Roseola
Roseola, also known as roseola infantum or sixth disease, is a common viral illness primarily affecting young children, typically under the age of four. It is caused by the human herpesvirus 6, which most children are exposed to by their early years. The disease begins with a high fever, which can reach up to 106°F and last for two to five days, often accompanied by symptoms like swollen lymph nodes, lethargy, and a lack of appetite. Febrile seizures may occur in some cases due to the rapid rise in temperature. Following the fever, a red or pink rash typically appears on the body, lasting from a few hours up to three days.
While treatment focuses on alleviating symptoms—such as giving acetaminophen or ibuprofen, ensuring adequate hydration, and maintaining comfort—most patients recover without complications. Rarely, roseola can lead to more serious conditions like encephalitis or aseptic meningitis. The illness has been recognized since the mid-nineteenth century, with a better understanding of its viral cause emerging in the late 20th century, revealing two primary strains of the virus responsible for the disease.
Roseola
ALSO KNOWN AS: Roseola infantum, exanthem subitum, sixth disease
ANATOMY OR SYSTEM AFFECTED: Abdomen, arms, brain, immune system, legs, skin
DEFINITION: A disease characterized by a mild fever and a rash that mostly affects young children
CAUSES: Herpesvirus infection
SYMPTOMS: Red or pink rash, high fever, swollen lymph nodes, lethargy, lack of appetite, diarrhea, sometimes febrile seizures
DURATION: A few weeks
TREATMENTS: Alleviation of symptoms; may include baths, acetaminophen and ibuprofen, adequate fluid intake, isolation during fever stage
Causes and Symptoms
Roseola is caused by the human herpesvirus 6, to which most children have been exposed by age four. Immunity passed from mother to usually protects infants from contracting roseola before they are six months old. Although the precise period of time during which patients are contagious is unknown, health professionals have determined that the virus incubates for as many as ten days after exposure. Patients usually are contagious only during the fever phase of roseola.
A child with roseola develops a fever that can reach 106 degrees Fahrenheit and persist for two to five days. The lymph glands in the throat may become swollen, and upper respiratory congestion may occur. Some children appear agitated, while others do not behave in an ill manner and continue normal activities. Lethargy, lack of appetite, and may accompany the fever. The fever occasionally causes febrile seizures as the reacts to sudden and extreme temperature changes. Approximately 5 to 15 percent of roseola patients experience these convulsions, which last several minutes and usually are not harmful.
When the fever ceases, a red or pink rash appears on most patients’ bodies and remains for several hours to three days. When pressed, the blanches. It does not blister, cause pain, or itch. Occasionally, a roseola patient is feverish and never develops a rash or has a rash without a preceding fever. A rash may appear prematurely during the fever phase or be delayed until after the fever has subsided. Some children infected with roseola never display any symptoms. Rarely, roseola can precede and aseptic meningitis.
Treatment and Therapy
Treatment for roseola consists of methods to soothe symptoms. Pediatricians recommend baths and the use of acetaminophen and ibuprofen, if the child is old enough, to lower the fever. Health professionals also advise patients to drink fluids to prevent dehydration. The patient should be isolated until the fever is gone.
A child who has convulsions should be examined by medical professionals immediately. Patients with dark purple rashes should also be seen by physicians, as should children whose rashes do not blanch when touched or remain more than several days. Blisters and itchy or painful rashes also demand professional attention. Children with roseola who seem unusually sick should also be taken for examination, as should children with prolonged fevers that do not improve with medication and baths.
Most patients recover fully. Although the resulting antibodies are present in most adults, roseola can be reactivated if the is weakened.
Perspective and Prospects
Roseola has been referred to in medical literature since the mid-nineteenth century. Early twentieth century investigators unsuccessfully attempted to identify the disease’s pathogen. By 1988, medical professionals determined that the herpevirus 6 causes roseola. Two strains, A and B, have been identified, with B causing most roseola cases in children. The herpesvirus 7 has been linked to cases occurring in older patients.
Bibliography
Gershon, Anne A., Samuel L. Katz, and Peter J. Hotez, eds. Krugman’s Infectious Diseases of Children. 11th ed. Philadelphia: Mosby, 2004.
Grossman, Leigh B., ed. Infection Control in the Child Care Center and Preschool. 8th ed. Charlottesville, Va.: Silverchair Science, 2012.
Hoekelman, Robert A., ed. Primary Pediatric Care. 4th ed. St. Louis, Mo.: Mosby, 2001.
Parker, James N., and Phillip M. Parker. Roseola: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References. San Diego, Calif.: Icon Health, 2004.
Pippin, Micah and Gloria Laws. "A Classic Presentation of Roseola Infantum." Cureus, 18 Jan. 2024, DOI: 10.7759/cureus.52504 . Accessed 8 Apr. 2024.
"Roseola." Cleveland Clinic, 12 Apr. 2023, my.clevelandclinic.org/health/diseases/12174-rosacea. Accessed 8 Apr. 2024.
"Roseola." Health Library, November 26, 2012.
"Roseola." MedlinePlus, August 2, 2011.