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What is fifth disease in kids?
Fifth disease in kids: the cold-like start, bright red slapped-cheek rash and lacy body rash, why kids rarely spread it once the rash shows, and when to call.
The short answer
Fifth disease is a common viral illness caused by parvovirus B19, especially in kids ages 5 to 15. It starts like a mild cold, then a few days later the cheeks turn bright red and a blotchy rash spreads to the chest, back, arms and legs, turning lacy and coming and going for 1 to 3 weeks. Children are most contagious before the rash and usually don't spread it once it appears. Most recover on their own; call the doctor about a widespread rash or if someone pregnant or with a blood disorder was exposed.
Fifth disease is a mild viral illness caused by parvovirus B19, best known for a bright red rash on both cheeks that looks like the child has been slapped, followed a few days later by a rash on the body. KidsHealth says most kids recover quickly and without problems, that it's especially common between ages 5 and 15, and that children usually don't spread it once the rash appears (Fifth Disease, accessed November 12, 2026). Treatment is mostly rest and comfort, with a few situations that call for the doctor.
How it usually unfolds
KidsHealth describes the illness in a predictable order:
1. A cold-like start. A low fever, headache, and a stuffy or runny nose. These clear up and the illness seems to be over. This is the stage when the virus spreads, and nobody suspects anything unusual.
2. Slapped cheeks. A few days later, the rash appears, usually starting on the face and turning the cheeks bright red. KidsHealth notes that kids younger than 10 are the most likely to get the rash.
3. The body rash. Red blotches, usually lighter than the cheeks, show up on the chest, back, arms and legs. The rash can itch. After a few days it takes on a lacy, net-like look.
4. Coming and going. The rash can seem worse when the skin is warm or in the sun, and it comes and goes before fading for good. KidsHealth says it usually lasts 1 to 3 weeks. Children's Hospital of Philadelphia adds that it can return with sunlight, very hot or cold temperatures, or an injury to the skin (Fifth Disease, accessed November 12, 2026). A rash that brightens after a warm bath or an afternoon outside is part of the pattern, not a sign the illness has returned.
| Stage | What you'll see | Contagious? |
|---|---|---|
| Cold-like start | Low fever, headache, stuffy or runny nose | Most contagious now |
| Cheek rash | Bright red cheeks | Usually not anymore |
| Body rash | Blotches on trunk, arms, legs; lacy after a few days | Usually not |
| Fading | Rash comes and goes with warmth or sun, for 1 to 3 weeks | No |
Older kids, teens and adults
Fifth disease can look different as kids get older. KidsHealth explains that older kids and adults might not get the red cheeks at all, but can have joint swelling and pain that lasts weeks to months, and very rarely years. In time it usually goes away without lasting problems. If a teenager has sore, swollen joints after a cold, mention fifth disease to the doctor.
How it spreads
Parvovirus B19 spreads in droplets when an infected person coughs or sneezes, and through touched surfaces. The timing is the surprising part: KidsHealth says a child is most contagious before the rash appears, while it still looks like an ordinary cold. By the time the cheeks turn red, the body has been fighting the virus for a while and the child usually isn't contagious anymore.
That timing is why fifth disease often moves quietly through a classroom. If your child's school or daycare sends a note about a case, the exposure probably happened days earlier. Ask your center about its own rules for rashes, since policies vary.
How doctors diagnose it
Doctors can usually recognize fifth disease by looking at the rash on the face and body, according to KidsHealth. If someone has other symptoms but no rash, the doctor may order blood tests to check for parvovirus B19.
Treatment at home
Because a virus causes it, antibiotics won't help. KidsHealth says it's usually mild and clears on its own, so most kids need no medicine and just need rest.
- Rest during the cold-like phase.
- Fever or joint pain: the doctor may recommend acetaminophen.
- Never give aspirin. KidsHealth notes aspirin has been linked to Reye syndrome, a rare but serious illness, in children with viral infections.
- Itching: ask the doctor how to ease it.
- Short nails make scratching less of a problem.
Once the fever and cold symptoms pass, there may be little to treat besides the rash.
Fifth disease or hives?
Both can be red and itchy, so it's an easy mix-up. KidsHealth describes hives as red, raised bumps or welts that often last a few hours to a couple of weeks, with new ones replacing those that fade (Hives, accessed November 12, 2026). Hives are often a reaction to an allergen and can show up anywhere. Fifth disease, by contrast, usually follows a mild cold, starts with bright red cheeks, and turns lacy on the body. If you can't tell, a photo of the rash at its worst helps the doctor.
Who needs extra care
For a few people, the virus is more serious. KidsHealth lists people with weak immune systems, such as those with cancer or AIDS, and those with some blood disorders, like sickle cell disease or hemolytic anemia. Parvovirus B19 can temporarily slow or stop the body from making red blood cells, which can lead to severe anemia that needs hospital care. Signs include looking pale, dizzy or drowsy.
KidsHealth also says that infection during pregnancy may cause problems for the fetus, especially in the first half of pregnancy. If you're pregnant and your child has fifth disease, call your own doctor.
When to call the doctor
KidsHealth advises calling the doctor if your child develops a rash, especially if it's widespread or comes with fever, cold symptoms or joint pain. Also call if you're pregnant, have a weak immune system, or have a blood disorder, and you either develop a rash or joint pain, or were around someone who had fifth disease or an unusual rash.
Talking to your child about it
Young kids notice when grown-ups stare at their face. Keep it light: "Your cheeks are red because of a little germ. It doesn't hurt you, and it's going away." For a child who feels self-conscious, give them a simple line for friends: "It's a rash from a cold."
Preventing spread
There's no vaccine, and KidsHealth says it's hard to fully prevent. Washing hands well and often is the best way to avoid the virus, and it helps stop many other infections too. The good news: once someone has had fifth disease, they won't get it again. KidsHealth says immunity lasts throughout life.
When a stretch of illness or a doctor's visit becomes something your child talks about a lot, a personalized book about brave moments at the doctor can tell the story with them in it. See the hospital book, a story about staying overnight in the hospital, and our guide to taking a toddler's temperature.
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FAQ
Can you get fifth disease twice?
No. After one infection, immunity lasts for life.
Why is it called fifth disease?
It's an old name. Its medical name is erythema infectiosum.
Does my child need a blood test?
Usually not. Doctors can typically tell from the rash; tests are for unclear cases.
