Roseola

Definition

Roseola is a common disease of babies or young children, in which several days of very high fever are followed by a characteristic rash.

Demographics

Roseola is an extraordinarily common infection, caused by a virus. About 90 percent of all children have been exposed to the virus, with about 33 percent actually demonstrating the syndrome of fever followed by rash.

The most common age for a child to contract roseola is between six and twelve months. Roseola infection strikes boys and girls equally. The infection may occur at any time of year, although late spring and early summer seem to be peak times for it.

Causes and symptoms

About 85 percent of the time, roseola is caused by a virus called human herpesvirus 6 (HHV-6). Although the virus is related to those herpesviruses known to cause sores on the lips or genitalia, HHV-6 causes a very different type of infection. HHV-6 is believed to be passed between people via infected saliva. A few other viruses (called enteroviruses) can produce a similar fever-then-rash illness, which is usually also called roseola.

Researchers believe that it takes about five to 15 days to develop illness after having been infected by HHV-6. Roseola strikes suddenly, when a previously well child spikes an impressively high fever. The temperature may reach 106°F (41°C) . As is always the case with sudden fever spikes, the extreme change in temperature may cause certain children to have seizures. About 5 to 35 percent of all children with roseola have febrile seizures .

The most notable thing about this early phase of roseola is the absence of symptoms, other than the high fever. Although some children have a slightly reddened throat or a slightly runny nose, most children have no symptoms whatsoever, other than the sudden development of high fever. This fever lasts for between three and five days.

Somewhere around the fifth day, a rash begins on the body. The rash is usually composed of flat pink patches or spots, although there may be some raised patches as well. The rash usually starts on the chest, back, and abdomen then spreads out to the arms and neck. It may or may not reach the legs and face. The rash lasts for about three days then fades.

Very rarely, roseola causes more serious disease. Patients so afflicted experience significant swelling of the lymph nodes, the liver, and the spleen. The liver may become sufficiently inflamed to interfere with its functioning, resulting in a yellowish color to the whites of the eyes and the skin (jaundice ). This syndrome (called a mononucleosis-like syndrome, after the disease mononucleosis that causes many of the same symptoms) has occurred in both infants and adults.

Diagnosis

The diagnosis of roseola is often made by carefully examining the feverish child to make sure that other illnesses are not causing the temperature spike. Once it is clear that no pneumonia , ear infection, strep throat , or other common childhood illness is present, the practitioner usually feels comfortable waiting to see if the characteristic rash of roseola begins.

Treatment

As of 2004, there were no treatments available to stop the course of roseola. Acetaminophen or ibuprofen is usually given to try to lower the fever. Children who are susceptible to seizures may be given a sedative medication when the fever first spikes in an attempt to prevent such a seizure.

Prognosis

Children recover quickly and completely from roseola. The only complications are those associated with seizures or the rare mononucleosis-like syndrome.

KEY TERMS

Jaundice —A condition in which the skin and whites of the eyes take on a yellowish color due to an increase of bilirubin (a compound produced by the liver) in the blood. Also called icterus.

Mononucleosis —An infection, caused by the Epstein-Barr virus, that causes swelling of lymph nodes, spleen, and liver, usually accompanied by extremely sore throat, fever, headache, and intense long-lasting fatigue. Also called infectious mononucleosis.

Prevention

Other than the usual good hygiene practices always recommended to decrease the spread of viral illness, no methods as of 2004 are available to specifically prevent roseola.

Parental concerns

Roseola is usually a benign illness, from which the child recovers uneventfully. One of the more major potential complications is the development of febrile seizures secondary to the rapid, high rise in fever. Rare cases of encephalitis or meningoencephalitis have also been reported.

Resources

BOOKS

Hall, Caroline Breese. "Human Herpesviruses 6 and 7 (Roseola, Exanthem Subitum)." In Principles and Practice of Pediatric Infectious Diseases, 2nd ed. Edited by Sarah S. Long et al. St. Louis, MO: Elsevier, 2003.

Leach, Charles T. "Roseola (Human Herpesviruses 6 and 7)." In Nelson Textbook of Pediatrics. Edited by Richard E. Behrman et al. Philadelphia: Saunders, 2004.

Rosalyn Carson-DeWitt, MD

Roseola

Definition

Roseola is a common disease of babies or young children, in which several days of very high fever are followed by a rash.

Description

Roseola is an extraordinarily common infection, caused by a virus. About 90% of all children have been exposed to the virus, with about 33% actually demonstrating the syndrome of fever followed by rash.

The most common age for a child to contract roseola is between six and twelve months. Roseola infection strikes boys and girls equally. The infection may occur at any time of year, although late spring and early summer seem to be peak times for it.

