What is slapped cheek disease?
Slapped cheek disease is sometimes called fifth disease or erythema infectiosum. It is an infection caused by the parvovirus B19 virus. It most commonly occurs in children aged 4-12 years, but anyone can be affected. It is infectious (can be passed on). The infectious period is for 4-20 days before the rash appears. By the time the rash develops, it is usually no longer infectious.
In the UK, April and May are the peak months for this condition. However, it may occur at any time.
The majority of adults in the UK have had this infection in the past, usually without realising it. You normally have slapped cheek disease only once in a lifetime. This is because you make antibodies during the infection which protect you from future infections with this same virus.
Note: pet dogs or cats can be immunised against parvovirus. However, these are animal parvoviruses which are different from parvovirus B19.
What are the symptoms of slapped cheek disease?
Rash
Typically, the rash looks like a bright red scald on one or both cheeks. It looks as if the cheek(s) have been slapped. Sometimes there is just a blotchy redness on the face. The rash is painless.
Sometimes a more widespread faint rash appears on the body, arms, and legs. Occasionally, the rash on the face and body keeps fading and returning several times for up to four weeks. However, it is more common for the rash to come and go completely within a few days.
Other symptoms
Although the rash can look quite dramatic, the illness itself is usually mild. You will usually not feel too ill. You may have a headache or mild temperature (fever) for a few days before the rash appears. Occasionally, mild pain and stiffness develop in one or more joints for a few days. This is more common in adults than children.
You may have no symptoms
Around one in five people who become infected with this virus do not develop any symptoms at all. Some people just have a fever and feel generally unwell, without any rashes.
Are there any tests for slapped cheek disease?
This condition is usually diagnosed by the appearance of the classical rash on your cheeks.
A blood test is sometimes performed. This will show if you have the disease and can also show if you have had this disease in the past. If you have had the disease in the past (even if you had it without developing any symptoms) then you will be immune to it.
Are there any complications from slapped cheek disease?
Usually not. Rarely, the aching joint symptoms last for some time after the other symptoms have gone.
The only times the illness may become more serious are:
- In children with some types of hereditary anaemia such as sickle cell disease, beta-thalassaemia and hereditary spherocytosis. This virus can cause these types of anaemia to become suddenly much worse.
- In people with a weakened immune system. If you have leukaemia or cancer, have had an organ transplant or have HIV infection then you may develop a more serious illness with this infection.
- In pregnant women. Most pregnant women are immune to this virus, or will not be seriously affected if they become infected by it. However, like some other viruses, the virus that causes slapped cheek disease can sometimes harm an unborn child. Miscarriage is more common in women who are infected with this virus before 20 weeks of pregnancy. Therefore, if you are pregnant, keep away from people who have slapped cheek disease. If you are pregnant and have been in contact with a person with the virus then your doctor may arrange for you to have a blood test.
What is the treatment?
You do not usually need any treatment. If you have a headache, temperature or aches and pains then painkillers such as paracetamol or ibuprofen will help.
Those people who develop complications (which is very rare) may require other treatment.
Can slapped cheek disease be prevented?
There is no vaccine or treatment that prevents this infection. Frequent handwashing reduces the risk of this infection been transmitted to other people.
There is no benefit of not going to school (or work) if you have this infection as you are only infectious before you develop the rash.