How to Diagnose Fifth Disease Vs. Hand, Foot and Mouth Disease

Fact Checked

isick, ill, little girl image by Natalja from

Fifth disease, or erythema infectiosum, and hand, foot and mouth disease (HFMD) are both common childhood viral infections spread by direct contact. Fifth disease, caused by human Parvovirus B19, is usually dismissed as a cold until a red rash that looks as though the child has been slapped appears on the cheeks. HFMD is primarily associated with coxsackievirus A16 and is characterized by similar mild symptoms plus small blisters in the mouth and on the extremities. According to, both viruses are best prevented by regular hand washing and using a diluted bleach solution to sanitize common areas in homes, schools and daycares.

Fifth Disease

Find out how fifth disease is spread and who might contract the virus. Direct contact, such as sharing cups or exposure to nasal droplets, passes this mild illness from person to person, but cold-like symptoms might not appear for up to three weeks. Fifth disease targets children, but adults can get it, too.

Educate yourself about the outward signs of fifth disease. In addition to the slapped-cheek rash, you also will see a pink, lacy rash resembling a tablecloth pattern on the torso and limbs; both might last up to 10 days. When the rashes appear, the child is no longer contagious and can return to school or daycare.

Manage fifth disease by trying to prevent it and then allowing it to run its course if your child contracts it. The rash might be itchy, and your child might run a low fever, have a sore throat and feel general malaise. Alleviate symptoms with acetaminophen, ibuprofen and antihistamines.

Hand, Foot and Mouth Disease

isick, ill, little girl image by Natalja from

Find out how HFMD is spread and who can contract the virus. HFMD mostly affects children who are 10 and younger, but adults and older children are susceptible to it as well. Your child is most contagious during the first week of the illness but can spread the virus — after symptoms resolve — for several weeks by direct contact with respiratory secretions or infected stool.

isick, ill, little girl image by Natalja from

Educate yourself about the signs and symptoms of HFMD. This disease presents in a similar manner to fifth disease with vague symptoms of a cold, but the incubation time is shorter with symptoms beginning within five days of exposure. Your child likely will have a sore throat and fever. Uncomfortable sores in the mouth that appear a few days after the fever starts will help you or your physician diagnose HFMD. A non-itchy rash and blisters will develop on the toes, feet, fingers, hands and sometimes the buttocks.

isick, ill, little girl image by Natalja from

Manage HFMD by trying to prevent it with good hygiene and then allowing it to run its course, usually within seven days. Focus on soothing foods and beverages such as ice pops and milkshakes to stay hydrated and minimize discomfort from mouth blisters. Use over-the-counter pain relievers as needed.


Each of these contagious diseases can be spread by people who show no symptoms, so teaching and using good hygiene is the best defense.

You can have hand, foot and mouth disease more than once because it is caused by more than one virus. HFMD is most common in the summer and fall, but it affects people living in warm climates year-round. Hand, foot and mouth disease is not the same as animal foot-and-mouth disease.

Fifth disease (Parvovirus B19) is not caused by the animal Parvovirus.


Fifth disease can be more risky for pregnant women, those who have sickle cell disease and similar types of chronic anemia or compromised immune systems. About 50 percent of adults are immune to fifth disease, but in rare cases exposure can cause miscarriage during early pregnancy.

If your child is chronically anemic, the characteristic fifth disease rash might not appear, so call your doctor if your child is constantly feverish, pale, weak or tired.

Rare complications do exist for HFMD, including viral meningitis and encephalitis. Meningitis can require hospitalization; encephalitis, which is a type of brain inflammation, can be fatal.