Erythema infectiosum

Reviewed by Dr Dan Rutherford, GP

What is erythema infectiosum?

Erythema infectiosum is also called 'slapped cheek disease' or 'fifth disease'. It is a viral infection that predominantly affects children between the ages of 5 and 15.

Parents, or people working with children, are also liable to infection.

The most striking symptom is a red rash on the cheeks. There is no cure - in time the infection goes.

How is erythema infectiosum contracted?

Erythema infectiosum is caused by a virus called parvovirus B19. The virus is transferred from one person to another via airborne droplets from the nose and throat, for example when coughing or sneezing. An infected pregnant woman can transfer the virus to her unborn baby.

The incubation period for parvovirus B19 is between one and three weeks and the person will be infectious for about a week before the illness actually becomes apparent. By the time symptoms are present, the person is no longer infectious.

What are the signs of erythema infectiosum?

A couple of days before the rash appears, mild symptoms of flu and itching may occur.

A rash and redness may be observed on the cheeks. The rash then spreads to the arms and legs either at the same time or a few days later. In very rare cases the whole body is involved.

Itching is usually present.

Painful or swollen joints frequently occurs in adults, especially women.

The patient may have a temperature and suffer from fatigue.

In many cases, the illness passes undetected as there are no noticeable symptoms. However, even people without symptoms may be infectious.

Who is at risk?

Pregnant women who have not had the disease before.

People with a lowered immune defence system.

People with chronic anaemia.

Good advice

Cool surroundings and cold packs will relieve itching.

If you are pregnant and believe you may have caught erythema infectiosum, you should consult your doctor who will take a blood sample.

How does the doctor make the diagnosis?

The diagnosis is usually made by viewing the symptoms.

A blood sample can be used to confirm the diagnosis and identify people who have had the illness in the past.

What about the future?

The illness usually clears up without complications. The rash will normally last for up to a week. It may return several times in the following weeks as a response to stress, dramatic changes in temperature or physical exertion. The swelling in the joints is also temporary, but can last longer.

Erythema infectiosum can also cause short-term anaemia.

The illness gives immunity which means that you can only have it once.

Pregnant women who are infected with erythema infectiosum have a 5 per cent risk of passing on the illness to their baby.

If a foetus is infected with erythema infectiosum it could lead to a miscarriage or stillbirth, but the risk is small. If the foetus is infected and becomes seriously anaemic, a blood transfusion in the uterus is possible.

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