Symptoms of Slapped cheek syndrome

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In 20-30% of cases of Parvovirus B19 infection, there are no symptoms at all; and in children the symptoms often go unnoticed. The incubation period appears to be between 13 and 18 days.

The following symptoms may occur:

low-grade mild fever and flu-like symptoms,
headache,
stuffy or runny nose,
sore throat,
lethargy,
in a few children there may be nausea, abdominal pain, diarrhoea,
adults sometimes develop aches and pains in the joints,
and in rare cases brain (neurological) or heart / circulation (cardiovascular) problems have been reported in adults.

Several days later, a distinctive red, lacy-like rash, may begin on the face and gives the appearance of â€˜slapped cheeksâ€™. This may also itch, and may spread to the body and limbs, sometimes affecting the palms of the hands and soles of the feet. The rash may take one to three weeks to clear during which it may periodically fade or worsen. It may also recur some time later following exposure to sunlight or heat.

People with existing conditions, which lower their immune system, e.g. leukaemia, those who have had an organ transplant, or those who have HIV may develop a serious, chronic kind of anaemia due to parvovirus infection. Also infection can produce severe anaemia and an aplastic crisis in people with sickle-cell anaemia or other abnormalities of haemoglobin.

During the first 20 weeks of pregnancy the virus can cause miscarriage. Also during this time, the virus can also cause a rare condition known as foetal hydrops, which can cause congestive heart failure, a severe form of oedema (swelling of body tissues due to excessive fluid) due to severe anaemia.

Physical symptoms are not present during the contagious stages of the virus. People infected with Parvovirus B19 can pass it on without knowing during the early part of the illness, but when the rash appears you or your child are no longer contagious.