Roseola

Overview

Roseola, a common infection primarily affecting children under the age of 2, is caused by a virus transmitted through person-to-person. Roseola can be spread through saliva or respiratory droplets, typically from individuals who are asymptomatic. It typically begins with a high fever, followed by a rash that is painless and non-itchy. About a quarter of those affected by roseola develop this rash.

Often referred to as sixth disease, roseola is usually mild and resolves on its own within a week. Treatment involves using cool cloths and fever-reducing medications.

Roseola is also known as roseola infantum, baby measles, three-day fever, or exanthem subitum.

Symptoms

If a child is exposed to someone with roseola and contracts the virus, it typically takes 1 to 2 weeks for signs and symptoms of the infection to manifest, although they may not appear at all. It is possible to acquire the roseola virus without exhibiting any signs of infection.

Common symptoms of roseola may include:

• Fever. Roseola typically begins with a sudden onset of high fever, often exceeding 103°F (39.4°C), which persists for 3 to 5 days. Some children may also experience accompanying symptoms such as a sore throat, runny nose, or cough before or along with the fever. Swollen lymph nodes in the neck may also develop during this time.
• Rash. Following the resolution of the fever, a rash commonly emerges. The roseola rash typically consists of numerous small spots or patches, which are typically flat in appearance. Initially, the rash tends to appear on the chest, back, and abdomen, subsequently spreading to the neck and arms. In some cases, it may extend to the legs and face. Notably, the rash is unlikely to cause itching or pain and can persist for hours to days. Additionally, the rash may occur independently of the preceding fever.

Additional signs and symptoms of roseola may encompass:

• Mild diarrhea
• Swollen eyelids
• Poor appetite
• Irritability

Look for immediate medical attention if:

If your child’s fever becomes high or rises rapidly, they may experience a convulsion, known as a febrile seizure. In the event of an unexplained seizure, immediate medical attention should be sought.

Speak with your child’s doctor if:

• Your child’s temperature is over 103 degrees Fahrenheit (39.4 degrees Celsius)
• The rash doesn’t get better in three days and the fever comes again

If anyone in your household has a compromised immune system and comes into contact with someone with roseola, it’s important to inform your doctor. Individuals with compromised immune systems may need to be monitored more closely for potential infections, which could pose a greater risk compared to those with a healthy immune system.

Causes

Roseola is primarily caused by human herpes virus 6, and occasionally by human herpes virus 7. It spreads through contact with an infected individual’s saliva, such as sharing utensils, or through airborne transmission, such as when an infected person coughs or sneezes. Symptoms typically manifest around 9 to 10 days after exposure to the virus.

Once the fever has been absent for 24 hours, roseola is no longer contagious. Unlike viral diseases like chickenpox, roseola rarely results in widespread outbreaks within communities. The infection is most common during the spring and fall seasons.

Risk factors

Older infants, particularly those between 6 and 15 months old, face the highest risk of contracting roseola. This susceptibility arises from their limited development of antibodies against various viruses. While newborns initially benefit from antibodies passed on by their mothers during pregnancy, this immunity diminishes over time.