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Rosy cheeks usually are a sign of good health, but if your child suddenly develops bright-red patches on her cheeks that also are raised and warm, she may have a viral illness known as fifth disease (erythema infectiosum). Like so many other childhood illnesses, this one is spread from person to person. The specific virus causing this disease has been identified as a parvovirus. Once the virus is in your child's body, it may take from four days to 14 days for symptoms to appear.

This is a mild disease, and most children feel well even when the rash is present. However, there can be mild coldlike symptoms: sore throat, headache, pink eyes, fatigue, a mild fever or itching. In rare cases, there may be aches in the knees or wrists. The disease process may be more severe in children with abnormalities of their hemoglobin or red blood cells, such as sickle-cell anemia, and in children with cancer.

The rash usually begins on the cheeks, causing them to look as if they've been slapped. During the next few days, the arms, and then the trunk, thighs, and buttocks will develop a pink, slightly raised rash that has a lacelike pattern. Fever is usually absent or mild. After five days to ten days the rash will fade, with the face clearing first, followed by the arms and then the trunk and legs. Interestingly, the rash may reappear briefly weeks or months later, particularly if your child becomes hot from bathing, exercise or sunlight, or spends time in the sun. Adults who get this disease may have only transient stiffness and/or swelling in the joints, with no fever or rash present.

Treatment of Fifth Disease

While fifth disease is not serious in most children, it may be confused with a rash that is. It also may mimic certain drug-related rashes, so it's important to inform your pediatrician about any medications your child may be taking. When you describe the symptoms over the phone, the doctor may suspect fifth disease, but he may still want to examine your child to be certain.

There is no specific treatment for fifth disease, but symptomatic relief is possible. For instance, if there's a fever over 102 degrees Fahrenheit (38.9 degrees Celsius), which is very rare with fifth disease, or minor aches and pains, you can use acetaminophen. When cold symptoms are interfering with sleeping or eating, check with your pediatrician about using a decongestant. Itching can be relieved by using an antihistamine. Also, if your child exhibits new symptoms, feels sicker or develops a high fever, call your pediatrician again.

Fifth disease is spread while the child is suffering the coldlike symptoms that precede the rash. By the time your child has a rash, she is no longer contagious. Nevertheless, as a rule, whenever your child has a rash or a fever, she should be kept away from other children until the illness is identified by your doctor. As a precaution, you should wait until she no longer has a fever and is feeling normal before allowing her to play with other children. Your youngster also should be kept away from pregnant women (particularly in their first trimester) until the rash fades, as the virus that causes this disease in rare cases may have a damaging effect on the fetus if the mother becomes infected.