Erythema infectiosum

Slapped cheek syndrome (also known as “fifth disease” or erythema infectiosum) is a type of viral infection that is most common in children, although it can affect anyone of any age. 

Slapped cheek syndrome usually affects children aged between six and 10 years. Most cases develop during the late winter months or early spring.

In children, the most common symptom is the appearance of a distinctive bright red rash on the cheeks. This is how the condition got its name.

Although many symptoms of slapped cheek syndrome are similar to other conditions, most cases can be diagnosed by examining the rash. Usually, no further testing is necessary in children.

Read more information about the symptoms of slapped cheek syndrome.

What treatment will my child need?

Most children will not need treatment as slapped cheek syndrome is usually a very mild condition that passes in a few days. Occasionally it can last up to four or five weeks.

There is no specific antiviral therapy available for slapped cheek syndrome.

Symptoms such as headaches, high temperature or itchy skin can usually be treated with over-the-counter medications such as paracetamol and antihistamines.

Adults, especially women, who frequently develop joint pain with or without a skin rash, can use non-steroidal anti-inflammatory drugs (NSAIDs) as painkillers.

You will probably only need to contact your GP if one or both of the following occurs:

• your (or your child’s) temperature rises to 39C or above
• your (or your child’s) symptoms suddenly worsen

Read more about treating slapped cheek syndrome.

What are the causes of slapped cheek syndrome?

Slapped cheek syndrome is caused by a virus called parvovirus B19. Parvovirus B19 is an airborne virus spread in much the same way as the cold or flu viruses. It can be spread through coughs and sneezes that release tiny droplets of contaminated saliva which are then breathed in by another person.

It's very difficult to prevent the spread of the virus as people are most contagious before their symptoms begin, so they are unaware they are infected.

Once you've been infected you should develop a lifelong immunity and not experience any further symptoms.

Read more about the causes of slapped cheek syndrome.

Complications

There are three high-risk groups in which the parvovirus B19 can cause a much more serious infection and trigger a range of complications. These are listed below.

• People with certain blood disorders, such as sickle cell anaemia or thalassaemia. This is where the blood doesn't contain enough healthy red blood cells (anaemia) and infection can lead to a further and more severe loss of red blood cells.
• Pregnant women without immunity. Parvovirus B19 infection can increase the risk of a miscarriage because the virus can cause severe anaemia in the unborn child. The overall risk of miscarriage after infection during pregnancy is thought to be less than 5%.
• People with a weakened immune system (immunocompromised), either due to a side effect of treatment, such as chemotherapy, or from a condition such as HIV. These groups can experience prolonged, and sometime severe, symptoms of infection.
• Older children and adults who develop slapped cheek syndrome may experience persistent joint pain once the skin rash disappears.

If you're in one of these high-risk groups and you have been in close contact with someone who goes on to develop slapped cheek syndrome, contact your GP for advice.

A blood test may be recommended to see if you are immune to the infection. If you are not immune, treatment can begin immediately to prevent complications.

You may need to be admitted to hospital and in some cases, a blood transfusion is necessary.

In rare cases, being infected with parvovirus B19 can lead to meningitis developing.

Read more about the complications of slapped cheek syndrome.

Prevention