What to Know About Parvovirus: Symptoms, Treatments, and Who’s at Risk

A seasonal respiratory virus known as parvovirus B19 is on the rise, according to a new health warning from the Centers for Disease Control and Prevention. Parvovirus is sometimes called fifth disease or slapped cheek syndrome because of the hallmark symptom of a red facial rash. Data from the alert show an uptick across all age groups, with the largest among children ages 5 to 9.

“The increase in cases could be related to a multitude of factors,” says Dr. Karen Acker, pediatric infectious diseases specialist and hospital epidemiologist at NewYork-Presbyterian Komansky Children’s Hospital and assistant professor of clinical pediatrics at Weill Cornell Medicine. “During COVID, children were also not exposed to parvovirus for a year or two. When you take away the baseline immunity, there’s a large population that’s more susceptible.”

Parvovirus is highly contagious and common. About 50% of adults have antibodies by age 20 and 70% by 40, according to the CDC alert. Symptoms are typically mild in children and healthy adults, but pregnant women and people who are immunocompromised are at higher risk.

“Generally, kids do fine, and the majority of the population will be exposed to it at some point during their life,” says Dr. Acker. “But people who are vulnerable should be extra careful to protect themselves.”

Health Matters asked Dr. Acker about parvovirus, how it spreads, and ways to protect yourself.

What are the symptoms of parvovirus?
The first signs are fever, joint pain, and sometimes a sore throat. After a few days of feeling unwell, you break out into a viral rash. The classic parvovirus rash is the “slapped cheek rash,” which is round and on the cheek. The rash can just be on the cheeks or it can spread to the entire body, all the way down to the legs. It varies in its appearance — it can be red, flat dots; raised dots; or lacy.

Is the rash painful?
The rash may look scary, but for the most part, it’s quite benign and painless. Some kids may have a little itchiness, but it’s not a main component of the parvovirus rash. It’s not like hives.

How long does parvovirus last?
The actual illness lasts about a week or less. The rash, however, can come and go for a while. You can be feeling better, and the rash goes away, and then it pops up again weeks to months after the initial infection because of sun exposure or temperature changes.

When are you most contagious?
Parvovirus spreads through respiratory droplets or during pregnancy from mother to fetus. You are most contagious when you have a fever. Once you get the rash, the virus is usually no longer transmissible. As kids go back to school, it’s important to follow school guidelines about them needing to be fever-free for a full 24 hours before returning to the classroom.

How do you treat it?
The treatment is similar to other viruses. Over-the-counter fever reducers, such as acetaminophen (Tylenol) and ibuprofen (Advil, Motrin), can reduce a child’s temperature and make them more comfortable. If the rash is itchy, you can apply hydrocortisone cream.

Who is at high risk?
In rare cases, parvovirus can cause serious health complications including myocarditis, hepatitis or encephalitis. If you are pregnant, it’s important to tell your obstetrician if you’ve been exposed to parvovirus and get tested. People who are immunocompromised — whether from getting chemotherapy or on medication to suppress their immune system — and those with certain types of anemia, especially sickle cell disease, can also be at increased risk for more severe outcomes.

How can you protect yourself?
Go back to the basics. Practice good hand hygiene and keep clean air circulating. Also, you can wear a mask if you’re out in public and concerned about being exposed. Know that we are surrounded by various infections, and it can be scary, but we also have very robust immune systems. Just do the best you can to protect yourself.