There is a period of 7 before the onset of the rash. The classical rash of Fifth disease occurs in 3 stages. The second stage appears 1 to 4 days afterwards with the appearance of a erythematous maculopapular rash on the trunk and limbs. The third stage of the rash is highly variable in duration, lasting from 1 to 3 weeks, and is characterized by marked changes in the intensity of the rash with periodic complete evanescence and recrudescence. The rash is often pruritic, and is more prominent on the extensor surfaces.
Subclinical infection can occur especially in children.
Reinfection has been documented. There is wide variation in the form of the rash, in many cases the rash is indistinguishable from rubella. The most common complication is joint involvement. Symptoms commence 1 to 6 days after the onset of the rash but may also occur in the absence of the rash. In children, both sexes are equally affected and symptoms seem to be more severe than adults and of longer duration.