Definition

A mild infectious condition called roseola infantum frequently affects infants and young toddlers and is found worldwide. Roseola infantum was formerly known as baby measles. It typically affects children between the ages of 6 months and 3 years old. Fever in infants is attributed to this condition in 10–45% of cases. Radicella infantum infection has been reported in roughly 95% of children at the age of two.

Exanthem subitum, or sixth illness, is another term for roseola infantum.

Causes

Human herpesvirus 6 (HHV-6) variant B, and less frequently HHV-7, are the viruses of the herpes virus group that cause roseola infantum. It is a DNA virus. Despite going by the name herpesvirus, the virus that causes oral herpes is unrelated to the one that causes roseola infantum.

Roseola is a contagious illness, indicating that individuals can contract it from one another. Saliva contains the HHV-6 because the virus replicates mostly in the salivary glands. When an infected child talks, coughs, or sneezes, droplets from their respiratory tracts are released, and other children around could inhale the droplets, which makes the infection spread. Children with roseola infantum can only spread the infection before symptoms appear, making it difficult to prevent the spread to other people. Even though the rashes persist, the infected child will no longer spread the virus once their body temperature stabilizes for 24 hours.

Risk factor

Roseola infantum can affect anyone, yet it typically affects children between six months and three years. Approximately 90% of all cases involve younger children than two years old. According to research, roseola infantum is more common in girls than boys.

Since many adults were vaccinated against this disease as children, they are typically immune to it. Following exposure to roseola, the immune system develops a defense mechanism against the virus. This explains why the majority of people will not get infected twice.

Symptoms

Because most roseola symptoms are mild, parents frequently are unaware that their children are infected with the virus. Mild rashes may go undetected.

The child will experience symptoms 10 to 15 days following infection. The initial symptom is a sudden high fever (typically above 39.5 degrees Celsius). The typical duration of this fever is three to seven days. Even with a high temperature, kids normally still stay awake and active. The fever normally subsides on the fourth day. Red rashes normally emerge after the fever goes down or when the body temperature drops. The rashes do not cause pain or itchiness. Rarely does the rash form on the face; the lesions usually start on the body, most commonly the stomach and chest, and then spread to the arms, legs, back, and neck. If the rashes are pressed, they will become pale or fade. The rash usually lasts for one or two days, but it may go away in a few hours. Some kids don't experience skin rashes—just a high fever.

Children with roseola may also have flu-like symptoms in addition to fever and rash, such as:

• Runny nose
• Light cough
• Sore throat
• Enlarged lymph nodes in the back of the head, behind the ears, or in the neck
• Diarrhea or stomach ache
• Seizures. Although uncommon, this infection may result in febrile seizures, which are seizures brought on by a quick, dramatic rise in body temperature combined with the virus' ability to pass through the membrane separating the blood from the brain. While concerning, this is typically not a major issue.

Diagnosis

Roseola infantum is a diagnosis that doctors might make based on the child's symptoms. Children between the ages of six months and three years who exhibit the classic symptoms of roseola infantum—a rash that develops after the fever goes down—will have their presence of roseola infantum considered. Rarely are additional tests needed unless they are required to confirm a diagnosis or rule out other illnesses. Tests can be performed, including standard blood tests, viral cultures, or blood tests to look for HHV virus antibodies. Although rarely performed, molecular assays like quantitative polymerase chain reaction (PCR) can be conducted.

Management

Roseola typically lasts four days to a week, and medical professionals are rarely needed for therapy; instead, home treatment is enough and just needed to address the symptoms. At-home treatments include the following:

• If the child appears irritable or uncomfortable with a fever, antipyretics such as ibuprofen, paracetamol, or acetaminophen could be given.
• Ensure your child gets plenty of fluids, such as formula, breast milk, or mineral water. Your child's fluid intake needs to be satisfied when experiencing a fever.
• Since antibiotics are used to treat bacterial infections and roseola infantum is a viral infection, there is no need to administer antibiotics in this case.
• No treatment is necessary for the rash as it does not induce pruritus or discomfort.
• Antiviral medications like foscarnet or ganciclovir may be required in cases of severe illness or in children whose immune systems have been compromised by cancer, autoimmune diseases, or other diseases.

Complications

The majority of kids recover from roseola without experiencing serious health issues. Children who have compromised immune systems are susceptible to complications like:

• Pneumonia
• Infection of the brain
• Myocarditis, or inflammation of the heart muscle
• Reduced platelet counts (thrombocytopenia)
• Inflammation of the liver
• Guillain-Barré Syndrome
• Rhabdomyolysis, or damage to skeletal muscle tissue

Due to a high fever, 10 to 15% of children with roseola develop febrile seizures. The average duration of a febrile seizure is under 15 minutes. These episodes, however, do not indicate epilepsy.

Prevention

The spread of roseola cannot be stopped since it spreads before symptoms. There is no vaccine for roseola. Adopting hygienic and healthy lifestyle practices is the best strategy to stop the virus from spreading. Your risk of infection can be decreased by:

• Avoiding close contact with those who are infected
• cover your mouth and nose with the inside of your elbow or upper arm when you cough or sneeze
• Washing your hands with hand sanitizer or soap and running water frequently

When to see a doctor?

Seek advice from a doctor if your child:

• Is unresponsive (difficult to wake up, extremely tired)
• Urinates less frequently than usual  
• Has a fever that does not go down after 48 hours
• Has experienced a fever (≥38.9 degrees Celsius) lasting more than 24 hours without any other symptoms
• Has experienced a seizure lasting less than five minutes 
• Feels itchy or has an uncomfortable rash
• Feels nauseous, vomits, or has diarrhea
• Shows signs of dehydration, such as weakness and dark urine

You ought to get immediate care if the child:

• Has experienced a seizure lasting longer than five minutes
• Is unconscious after the seizure
• Has breathing difficulties, which may indicate a lung infection
• Has a bright red or purple rashes that does not fade when the rash is pressed, along with a fever, which could indicate a meningococcal infection 

Looking for more information about other diseases? Click here, yes!