrome though.

If your child has slapped cheek syndrome, it’s especially important to keep him or her away from pregnant women, as it can cause problems affecting the foetus if a mum-to-be gets infected with the virus during pregnancy.

What Is the Treatment for Slapped Cheek Syndrome?

Slapped cheek syndrome usually clears up by itself without any special treatment, but there are some ways you can help ease the symptoms and make your little one more comfortable in the meantime:

  • Make sure your child gets lots of rest

  • Give your child plenty of fluids to avoid dehydration

  • Ask your doctor if any medicine is recommended for bringing down any fever

  • Apply a mild moisturising cream to itchy skin

  • Ask your doctor or pharmacist to recommend an antihistamine that’s suitable for your child, if necessary.

How Does Your Child Get Slapped Cheek Syndrome?

Like many other viral illnesses, the parvovirus B19 germ that causes slapped cheek syndrome is spread through the respiratory secretions (saliva, spit and mucus) of infected individuals. This means, for example, that it can be passed from an infected person to your child via the respiratory droplets in coughs or sneezes, or if your child comes into contact with a surface or object that has been contaminated.

Can Slapped Cheek Syndrome Be Prevented?

There is no vaccine or other treatment that protects against the parvovirus B19 virus. It’s also impossible to completely avoid people who have the disease, because a person with slapped cheek syndrome may be infectious for a week or more before the rash appears and they may not realise they are contagious. To make spotting people who have the disease even harder, some people who have it show no slapped cheek symptoms at all during the infectious stage. Still, there are a few things that you and your family can do to lessen the chance of anyone in your household getting the infection:

  • Wash your hands (and your child’s) often with soap and water for a minimum of 20 seconds

  • Trap germs with a tissue when sneezing or coughing, and throw away the used tissues immediately

  • Disinfect common surfaces like counter tops, door handles and toys regularly

  • Avoid people who you suspect may have the virus

  • If you think your little one (or anyone else in your family) might have slapped cheek syndrome, keep them home and ensure they avoid contact with others until the rash appears – this is a sign that someone with slapped cheek syndrome is no longer infectious.

When Should You See a Doctor?

It’s not usually necessary to see a doctor for a slapped cheek syndrome rash. However, do check with your doctor or health visitor if you have any concerns, or if you’re unsure whether your child’s rash is caused by slapped cheek syndrome or something else.

To be on the safe side or if you’re worried at all, speak to your doctor if your baby or toddler has a fever.

If you’re pregnant... ...and you think you might have been in contact with someone who has slapped cheek syndrome, it’s important to let your doctor know immediately. Your doctor will give you a blood test to determine whether you

  • are already immune to the virus (as 50 to 60 percent of adults are)

  • don’t have parvovirus B19 but aren’t immune to it, so there’s a risk of infection

  • are infected with parvovirus B19.

If you don’t have the disease but aren’t immune, you may be asked to go back for another blood test one month later and avoid contact with other mums-to-be until then, as a precaution against further spreading the virus. If you are infected, then in some cases – especially between 4 and 20 weeks pregnant – there’s a very small chance that the parvovirus B19 could be passed on to the foetus; or (in rare cases) that you could miscarry. If you do test positive for parvovirus B19, try not to panic. You’ll be monitored very closely in order to diagnose – and effectively treat – any problems, such as anaemia, that may develop in you or your foetus. Having parvovirus B19 infection when you’re pregnant is not believed to cause any birth defects in your baby.

The Bottom Line

Slapped cheek syndrome can leave your little one feeling under the weather, but – with plenty of TLC and some rest – it shouldn’t be long before your child is back to his or her old self again.

How we wrote this article
The information in this article is based on the expert advice found in trusted medical and government sources, such as the National Health Service (NHS). You can find a full list of sources used for this article below. The content on this page should not replace professional medical advice. Always consult medical professionals for full diagnosis and treatment.