Hand, foot and mouth disease is a mild viral illness which resolves itself in a few days. Affecting mainly children, it’s more common in warmer weather. Good personal hygiene and teaching children to cover their coughs and sneezes can help prevent the spread of the virus.…
Slapped cheek disease
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.
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.
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;
- Sore throat;
- Muscle aches;
- A runny nose, and;
'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 color 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 color 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.
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.
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.
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.
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.
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 (anemia). This can be serious in people with certain blood disorders such as thalassemia or sickle-cell anemia.
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 anemia. 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.
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.
- Edmonson M.B. Riedesel E.L. Williams G.P. et al. (2010). Generalized Petechial Rashes in Children During a Parvovirus B19 Outbreak. Pediatrics 125: e787–e792.
- Murtagh J. (2008). John Murtagh’s Patient Education (Australian edition.). North Ryde N.S.W.: McGraw-Hill Book Company Australia.
- Young N.S. & Brown K.E. (2004). Parvovirus B19. New England Journal of Medicine 350: 586–597.
- Anderson L.J. & Török T.J. (1989). Human Parvovirus B19. New England Journal of Medicine 321: 536538.
- Choices N.H.S. (2014 March 18). Slapped cheek syndrome - Health A-Z - NHS Choices. Accessed 29 July 2014 from http://www.nhs.uk/conditions/slapped-cheek-syndrome/pages/introduction.aspx
- Clinical manifestations and pathogenesis of human parvovirus B19 infection. Accessed 29 July 2014 from http://www.uptodate.com/contents/clinical-manifestations-and-pathogenesis-of-human-parvovirus-b19-infection?source=search_result&search=erythema+infectiosum&selectedTitle=1%7E29
- Edmonson M.B. Riedesel E.L. Williams G.P. et al. (2010). Generalized Petechial Rashes in Children During a Parvovirus B19 Outbreak. Pediatrics 125: e787e792.
- Erythema Infectiosum. Accessed 29 July 2014 from http://pediatrics.med.nyu.edu/rheumatology/conditions-we-treat/conditions/erythema-infectiosum
- Fifth Disease. Text. Accessed 29 July 2014 from http://www.nlm.nih.gov/medlineplus/fifthdisease.html
- Health D. of. Home. Accessed 29 July 2014 from http://www.betterhealth.vic.gov.au/
- Louth M. (2013). Infectious diseases in children Fifth disease (Slapped cheek disease). Practice Nurse 43: 32-25.
- MD Consult - Worse Than a Slap in the Face - The American Journal of Medicine - Medical Journal. Accessed 29 July 2014 from http://www.mdconsult.com.ezproxy.lib.rmit.edu.au/das/article/body/457070400-2/jorg=journal&source=&sp=22862653&sid=0/N/733445/1.html?issn=0002-9343
- Murtagh J. (2008). John Murtaghs Patient Education (Australian edition.). North Ryde N.S.W.: McGraw-Hill Book Company Australia.
- Parvovirus B19 infection (fifth disease slapped cheek slapped face erythema infectiosum) - symptoms treatment and prevention?:: SA Health. Accessed 29 July 2014 from http://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/health+topics/health+conditions+prevention+and+treatment/infectious+diseases/parvovirus+b19+infection/parvovirus+b19+infection+fifth+disease+slapped+cheek+slapped+face+erythema+infectiosum+-+symptoms+treatment+and+prevention
- Rahiala J. Koskenvuo M. Norja P. et al. (2013). Human parvoviruses B19 PARV4 and bocavirus in pediatric patients with allogeneic hematopoietic SCT. Bone Marrow Transplantation 48: 13081312.
- Slapped cheek disease. Better Health Channel. Accessed 29 July 2014 from http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Slapped_cheek_disease
- Slapped cheek infection information sheet - Department of Health Victoria Australia. instructional. Accessed 29 July 2014 from http://ideas.health.vic.gov.au/bluebook/erythema-info.asp
- Young N.S. & Brown K.E. (2004). Parvovirus B19. New England Journal of Medicine 350: 586597.
FAQ Frequently asked questions
What is slapped cheek disease?
Slapped cheek disease, or fifth disease, is a common childhood illness caused by an infection with a virus called erythrovirus, or parvovirus B19.
What are the symptoms of slapped cheek disease?
The symptoms of slapped cheek disease usually appear about four to 14 days after infection. One in five people infected with the virus have no symptoms at all and may not know they've been infected. Early symptoms of fifth disease resemble …
What causes slapped cheek disease?
A virus called erythrovirus or parvovirus B19 causes slapped cheek disease.
Who gets slapped cheek disease?
Children four to 10 years of age are most commonly affected by slapped cheek disease. However, the disease can also appear in older children, teenagers and adults.
How is slapped cheek disease diagnosed?
Slapped cheek disease is usually diagnosed by its signs, especially the rash. If necessary, blood tests can be done to confirm a diagnosis.
Will the slapped cheek disease clear up on its own?
Slapped cheek disease will clear up on its own within a few weeks as the virus is cleared from the body.
What can be done at home to treat slapped cheek disease ?
Bed rest, plenty of fluids and, if required, medication against fever or aching, can help relieve symptoms of slapped cheek disease if they're too troublesome.
Is slapped cheek disease contagious?
Slapped cheek disease is very contagious, and many people the world over have been exposed to it.