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Children's health

Slapped cheek syndrome (fifth disease) in children: rash, spread and who should check in

Slapped cheek syndrome, also called fifth disease, is a common viral illness in children that causes a bright red rash on the cheeks. It is usually mild and clears without treatment. The key practical points are that children are infectious before the rash and not after it, and that a few groups, including pregnant women and people with certain blood disorders, should seek advice if exposed.

Last checked: 2026-10-04

Key facts

At a glance.

  • How long it lasts

    The NHS says slapped cheek syndrome is common in children and should get better within 3 weeks; the rash usually fades within 1 to 3 weeks.

  • When it spreads

    You can only pass it on before the rash appears, so a child with the cheek rash is no longer infectious, according to the NHS and NHS inform.

  • Attendance

    The NHS says there is no need to stay off school or work after the rash appears, and UKHSA lists slapped cheek as needing no exclusion. Tell the school.

  • Groups who should seek advice

    The NHS lists pregnancy, blood disorders such as sickle cell disease or thalassaemia, and a weakened immune system.

  • Anaemia warning signs

    Very pale skin, shortness of breath, extreme tiredness or fainting need an urgent GP appointment or NHS 111, says the NHS.

What slapped cheek syndrome is

The condition is caused by parvovirus B19. NHS inform describes it as a viral infection most common in children but possible at any age, usually causing a bright red rash on the cheeks. The NHS says it is rarer in adults but can be more serious in them. Many children have it without anyone naming it, and some people notice no early symptoms at all.

Symptoms in the order they appear

NHS inform says symptoms usually develop 4 to 14 days after infection and sometimes up to 21 days. The first phase is a few days of feeling unwell, which can include a temperature of around 38C, runny nose, sore throat, headache or an upset stomach. This early phase is when the infection is most contagious.

After a few days a bright red rash may appear on one or both cheeks. A few days later a lighter rash may appear on the chest, back, arms and legs; NHS inform describes it as often raised and lace-like and sometimes itchy. The NHS notes the rash may be less obvious on brown and black skin.

  • The rash usually fades within 1 to 3 weeks but can sometimes last longer, especially if the child is hot or stressed (NHS).

  • NHS inform says it can come and go for a few weeks, triggered by exercise, heat, anxiety or stress.

  • Joint pain and stiffness are more typical in adults and rare in children, but can continue for many weeks (NHS).

How it spreads and why it is hard to prevent

The virus travels in droplets from coughs and sneezes and on contaminated surfaces. NHS inform says the infection spreads in a similar way to colds and flu. Because people are most contagious before the characteristic rash, it is hard to know who to avoid, and the NHS says it is hard to avoid spreading it for exactly that reason. There is currently no vaccine, according to NHS inform.

Regular handwashing with soap and water, tissues for coughs and sneezes and prompt disposal of used tissues are the measures listed by the NHS.

Looking after a child at home

Treatment is supportive. The NHS suggests rest, plenty of fluids to avoid dehydration (babies should continue normal feeds), and paracetamol or ibuprofen if the child is uncomfortable. NHS inform adds an emollient for itchy skin and a pharmacist for advice on antihistamines suitable for children. Aspirin should not be given to anyone under 16.

You do not usually need to see a GP for typical slapped cheek syndrome.

Who should speak to a clinician

The NHS says to see a GP if you think you have slapped cheek syndrome and any of the following applies.

  • You are pregnant: there is a very small risk of miscarriage or other complications.

  • You have a blood disorder such as sickle cell disease or thalassaemia: there is a risk of severe anaemia.

  • You have a weakened immune system, for example from chemotherapy, leukaemia, HIV or diabetes.

Urgent signs: possible severe anaemia

The NHS says to ask for an urgent GP appointment or get help from NHS 111 if someone with slapped cheek syndrome has very pale skin, shortness of breath, extreme tiredness or has fainted, as these can be signs of severe anaemia and hospital treatment including a blood transfusion may be needed. NHS inform says a blood test may be done to check immunity, and that someone who is not immune will be monitored closely.

School and nursery

Once the rash has appeared the infection can no longer be passed on, so unless a child is unwell they can attend. The NHS asks that you let the school or teacher know, partly so that pregnant staff and parents can be told. The UKHSA exclusion table lists slapped cheek as no exclusion required, and no need to contact the health protection team.

Frequently asked

Questions people ask.

Quick, plain-English answers to the questions we hear most.

  • Is my child contagious with the red cheeks?

    No. The NHS says you can only spread slapped cheek syndrome before the rash appears, and NHS inform says that once the rash appears it can no longer be passed on.

  • Does my child have to stay off school?

    Not because of the rash. The NHS says you do not have to stay off work or school after the rash appears, and UKHSA lists no exclusion. A child who is feeling too unwell can of course stay at home.

  • Why should I tell the school?

    The NHS and NHS inform both say to let the school know. Pregnant staff or parents, and people with blood disorders or weak immunity, are the ones who should be told so they can speak to their midwife or GP.

  • I am pregnant and my child has the rash. What should I do?

    The NHS says to tell your midwife or a GP if you are pregnant and have been near someone with slapped cheek syndrome. NHS inform notes a very small risk of miscarriage or other complications and that a blood test may check immunity.

  • Can slapped cheek cause anaemia in a child?

    The NHS says people with blood disorders such as sickle cell disease or thalassaemia are at risk of severe anaemia. Pale skin, breathlessness, extreme tiredness or fainting need urgent advice.

  • How long does the rash last?

    The NHS says usually 1 to 3 weeks, sometimes longer. NHS inform says 1 to 2 weeks, and that it can reappear for a few weeks with heat, exercise, anxiety or stress.

  • Is there a vaccine or specific medicine?

    NHS inform says there is currently no vaccine. It describes the illness as clearing without specific treatment, with rest, fluids and pain relief as comfort measures.

  • Why do adults get joint pain?

    The NHS says adults might have joint pain and stiffness, which can occasionally occur in children and may continue for many weeks after other symptoms have gone. NHS inform says it can last for several weeks or even months.

  • Can my child get it again?

    The sources read for this page do not state whether reinfection occurs, so this guide makes no claim. Ask your GP if you have a specific concern, for example in pregnancy.

  • What else can look like slapped cheek?

    The NHS points parents who are unsure to its page on other rashes in babies and children. A rash with fever and a child who seems very unwell should be assessed rather than assumed to be a mild viral rash.

Where this comes from

Sources and checking.

This guide is for information, not medical advice.

Your GP or consultant knows your history and can tell you which parts apply to you. If your symptoms are severe, rapidly worsening, or come with red-flag features, seek urgent medical care. Figures and availability change, so treat them as a guide and confirm with the provider.

Published 2026-10-04, next review 2027-10-04.

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