is one of several possible manifestations of infection by parvovirus B19
. The disease is also referred to as erythema infectiosum
(meaning infectious redness
) and as slapped cheek syndrome
, slap face
or slapped face
. In Japan the disease is called 'apple sickness or ringo-byou' (りんご病）in reference to the symptom of facial redness. The name "fifth disease" derives from its historical classification as the fifth of the classical childhood skin rashes or exanthems
The bright red cheeks are a defining symptom of the infection in children (hence the name "slapped cheek disease"). Occasionally the rash will extend over the bridge of the nose or around the mouth. In addition to the red cheeks, children often develop a red, lacy rash
on the rest of the body, with the upper arms and legs being the most common locations. The rash can last a couple of days (some cases lasting for several weeks) and may itch. Patients are usually no longer infectious once the rash has appeared.
Teenagers and adults may present with a self-limited arthritis.
The disease is usually mild, but in certain risk groups it can have serious consequences:
Any age may be affected although it is most common in children aged five to fifteen years. By the time adulthood is reached about half the population will have become immune
following infection at some time in their past. Outbreaks can arise especially in nurseries and schools .The Rash is typically described as 'Erythema Infectiosum'.