"Slapped-Cheek" disease (also known as Fifth disease or erythema infectiosum) is another viral infection common in children. It is caused by Parvovirus B-19 and is not related to the parvovirus against which you immunize your pets.

This illness, like other viruses, is spread by respiratory mechanism (e.g. sneezing) and by hand-to-hand contact. Most of the time you can't figure out who gave it to your child. It causes a mild flu-like illness for the first week consisting of low-grade fever, sore throat (remember all sore throats are not Strep), and runny nose. Then a rash occurs causing red cheeks and often redness about the trunk, neck and buttocks. This rash doesn't itch and is actually caused by the body's reaction to fighting the infection rather than the infection itself.

Complications of this infection are uncommon. Joint stiffness and pain may occur in adolescence which may last from two to four weeks but does not cause any permanent damage. Some children have cells in the bone marrow (where cells are produced) which are affected which can lead to anemia. Usually this is not noticed by either the parent or pediatrician because the anemia is usually mild and resolves. Rarely, it can be severe enough to require blood transfusion. The biggest risk of this infection is not to the child but to that person's pregnant contacts.

Pregnant women (particularly those who are in their 1st trimester) who have not had the disease are at risk for infection which may cause problems with the fetus including death.

If your child gets Fifth disease (slapped-cheek, erythema infectiosum):

• Give Acetaminophen for fever
• He/She does not need to be kept out of daycare or school. By the time the diagnosis is made (i.e. when the rash occurs) the child is not infectious.
• To be safe, however, women who are pregnant should refrain from taking of the child until symptoms resolve.