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Slapped Cheek Syndrome - Causes, Symptoms, Treatment, and Prevention

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Slapped cheek syndrome is a viral infection among primary school children. Read the article below to learn more about its causes, symptoms, and treatment.

Medically reviewed by

Dr. Dhepe Snehal Madhav

Published At October 11, 2022
Reviewed AtMarch 2, 2023

What Is Slapped Cheek Syndrome?

Slapped cheek syndrome is a mild viral infection caused by the human parvovirus B19. It is a common condition among children between four and ten years. It is characterized by bright red rashes on cheeks that look like the child has been slapped. It's also called the fifth disease or erythema infectiosum. The fifth disease got its name because it was the fifth viral rash in the list of conditions that affect children.

What Causes Slapped Cheek Syndrome?

The human parvovirus B19 causes slapped cheek syndrome. It is commonly seen among primary school-aged children in winter and spring. The virus is spread from one person to another through personal contact, sneezing, or coughing. The infection also passes on through an infected pregnant woman's blood to her baby, although it is rare. The condition is contagious only before the rash appears; the child is no longer considered infectious once the rash appears.

What Does Slapped Cheek Syndrome Look Like?

The characteristic symptom of slapped cheek syndrome is bright red rashes on the cheeks that look like the child has been slapped. The rash appears seven to ten days after getting flu-like symptoms.

The early symptoms are usually mild and may include the following:

  • Low-grade fever.

  • Cough.

  • Runny nose.

  • Headache.

  • Rash.

  • Sore throat.

  • Fatigue.

  • Headaches.

  • Muscular pain.

  • Joint pain and swelling (more common in adults).

People may get a second rash on their arms, trunks (chest and back), and buttocks after a couple of days. These itchy rashes usually go away in seven to ten days. When the rashes start to go away, they fade from the center outward, giving it a "lacy" appearance. However, even after the rashes go away, they can reappear after a few weeks or months when the skin is exposed to sunlight or exercise.

How Does Slapped Cheek Syndrome Spread?

This Parvovirus B19 spreads from one person to another through saliva droplets or nasal secretions when someone infected with this virus sneezes or coughs. A pregnant mother can also pass the infection to her baby through blood. Children are not contagious after the rash appears. However, people with weakened immune systems infected with parvovirus B19 may be contagious for longer periods. Once you have become infected with parvovirus B19, you get lifelong immunity against this virus.

How Is Slapped Cheek Syndrome Diagnosed?

Slapped cheek syndrome is diagnosed quickly based on the symptoms. It does not require any tests. Bright red rashes across the cheeks are the most recognized symptom. However, a healthcare professional may do a blood test in some rare cases to confirm the disease. The blood test is helpful for pregnant women suspected of having the infection.

What Are the Complications of Slapped Cheek Syndrome?

Slapped cheek syndrome is usually mild in children and healthy adults. Most people recover completely from the infection, but some may get serious health complications, especially those with weakened immune systems.

Some of the complications include:

  • Anemia: Parvovirus B19 may stop the production of red blood cells leading to an anemia crisis. Although the problem is temporary, anemia can be severe for those with weakened immune systems. People with HIV, cancers, or organ transplants are more at risk of complications due to weak immune systems. In addition, those with sickle-cell anemia are more likely to have problems if they have slapped cheek syndrome. Sometimes, in pregnant women, the infection may affect red blood cells in the fetus; this may lead to severe anemia resulting in miscarriage or stillbirth.

  • Arthritis: About 10 % of children and 80 % of adults, especially women, may develop joint pain and swelling (polyarthropathy syndrome). The symptoms usually last one to three weeks, but they can take a long time to go away.

  • Pregnant women exposed to the virus can infect unborn babies through their blood. The virus does not cause any birth defects or developmental problems. Pregnant women should see a doctor to avoid complications as soon as they are exposed to this virus. The baby may develop severe anemia that may lead to miscarriage or stillbirth. The baby may need a blood transfusion in some rare cases. However, most pregnant mothers infected with this virus deliver normal and healthy babies.

When To See a Doctor?

Consult a doctor when you get exposed to the virus, and if you have:

  • Pregnancy.

  • Itchy rash.

  • Sickle cell anemia.

  • Weak immune system due to HIV, leukemia, or other cancers.

How Is Slapped Cheek Syndrome Treated?

Most cases of slapped cheek syndrome are usually mild and go away naturally in healthy children and adults. Treatment relieves symptoms like fever, itching, joint pain, and swelling. Those with complications from the infection reach out to healthcare providers for medical treatment. Unfortunately, there is no particular medicine to treat parvovirus B19. But the following medications can help relieve symptoms:

  • Acetaminophen can relieve flu-like symptoms, joint pain, or swelling.

  • Antihistamines to treat the itching.

How Is Slapped Cheek Syndrome Prevented?

Presently, no medicine or vaccine is available to cure human parvovirus B19 infection.

The best way is to reduce disease risk by following these steps:

  • Washing hands often with soap and water.

  • Covering mouth and nose properly while coughing or sneezing.

  • Not touching the face.

  • Avoiding close contact with infected people.

  • Staying home when sick.

  • Not sharing personal articles or food items.

What Is the Prognosis or Outlook Of Slapped Cheek Syndrome?

People who get infected once are unlikely to get an infection again as they become immune to it. Healthy children and adults usually recover naturally from the virus without any complications.

Conclusion

Although slapped cheek syndrome can look intimidating with its characteristic red rash, it is easily treatable. The main problem lies in its spread. The infection spreads quickly through respiratory droplets when someone infected with this virus sneezes or coughs. Therefore, if any family member has symptoms of this condition, isolate him or see a health care provider.

Dr. Dhepe Snehal Madhav
Dr. Dhepe Snehal Madhav

Venereology

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