Slapped cheek (fifth disease)

  • Slapped cheek is a viral infection caused by the human parvovirus B19. It is also called fifth disease or erythema infectiosum.

    Slapped cheek is common and usually affects children between the ages of four and 10 years, but can happen at any age.

    Most children who get slapped cheek do not have any symptoms, and if they do the symptoms are usually very mild. A common symptom is cheeks that look like they have been slapped, which is where the virus gets its name.

    Slapped cheek is not life threatening and complications are rare.

    Signs and symptoms

    It may take between four and 14 days after your child is exposed to slapped cheek for any symptoms to show. The symptoms can vary, and are usually so mild that many parents won't realise that their child has had the virus.

    • The first symptoms can include fever, headache, stomach upsets, aches and pains.
    • After a few days of being unwell, a bright red rash may appear on the cheeks.
    • Your child may also have a different rash on their chest, back, arms and legs, which looks like a pink lace pattern on the skin.
    • The rashes can come and go for several weeks, or even months, especially if the skin is exposed to sunlight or after exercise.

    How is slapped cheek spread?

    Slapped cheek is spread by touching or breathing in the coughed or sneezed fluid drops from an infected person. Children with slapped cheek are contagious until 24 hours after their fever has resolved. They will not be able to spread the infection to other people after this time, even if they have a rash.

    Often parents won’t know their child has slapped cheek. However, if your child is unwell with a fever, keeping them home from child care, kindergarten or school will help prevent them spreading the illness to others.

    Care at home

    Most children do not need any treatment, except for rest to allow the body to fight the infection. Because slapped cheek is caused by a virus, antibiotics are not given to children with slapped cheek as antibiotics do not treat viruses.

    You can give your child paracetamol or ibuprofen to help them feel more comfortable if they are bothered by a fever or aches and pains. See our fact sheet Pain relief for children.

    When to see a doctor

    A few children with slapped cheek develop swelling and pain in the joints of their hands and feet. If this happens, take your child to the GP for advice on how to treat these symptoms.

    If your child has sickle cell anaemia, severe anaemia, is taking long-term steroids or is immunocompromised (has a weakened immune system) due to a medical condition or medical treatment, speak to your child’s GP or medical team if you suspect your child has slapped cheek.

    If you are pregnant and have been exposed to someone with slapped cheek, speak to your GP.

    If your child is unwell with a fever and a skin rash (small bright red spots or purple spots or unexplained bruises) that does not turn to skin-colour (blanch) when you press on it, this may be a sign of meningococcal infection (see our fact sheet Meningococcal infection).

    Key points to remember

    • Symptoms can vary between children, and the infection can show very few symptoms.
    • Slapped cheek is caused by a virus and antibiotics will not work to treat it.
    • 24 hours after the fever goes away, a child with a rash is not able to spread the infection to others.

    For more information

    Common questions our doctors are asked

    I’m pregnant and my child has had slapped cheek. Should I be worried?

    If you are pregnant and exposed to someone with slapped cheek, ask your GP to test if you have had human parvovirus B19 in the past. The GP will perform a parvovirus IgG serology test. If you have already had human parvovirus B19, then there are no concerns for your unborn baby. If you have not, your unborn baby can get a type of anaemia (low level of red blood cells in the blood). This is rarely serious and usually resolves by itself. Your obstetrician can provide more advice. The virus does not cause any other problems for your baby.

    Do I need to put any creams on my child’s rash?

    No. The rashes caused by slapped cheek will not cause any discomfort to your child, and will get better on their own.

    Can you catch slapped cheek from cats and dogs?

    No. Slapped cheek is caused by the human parvovirus B19, which is not the same as the parvovirus that is seen in cats and dogs.

    Developed by The Royal Children's Hospital Infection Control, Infectious Diseases and Emergency departments. We acknowledge the input of RCH consumers and carers.

    Reviewed February 2018.

    This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.

    Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit


This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.