Slapped cheek syndrome

What is it? What are the symptoms? What are the treatments?

What is slapped cheek syndrome?

Slapped cheek syndrome, also known as fifth disease, is a common contagious viral infection that usually affects children between the ages of three and 15, although it can strike people of all ages. It occurs most often in winter and spring and is caused by parvovirus B19. There are so few symptoms that lots of cases go completely unnoticed, although it's thought to be very common, and once you've had it, you have lifelong immunity against the virus that causes it. Up to 80% of adults in the UK are thought to have immunity from a previous infection with parvovirus B19.

It's caught by inhaling airborne droplets of saliva from other people's coughs and sneezes.

There's an increased risk of miscarriage if the disease is caught in pregnancy as it can cause severe anaemia in unborn babies, and mums-to-be who contract the disease may need hospitalisation so their babies can be treated in the womb.

What are the symptoms of Slapped cheek syndrome?

There's an incubation period of around 14 to 18 days before symptoms of slapped cheek syndrome first appear. They usually emerge in a set pattern, starting with a fever (temperature of 38°C or above), sore throat, upset tummy, headache and itchy skin. This is when the disease is most infectious.

A few days to a week later, the rash appears over both cheeks, as if they've been slapped. Then, up to four days later, the rash will spread across the chest, abdomen, arms and thighs. It can be very itchy and uncomfortable, and is usually raised.

In adults, the main symptoms are aches, pains and stiffness of the joints, especially knees, wrists and ankles. This can last for months or, in rarer cases, years. Only about 50% of adults have the rash, and there are usually none of the other symptoms.

If you're pregnant and you think you have symptoms contact your GP straight away.

What are the treatments and remedies of Slapped cheek syndrome?

There's usually no treatment for slapped cheek syndrome, except for home treatments such as paracetamol or ibuprofen to bring the temperature down. Symptoms in children can persist for up to five weeks.

Certain vulnerable groups of people may need specialised medical treatment, however. These include people with certain blood disorders, who may need a blood transfusion, as it can destroy red blood cells, and those with lowered immunity, who may need an injection of antibodies from a donor with immunity to the disease to prevent complications.

Pregnant women may be admitted to hospital so their unborn babies can be given a blood transfusion in the womb.

You should contact your doctor immediately if you think you may have slapped cheek disease and you fall into any of these 'at risk' groups.

This guide

The information in this Bounty A-Z of Family Health is not a substitute for an examination, diagnosis or treatment by a doctor, midwife, health visitor or any other qualified health professional. If in doubt, always speak to a doctor.

Bounty will not be held responsible or liable for any injury, loss, damage, or illness, however this occurs or appears, after using the information given on this website and in particular the A-Z of Family Health.

Further help

For health advice and information 24 hours a day, 365 days a year, the NHS offers call and web services. You can also visit NHS websites for services, health information and health news at nhs.uk 

  • England – call 111 from any landline or mobile phone free of charge, or visit nhs.uk 
  • Scotland – call 111 from any landline or mobile phone free of charge, or visit nhs24.com 
  • Wales – call 0845 4647 , or visit nhsdirect.wales.nhs.uk 
  • Northern Ireland – visit hscni.net


Slapped cheek syndrome