Slapped cheek syndrome (also called fifth disease or parvovirus B19) is a viral infection that's most common in children, although it can affect people of any age. It usually causes a bright red rash on the cheeks.

Although the rash can look alarming, slapped cheek syndrome is normally a mild infection that clears up by itself in one to three weeks. Once you've had the infection, you're usually immune to it for life.

However, slapped cheek syndrome can be more serious for some people. If you're pregnant, have a blood disorder or a weakened immune system and have been exposed to the virus, you should get medical advice.

This page covers:

Symptoms

When to get medical advice

What to do if you or your child has it

How you get it

Prevention

Symptoms of slapped cheek syndrome

Symptoms of slapped cheek syndrome usually develop 4-14 days after becoming infected, but sometimes may not appear for up to 21 days.

Initial symptoms

Some people with slapped cheek syndrome won't notice any early symptoms, but most people will have the following symptoms for a few days:

• a slightly high temperature (fever) of around 38C (100.4F)
• a runny nose 
• a sore throat
• a headache
• an upset stomach
• feeling generally unwell

The infection is most contagious during this initial period.

In adults, these symptoms are often accompanied by joint pain and stiffness, which may continue for several weeks or even months after the other symptoms have passed.

Slapped cheek rash

After a few days, a distinctive bright red rash on both cheeks (the so-called "slapped cheeks") normally appears, although adults may not get this.

By the time this rash develops, the condition is no longer contagious.

After another few days, a light pink rash may also appear on the chest, stomach, arms and thighs. This often has a raised, lace-like appearance and may be itchy.

The rashes will normally fade within a week or two, although occasionally the body rash may come and go for a few weeks after the infection has passed. This can be triggered by exercise, heat, anxiety or stress.

When to get medical advice

You don't usually need to see your GP if you think you or your child has slapped cheek syndrome, as the condition normally gets better on its own.

However, you should contact your GP, call NHS 111 or contact your local out-of-hours service if you have been exposed to anyone with slapped cheek or you have symptoms of the infection and:

• you're pregnant – infection in pregnancy, particularly early pregnancy, carries a risk of causing miscarriage, stillbirth or other complications; however, this risk is small and most pregnant women will already be immune (read more about the risks of slapped cheek syndrome in pregnancy)
• you have a blood disorder, such as sickle cell anaemia or thalassaemia, or a weakened immune system – the infection can cause severe anaemia that may need to be treated in hospital
• you have symptoms of severe anaemia, such as very pale skin, severe shortness of breath, extreme tiredness or fainting

In these cases, a blood test may be carried out to see if you're immune to the infection. If you're not immune, you'll be monitored carefully to check for any problems.

If you develop severe anaemia, it's likely that you'll need to be admitted to hospital and have a blood transfusion to replace your damaged blood cells.

What to do if you or your child has slapped cheek

Slapped cheek syndrome is usually mild and should clear up without specific treatment.

If you or your child is feeling unwell, you can try the following to ease the symptoms:

• rest and drink plenty of fluids – babies should continue their normal feeds
• for a fever, headaches or joint pain, you can take painkillers, such as paracetamol or ibuprofen – children under 16 shouldn't take aspirin
• to reduce itchiness, you can take antihistamines or use an emollient (moisturising lotion) – some antihistamines are not suitable for young children, so check with your pharmacist first

Unless you or your child is feeling unwell, there’s no need to stay away from school or work once the rash has developed, as the infection is no longer contagious by this point.

It's a good idea to notify your child's school about the infection, so children who develop early symptoms can be spotted quickly and vulnerable people can be made aware that they may need to get medical advice.

How do you get slapped cheek syndrome?

Slapped cheek syndrome is caused by a virus called parvovirus B19. This is found in the droplets in the coughs and sneezes of someone with the infection.

The virus is spread in a similar way to colds and flu. You can become infected by: 

• inhaling droplets that are sneezed or coughed out by someone with the infection
• touching a contaminated surface or object and then touching your mouth or nose

Someone with slapped cheek syndrome is infectious during the period before the rash develops. Once the rash appears, the condition can no longer be passed on.

Preventing slapped cheek syndrome