What is slapped cheek disease?

Slapped cheek disease is a viral disease that is common in children, between 4-10 years, but can also appear in adults in a more severe form. Slapped cheek disease is also known as fifth disease or by its medical name, erythema infectiosum. 

The main characteristic of slapped cheek disease is a distinctive red rash on the cheeks. Although somewhat dramatic in appearance, slapped cheek disease is normally a mild illness and will go away on its own without requiring treatment.

Causes

Slapped cheek disease is caused by a virus called erythrovirus, or parvovirus B19. Other viruses of the parvovirus family cause illnesses in animals.

Slapped cheek disease is most commonly passed from person to person via sneezing and coughing. When an infected person sneezes or coughs, the virus spreads via millions of tiny droplets, each containing many viruses that are spread into the air. If a droplet enters your nose or mouth, you may then be infected. The droplets can also collect on surfaces and objects, so you can also catch it by touching an infected surface and then touching your nose or mouth area.

Children are most often infected by other children in child care facilities, school, or at home. Outbreaks of the virus among children tend to occur in colder months.

The virus can also pass between people as a result of blood transfusions or organ transplants, but this is rare. After catching slapped cheek disease once, a person normally develops immunity to it from that point on.

Immunity

The body's ability to protect against an infection or toxin, generated by immunisations or exposure to previous infection.

Signs and symptoms

The symptoms of slapped cheek disease usually appear about four to 14 days after infection. Most people infected with the virus have no symptoms at all and may not know they've been infected.

Early symptoms of the disease resemble common cold symptoms. These can include:

  • Mild fever;
  • Headache;
  • Sore throat;
  • Sneezing;
  • Coughing;
  • Muscle aches;
  • A runny nose, and;
  • Tiredness.

'Slapped cheek' rash

A few days after the early symptoms appear, they begin to reduce. At this point, a distinctive red rash usually appears on the cheeks. The strong reddish colour makes the cheek look as if it has been slapped, which gives the disease the 'slapped cheek' name. Children are more prone to the rash than adults.

The red colour may become more noticeable during exercise, or when exposed to sunlight, wind or heat. The rash often passes after about a week, but in some cases stays for several weeks, or goes away only to appear again.

By the time the rash has appeared, that person is no longer infectious and can be in contact with other people at child care, school or work.

In some cases, the facial rash is followed by a body rash. It usually appears on the arms and legs and sometimes on the chest and back as well. The body rash normally goes away by itself after a week or two.

The fifth disease rash can appear on the face and the body.The distinctive rash of slapped cheek disease. 

Joint pain

Pain in the joints may appear a few days after the early symptoms. This is more common in adults and older children. The pain normally passes after a few days, but in a few cases may persist for weeks or even months.

Joints

A connecting surface or tissue between two bones.

Methods for diagnosis

Your doctor will usually diagnose slapped cheek disease by its symptoms. If necessary, blood tests for the presence of the virus can be performed.

Types of treatment

There is no specific treatment for the slapped cheek disease as antibiotics and existing antiviral medications have no effect on the virus. The disease should clear up on its own within a few weeks.

If symptoms are troublesome, the recommended treatments include:

  • Bed rest;
  • Medicines to reduce fever and coughing and ease throat soreness;
  • Drinking plenty of fluids;
  • Skin lotions to relieve the itching, and;
  • Protection of the face from excessive sunlight.

Potential complications

Slapped cheek disease is normally a mild illness and will go away on its own within two to four weeks. However, some at-risk people may experience complications and will benefit from medical attention.

Persistent infection

In people whose immune system is weak as a result of illness, age or medical treatment, the infection may remain in the body for a longer period and continue to cause problems.

Anaemia

In some at-risk people, the erythrovirus can cause problems with the development of red blood cells. This may lead to a shortage in red blood cells in the body (anaemia). This can be serious in people with certain blood disorders such as thalassemia or sickle-cell anaemia.

Pregnancy

Many, if not most, women are already immune to the virus by the time they reach adulthood. In pregnant women, who are not already immune to the virus and are infected before week 20 of their pregnancy, the unborn baby has a small chance of developing a problem, such as anaemia. In rare cases, this can lead to miscarriage.

If you have been exposed to someone with slapped cheek while you are pregnant, seek advice from your local doctor or obstetrician.

Immune system

The organs and cells involved in protecting the body against infection.

Miscarriage

The loss of a pregnancy before 20 weeks.

Sickle-cell anaemia

A hereditary form of anaemia in which a defective form of haemoglobin cause red blood cells to be an abnormal crescent shape. This causes the cells to break down prematurely, which can then lead to anaemia.

Prevention

Currently, there are no vaccines against the virus that causes the slapped cheek disease. To prevent catching or passing on the virus, it is advisable to wash your hands frequently, especially before eating or touching the mouth or nose.