Slapped cheek disease

Also known as fifth disease or erythema infectiosum

Slapped cheek disease is caused by parvovirus B19 infection and mostly affects children. It tends to cause bright red cheeks with a rash that looks like a scald or the mark left by a sharp blow.

Key points

  1. In healthy children, slapped cheek disease is mild and short-lived.
  2. For children with reduced immunity or blood disorders, the illness can be more severe.  
  3. In very rare cases, women who come into contact with the virus for the first time during the first 20 weeks of pregnancy can pass the disease on to their babies, this can be serious.


The tell-tale hot red rash on the cheeks associated with slapped cheek disease usually appears between days 3 and 7.  It lasts 1 to 3 days and is often followed by a fine red rash on the body, arms and legs that has a characteristic pink lace-like pattern. The body rash may be itchy and may fade, then flare up again when the child is hot or upset, for anything from 2 to 6 weeks.

Early symptoms include:

The small number of adults who catch slapped cheek disease may find that they don’t develop a rash, but have sore joints, particularly in the hands and feet. This generally lasts only about 2 weeks, but sometimes lasts several months.

How is it passed on?

Slapped cheek disease is passed on via droplets from the respiratory tract of an infected person, mainly through coughing or sneezing.  Incubation: It takes anything from 4 to 12 days to develop the first symptoms following infection.

A person who has been infected can pass the virus on to others from 5 to 6 days before the first symptoms appear. Once the rash appears on the face a person is no longer infectious.

Slapped cheek disease epidemics occur about every 3 to 7 years, usually in spring or autumn. It spreads rapidly through schools as it is infectious before symptoms appear.  Approximately 60% of adults have natural immunity to parvovirus B19, having been exposed to it as children.

Very rarely, unborn babies can be affected by parvovirus B19 via their mothers’ blood.  This occurs in just 5% of women who are infected with parvovirus B19 for the first time during the first 20 weeks of pregnancy. Because 60% of all women of childbearing age are already naturally immune to this virus, the risk is considered extremely low.

Potential complications

Slapped cheek disease can have serious implications for people with reduced immunity (e.g. those undergoing chemotherapy, or people with HIV/AIDS) and those with underlying blood disorders. Bone marrow failure and a sudden inability to produce blood cells (aplastic crisis) are both serious effects that require medical attention.

In a very small number of cases, infection with the disease results in serious anaemia and miscarriage for babies whose mothers catch slapped cheek disease during the first 20 weeks of pregnancy.


Slapped cheek disease is caused by a virus, so there is no cure. Treatment in otherwise healthy people focuses on easing the symptoms with:

  • rest
  • plenty of fluids
  • cool flannels for cheeks
  • paracetamol for fever or aches.

Anyone with reduced immunity or blood disorders who catches slapped cheek disease should seek medical attention to monitor and treat potentially serious complications.  Pregnant women who have been exposed to someone with slapped cheek disease should consult with their lead maternity carer (LMC) or their doctor.


Slapped cheek disease is often caught from people with no symptoms. Quarantine (staying away from anyone else) is, therefore, not an effective way of preventing its spread. As long as the person feels well enough, it is not necessary for them to be away from school or work.

To minimise the chance of catching or passing on slapped cheek disease:

  • Cover all coughs (cough into the crook of your elbow and face away from people and food).
  • Wash and dry hands regularly and thoroughly.
  • Don’t share food or eating utensils.

Learn more

Images of fifth disease DermNet NZ
Photos of dlapped-cheek rash Centers for Disease Control and Prevention, USA
Slapped cheek disease (fifth disease) Southern Cross Medical Library
Slapped cheek disease Better Health Channel Australia
Slapped cheek cisease NZ Ministry of Health

Credits: Editorial team.