Slap Cheek Syndrome

Slapped cheek syndrome (also known as “fifth disease”) is a type of viral infection that is most common in children, although it can affect anyone of any age. 

Slapped cheek syndrome usually affects children between the ages of 3 and 15. Most cases develop during the late winter months or early spring.

The most common symptom of slapped cheek syndrome is the appearance of a distinctive bright red rash on the cheeks. This is how the condition got its name.

pped cheek syndrome 

The symptoms of slapped cheek syndrome usually begin in the first couple of weeks after your child is exposed to the parvovirus B19 virus. The symptoms tend to follow three distinct stages.

First stage

The first stage is usually characterised by mild flu-like symptoms, such as:

• a high temperature (fever) of 38C (100.4F), although your child’s temperature will not usually rise above 38.5C (101F)
• sore throat
• headache
• upset stomach
• feeling tired
• itchy skin

In many cases these symptoms do not occur, or are so mild as to be barely noticeable.

During the first stage of symptoms, your child will be most contagious.

Second stage

Between three to seven days after the symptoms start, your child will develop a bright red rash on both cheeks (the so-called "slapped cheeks"). The rash may be particularly noticeable in bright sunlight.

Third stage

The third stage of symptoms usually begins one to four days after the appearance of the "slapped cheek" rash.

During this stage, the rash will usually spread to your child’s chest, stomach, arms and thighs. The rash usually has a raised, lace-like appearance and may cause discomfort and itching.

The rash is usually more noticeable after exercise, or if your child is hot, anxious or stressed.

By this time, your child should no longer be contagious and they will be able to return to nursery or school without the risk of passing the infection onto others.

The rash should then pass after a few days. In rare cases it can last up to four or five weeks.

Parvovirus B19 infection in adults

The most common symptom of a parvovirus B19 infection in adults is joint pain and stiffness in your:

• hands
• knees
• wrists
• ankles

Other symptoms, such as developing a fever and sore throat, are rare in adults.

In most people, the symptoms of a parvovirus B19 infection will pass within one to three weeks, although one-in-five adults will experience recurring episodes of joint pain and stiffness for several months, sometimes years.

cheek syndrome 

There is no vaccination for slapped cheek syndrome and, for most people, the infection is usually a mild illness, which quickly passes without the need for treatment.

There are various self-care techniques that you can use to help relieve symptoms. These are explained below.

• Painkillers, such as paracetamol or ibuprofen, can be used to relieve symptoms, such as a high temperature, headache and joint pain. Children aged 16 or under should not take aspirin.
• Antihistamines can be used to relieve the symptoms of itchy skin. Some antihistamines are not suitable for children who are less than two years old, so check with your pharmacist beforehand.
• Another way to soothe itchy skin is to use a moisturising lotion.
• Make sure that you (or your child) get plenty of rest and drink plenty of fluids as this will help to relieve the symptoms of sore throat and a high temperature.
• Adults who develop joint pain can be treated with painkillers that are non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen.

Complications

There are three high-risk groups in which the parvovirus B19 can cause a much more serious infection and trigger a range of complications. These are listed below.

• People with certain blood disorders, such as sickle cell anaemia. This is where the blood doesn't contain enough healthy red blood cells (anaemia) and infection can lead to a further and more severe loss of red blood cells.
• Pregnant women without immunity. Parvovirus B19 infection can increase the risk of a miscarriage because the virus can cause severe anaemia in the unborn child.
• People with a weakened immune system (immunocompromised), either due to a side effect of treatment, such as chemotherapy, or from a condition such as HIV. These groups can experience prolonged, and sometime severe, symptoms of infection.

If you're in one of these high-risk groups and you have been in close contact with someone who goes on to develop slapped cheek syndrome, contact your GP for advice.

People in these groups may need to be admitted to hospital. In some cases, they may need a blood transfusion.