Slapped Cheek Syndrome, also known as Erythema infectiosum or Parvovirus B19 infection is an extremely contagious infection usually observed in children. It is chiefly characterized by a bright red rash on the cheeks as if someone has slapped hard, thus the name. It is also referred to as the Fifth Disease since historically, it is placed on the standard list of rash-causing childhood diseases, which also includes measles (first), scarlet fever (second), rubella (third), Dukes' disease (fourth, but is no longer widely accepted as distinct), and roseola (sixth). The rashes usually develop on the cheeks, but some kids get these rashes on the wrists, knees, and ankles as well.

Although the parvovirus infection shows mild symptoms in children, adults have a more severe form and in the case of pregnant women, this viral infection can lead to severe health issues in the foetus. But the silver lining to the dark cloud is that, once anyone gets this viral infection, they usually become immune to it throughout life.


The Parvovirus can be categorised into 3 types:

Human parvovirus: Affecting and spreading between humans.

Canine parvovirus: Usually affecting and spreading in different canine species.

Feline panleukopenia virus: Type of parvovirus which infects and spreads only in the feline species.

That being said, the virus doesn’t spread in between different species, i.e. a human cannot catch the parvovirus or the fifth disease from an animal, and an animal cannot catch it from a human.


The Slapped Cheek Syndrome usually happens due to the single-celled Parvovirus B-19 that usually targets the red blood cells in the bone marrow. The virus mainly spreads between humans through the air, saliva, or as a result of close contact and hence the common forms of transmission are through sneezing or coughing, or sometimes due to direct hand-to-hand contact. The infection is extremely contagious in the initial days but once the rash appears the person is no longer contagious, i.e. they will not transmit the disease and can move around freely and spend time with loved ones. Also Read: Fever: Types, Causes, Symptoms And Treatment

Although the human parvovirus infection is quite common among school-age children during outbreaks in the winter and spring months, but anyone can become ill with it any time of the year.
slapped cheek syndrome

Risk Factors

People who are more at risk of the slapped cheek syndrome or parvovirus infection include:

Pregnancy: Pregnant women are more at risk if they are diagnosed with parvovirus infection as it affects red blood cells in the fetus that can ultimately cause severe anemia that could lead to miscarriage or stillbirth.

Anemia: People suffering from anemia may have certain complications. The infection may stop the production of red blood cells and cause an anemia crisis. Also Read: Anemia: Causes, Symptoms And Treatment

Weakened Immune System: The human parvovirus can also lead to severe anemic conditions in people with an already compromised immune system as a result of HIV, organ transplant surgery or cancer.


The symptoms start showing up within 4-14 days after getting exposed but sometimes may even take up to 21 days.  The most characteristic sign of the human parvovirus infection is the distinct bright red rash on both cheeks. Other common signs and symptoms include:

  • Fever
  • Upset stomach
  • Headache
  • Runny nose
  • Stuffy nose
  • Weakness and general debility
  • Itching
  • Sore throat
  • Irritability
  • Nausea
  • Diarrhoea
  • Abdominal pain
  • Arthralgia or joint pain

Diagnosis And Treatment

Although in some cases, the human parvovirus infection or slapped cheek syndrome clears away on its own, it is still better to consult a doctor on noticing the signs and symptoms right away to prevent the infection from spreading on to others. The doctor usually does a thorough physical checkup, acknowledges the patient’s past medical history and does a few blood tests to look for specific antibodies that might develop on getting exposed to the virus.


In case of a mild slapped cheek syndrome, the doctor usually prescribes the following:

  • Pain-killers and antibiotics in case of fever and headache
  • Anti-histamines to subdue itching and inflammation 
  • Proper rest and consumption of fluids to get relief from stomach trouble

But in case the person is suffering from anemia or has a weakened immune system the doctor usually performs blood transfusions or injects immune globulin injections, to treat the infection.