Slapped cheek

Slapped cheek (also known as fifth disease) is a common childhood illness. It causes bright red cheeks – like you’ve been slapped – and a lace-like rash on the body.


Slapped cheek most commonly affects children under 10 years of age. Some adults may get it if they are not immune from having slapped cheek in childhood.

How is slapped cheek spread?

Slapped cheek is caused by the human parvovirus B19 (no connection to the animal parvovirus).

Slapped cheek is passed on in droplets from the respiratory tract of an infected person, mainly by close contact, coughing and sneezing. Once infected the time until symptoms appear is between 4 and 20 days.

If you catch slapped cheek, you’ll be infectious for 5 or 6 days before the first symptom appears. You’ll stop being infectious once the rash appears.

Slapped cheek rapidly spreads through schools and childcare facilities and is most common during winter and spring.

If you are pregnant

If you are pregnant and catch slapped cheek during the first half of your pregnancy, there is a small risk that your baby can develop a serious form of anaemia (low iron levels in the blood), or that you may have a miscarriage.

If you come into contact with a child with slapped cheek, contact your doctor or lead maternity carer.

Time off from kura or school

Affected children may remain at school, because you stop being infectious once the rash appears.


Slapped cheek is a mild disease and most children will have only mild symptoms.

Early symptoms may include:

  • low-grade fever
  • chills
  • headache
  • body ache
  • sore throat
  • diarrhoea.

After 3–7 days these symptoms improve and a rash develops. This starts with firm, bright red cheeks that are burning hot (‘slapped cheek’). A fine, red, lace-like rash then develops on the child’s body, arms and legs. The rash may be itchy and may seem to fade and then flare up when the child is hot or upset. The rash usually lasts for 2 weeks but may last up to 6 weeks.

Adult symptoms

Adults with slapped cheek are less likely to have a rash but may suffer from painful, swollen joints, especially in the hands and feet. The joint pain may last for 1–2 weeks and in some more severe cases up to 6 weeks.


Slapped cheek should clear up on its own within 3 weeks. There is no specific treatment for slapped check, but to keep your child comfortable you can:

  • let them have plenty of rest
  • give paracetamol to relieve fever
  • use cold cloths to relieve discomfort of hot cheeks
  • make sure they drink plenty of water.

Call Healthline 0800 611 116 if you are unsure what you should do.


As slapped cheek is infectious before it is diagnosed, keeping your child home from preschool or school will not prevent the spread of the disease.

If you are exposed to slapped cheek, try to stop it spreading by making sure you and your children:

  • wash your hands frequently
  • cover your nose and mouth when coughing or sneezing
  • do not share food, eating utensils and drink bottles.

Also try to avoid contact with pregnant women and people who have low immunity to disease.

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