Causes and symptoms

About 85% of the time, roseola is caused by a virus called Human Herpesvirus 6, or HHV-6. Although the virus is related to those herpesviruses known to cause sores on the lips or genitalia, HHV-6 causes a very different type of infection. HHV-6 is believed to be passed between people via infected saliva. A few other viruses (called enteroviruses) can produce a similar fever-then-rash illness, which is usually also called roseola.

Researchers believe that it takes about 5-15 days to develop illness after having been infected by HHV-6. Roseola strikes suddenly, when a previously-well child spikes an impressively high fever. The temperature may reach 106°F. As is always the case with sudden fever spikes, the extreme change in temperature may cause certain children to have seizures. About 5-35% of all children with roseola will have these "febrile seizures."

The most notable thing about this early phase of roseola is the absence of symptoms, other than the high fever. Although some children have a slightly reddened throat, or a slightly runny nose, most children have no symptoms whatsoever, other than the sudden development of high fever. This fever lasts for between three and five days.

Somewhere around the fifth day, a rash begins on the body. The rash is usually composed of flat pink patches or spots, although there may be some raised patches as well. The rash usually starts on the chest, back, and abdomen, and then spreads out to the arms and neck. It may or may not reach the legs and face. The rash lasts for about three days, then fades.

Very rarely, roseola will cause more serious disease. Patients so afflicted will experience significant swelling of the lymph nodes, the liver, and the spleen. The liver may become sufficiently inflamed to interfere with its functioning, resulting in a yellowish color to the whites of the eyes and the skin (jaundice ). This syndrome (called a mononucleosis-like syndrome, after the disease called mononucleosis that causes many of the same symptoms) has occurred in both infants and adults.

Diagnosis

The diagnosis of roseola is often made by carefully examining the feverish child to make sure that other illnesses are not causing the temperature spike. Once it is clear that no pneumonia, ear infection, strep throat, or other common childhood illness is present, the practitioner usually feels comfortable waiting to see if the characteristic rash of roseola begins.

Treatment

There are no treatments available to stop the course of roseola. Acetaminophen or ibuprofen is usually given to try to lower the fever. Children who are susceptible to seizures may be given a sedative medication when the fever first spikes, in an attempt to prevent such a seizure.

Prognosis

Children recover quickly and completely from roseola. The only complications are those associated with seizures, or the rare mononucleosis-like syndrome.

Prevention

Other than the usual good hygiene practices always recommended to decrease the spread of viral illness, no methods are available to specifically prevent roseola.

KEY TERMS

Jaundice— The development of a yellowish tone to the skin and the whites of the eyes, caused by poor liver function.

Mononuclosis— An infection which causes swelling of lymph nodes, spleen, and liver, usually accompanied by extremely sore throat, fever, headache, and intense long-lasting fatigue.

Resources

BOOKS

Kohl, Steve. "Human Herpesvirus 6." In Nelson Textbook of Pediatrics, edited by Richard E. Behrman. Philadelphia: W. B. Saunders Co., 1996.

Roseola Infantum

What Is Roseola Infantum?

How Common Is It?

Is Roseola Infantum Contagious?

What Are the Signs and Symptoms?

How Is Roseola Infantum Diagnosed?

How Is the Infection Treated?

Are There Complications?

Can Roseola Infantum Be Prevented?

Resource

Roseola infantum (ro-see-O-luh in-FAN-tum) is a viral infection seen in young children that produces a rash and high fever.

KEYWORDS

for searching the Internet and other reference sources

Exanthem subitum

Human herpesvirus type 6

Human herpesvirus type 7

What Is Roseola Infantum?

Also known as exanthem subitum (eg-ZAN-thum SU-bih-tum), roseola infantum is an acute* viral infection that mainly affects children between the ages of 6 months and 3 years and is characterized by high fever followed by a rash. The disease stems from infection with human herpesvirus (her-peez-VY-rus) type 6 (HHV 6) or human herpesvirus type 7 (HHV 7). Both of these are part of the same family of viruses as varicella zoster (var-uh-SEH-luh ZOS-ter), which causes chicken pox; Epstein-Barr (EP-steen BAR) virus, which causes mononucleosis*; cytomegalovirus*; and herpes simplex* virus.

*acute

describes an infection or other illness that comes on suddenly and usually does not last very long.

*mononucleosis

(mah-no-nu-klee-O-sis) is an infectious illness caused by a virus that often leads to fever, sore throat, swollen glands, and tiredness.

*cytomegalovirus

(sye-tuh-meh-guh-lo-VY-rus), or CMV, infection is very common and usually causes no symptoms. It poses little risk for healthy people, but it can lead to serious illness in people with weak immune systems.

*herpes simplex

(HER-peez SIM-plex) is a virus that can cause infections of the skin, mouth, genitals, and other parts of the body.

How Common Is It?

