Fifths disease (erythema infectiosum) is caused by a virus and is most common between the ages of 2-12. The incubation period is 4-14 days. This illness is associated with a characteristic rash. The child appears to have a classic slapped-cheek. The cheeks are intensely red and hot to touch, but they are not painful. The area around the mouth is usually pale. After 1-4 days a lace-like raised rash appears on the arms and thighs. The rash gradually spreads down the arms and legs and occasionally to the trunk. Mild itching is sometimes a problem. It takes an average of ten days for the rash to completely fade. The rash may reoccur for varying periods of time when exposed to temperature change or sunlight. Mild fever and joint pain may accompany this illness. Since this is a virus and must run its course, there is generally no specific treatment. Consult with you primary care physician for the recommended pain reliever of choice as well as treatment for the itching. Fluids should be encouraged, especially if fever is present. Your child should remain at home for at least 24 hours after the fever has gone. If no fever is present your child may attend school. Respiratory secretions may spread the virus so encourage your child to cover their mouth if coughing or sneezing. Good hand washing is also essential.