Slapped cheek syndrome

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

Slapped cheek syndrome is normally a mild infection that clears up by itself in 1 to 3 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.

Symptoms of slapped cheek syndrome

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

First 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 38°C (100.4°F)
  • a runny nose
  • a sore throat
  • a headache
  • an upset stomach
  • feeling generally unwell

The infection is most contagious during this initial period.

Adults may also feel joint pain and stiffness. This may continue for several weeks or even months after the other symptoms have passed.

Slapped cheek rash

Image source: dermnetnz.org

After a few days, a distinctive bright red rash on both cheeks (‘slapped cheeks’) normally appears. 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. 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 it normally gets better on its own.

Speak to your GP practice if:

You’ve been exposed to anyone with slapped cheek syndrome or you have symptoms of the infection and:

  • you’re pregnant – there’s a very small risk of miscarriage or other complications
  • you have a blood disorder, such as sickle cell anaemia or thalassaemia
  • you have a weakened immune system
  • ask for an urgent appointment if you have symptoms of severe anaemia, such as very pale skin, shortness of breath, extreme tiredness or fainting

If your GP is closed, phone 111.

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 be sent to hospital for a blood transfusion.

What to do if you or your child has slapped cheek syndrome

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

If you or your child is feeling unwell, there are things you can do help ease the symptoms.

Do

  • rest
  • drink plenty of fluids – babies should continue their normal feeds
  • take paracetamol or ibuprofen for a high temperature, headaches or joint pain – children under 16 shouldn’t take aspirin
  • use an emollient (moisturising lotion) on itchy skin
  • speak to a pharmacist about itchy skin – they can recommend the best antihistamine for children

Unless you or your child is feeling unwell, you do not have to stay away from work or school once the rash has developed. The infection is no longer contagious by this point.

Let your child’s school know if your child has slapped cheek syndrome.

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

It’s very difficult to prevent slapped cheek syndrome. This is because people who have the infection are most contagious before they develop any obvious symptoms.

Make sure that everyone you live with washes their hands often to help stop the infection from spreading.

There’s currently no vaccine available to protect you against the condition.


Last updated:
04 December 2023