HHV 6 and HHV 7 affect almost all children who are between 6 months and 3 years of age, but not all of these infections produce the illness recognized as roseola infantum. Roseola rarely is seen in children more than 4 years old, and the illness appears most often during the spring and fall.

Is Roseola Infantum Contagious?

Roseola spreads from person to person, most likely through tiny drops of fluid expelled from the mouth and nose of an infected child when he or she laughs, coughs, sneezes, or talks.

What Are the Signs and Symptoms?

Symptoms of roseola infantum usually appear between 5 and 15 days after exposure to the virus. Children may first have a mild respiratory tract* illness, followed by a high fever that can reach 105 degrees Fahrenheit and last from 2 to 5 days. When the fever subsides, a rash appears, starting on the trunk of the body and spreading to the limbs, face, and neck. The rash of raised red and pink splotches, which fade to white when pressed, lasts from 1 to 3 days. Additional symptoms of the infection can include tiredness, swollen eyelids, a runny nose, swollen lymph nodes* in the neck, and irritability. In up to 10 percent of children, the high fever associated with roseola infantum causes febrile seizures*.

*respiratory tract

includes the nose, mouth, throat, and lungs. It is the pathway through which air and gases are transported down into the lungs and back out of the body.

*lymph

(LIMF) nodes are small, bean-shaped masses of tissue that contain immune system cells that fight harmful microorganisms. Lymph nodes may swell during infections.

*seizures

(SEE-zhurs) are sudden bursts of disorganized electrical activity that interrupt the normal functioning of the brain, often leading to uncontrolled movements in the body and sometimes a temporary change in consciousness. A febrile seizure is a type of seizure, seen in infants and young children, that is triggered by fever.

How Is Roseola Infantum Diagnosed?

To diagnose roseola, doctors look for physical symptoms and signs such as rash and swollen lymph nodes, particularly those in the back of the scalp. A medical history may show that the child has been exposed to others with the disease at home or in a child care setting. Because the rash appears after the fever, roseola often is diagnosed after the child has begun to recover from the illness.

How Is the Infection Treated?

Most cases of roseola infantum respond well to treatment at home. Acetaminophen* can help lower a fever, and drinking lots of clear fluids can prevent dehydration*. Children usually feel ill only while they still have a fever and probably will be less active during that time. By the time the rash appears, a child’s behavior may be almost back to normal.

*acetaminophen

(uh-see-teh-MIH-noh-fen) is a medication commonly used to reduce fever and relieve pain.

*dehydration

(dee-hi-DRAY-shun) is a condition in which the body is depleted of water, usually caused by excessive and unre-placed loss of body fluids, such as through sweating, vomiting, or diarrhea.

Are There Complications?

Most cases of infection resolve in 4 to 6 days without additional problems. Seizures are the most common complication, but this does not mean that the child will have an increased risk of a long-term seizure problem. In rare cases, the disease may lead to the development of meningitis (meh-nin-JY-tis, which is inflammation of the membranes covering the brain and spinal cord) or encephalitis (en-seh-fuh-LYE-tis, which is inflammation of the brain).

Can Roseola Infantum Be Prevented?

There is no simple way for children to avoid exposure to HHV6 and HHV7 completely. Young children have lots of close contact with each other. Adults rarely contract this illness, possibly indicating that having roseola as a child provides lifelong immunity* to the viruses. Some children do experience a second bout of the disease, but this occurs infrequently. Like other viruses in this family, HHV6 and HHV7 can reactivate after the first infection and cause illness, but this happens primarily in people who have a weakened immune system.

*immunity

(ih-MYOON-uh-tee) is the condition of being protected against an infectious disease. Immunity often develops after a germ is introduced to the body. One type of immunity occurs when the body makes special protein molecules called antibodies to fight the disease-causing germ. The next time that germ enters the body, the antibodies quickly attack it, usually preventing the germ from causing disease.

See also

Cytomegalovirus (CMV) Infection

Encephalitis

Herpes Simplex Virus Infections

Meningitis

Mononucleosis, Infectious

Varicella (Chicken Pox) and Herpes Zoster (Shingles)

Resource

Website

KidsHealth.org. KidsHealth is a website created by the medical experts of the Nemours Foundation and is devoted to issues of children’s health. It contains articles on a variety of health topics, including roseola infantum.

http://www.KidsHealth.org

ro·se·o·la / ˌrōzēˈōlə; rōˈzēələ/ • n. Med. a rose-colored rash occurring in measles, typhoid fever, syphilis, and some other diseases. ∎  (in full roseola infantum / inˈfantəm/ ) a disease of young children in which a fever is followed by a rash, caused by a herpesvirus.

roseola (roseola infantum, exanthem subitum) (roh-zee-ŏ-lă) n. a condition of young children in which a fever lasting for three or four days is followed by a rose-coloured rash that fades after two days. It is caused by human herpesvirus 6.