Fifth disease is spread mainly by contact with the mucus of infected people usually through coughing or sneezing. The disease may also be spread from mother to child during pregnancy and rarely through transfusion of blood or blood products, such as platelets or serum. Minor outbreaks of fifth disease usually happen in the spring, possibly in local pre-schools, day care centers, or sometimes in an isolated case.

The main symptom of fifth disease in children is a blotchy, red rash that begins on the cheeks and within a day or two is followed by a pink lace-like pattern, which spreads to the exposed areas of the arms and legs. In the beginning, the facial rash may cause the child to have a characteristic slapped face appearance. The rash usually fades within seven to ten days, but may return over a one to three week period, if the child is exposed to sunlight or heat.

Fifth disease rarely happens in adults, but when it does, about one-fourth of adults who have fifth disease have no symptoms at all. Common symptoms of fifth disease in adults include:

• painful and swollen joints that may last from a few days to several months, and
• a rash that may be mistaken for the rash of rubella or scarlet fever.
• A very rare symptom for both children and adults is fever, which
• is usually very mild, if present at all, and usually comes before
• the rash. Fatigue may also happen prior to the rash appearing.

Fifth disease is usually diagnosed by a doctor from the person’s symptoms and from reports of outbreaks in the area.

Treatment is rarely needed, as a person with fifth disease usually does not show any symptoms that require treatment. The rash usually clears on its own within ten days. If a headache or joint pain occur, an aspirin substitute such as Tylenol or Panadol may be taken. Children and teenagers should not take aspirin as aspirin use in these age groups has been associated with a rare and serious liver and brain disorder called Reye’s syndrome.

Parents of children and persons with medical conditions are advised to read product labels carefully before taking any over-the-counter medication and consult a pharmacist if they have questions about use.

Serious problems associated with fifth disease rarely happen. However, some people may be at risk for these problems, including those whose health is weakened by other conditions such as:

• pregnancy,
• chronic blood disorders, including sickle cell disease, or
• immune system disorders.

If a pregnant woman gets fifth disease, the baby may be at risk for fetal anemia and death. However, birth defects do not happen as a result of infection with fifth disease during pregnancy.

People who have immune system problems are at risk of developing severe, chronic anemia from an infection of fifth disease. Symptoms of severe chronic anemia include:

• chronic fatigue,
• lack of energy,
• pale skin, and
• a low red blood cell count.

Anyone with this condition will remain contagious with fifth disease anywhere from a few months to years.

People in these three groups should call their doctor immediately if they suspect that they have been infected with fifth disease. For others not in these high risk groups, they may take care of their symptoms effectively and safely with home treatment.

To reduce the chances of getting fifth disease:

• wash hands often,
• don’t share eating utensils and drinking containers with an infected person, and
• avoid schools, day care centers, or hospitals during a known outbreak
• of fifth disease especially if you are pregnant, have a chronic
• blood disorder or an immune system problem.