A common viral infection that typically affects young children between the ages of 6 months and 2 years is called roseola. It is frequently identified by an intense fever that spikes out of nowhere and is followed by a characteristic rash. Although the condition can be concerning, it usually goes away on its own and is mild.
A fever that seems to appear out of nowhere and lasts for several days may be noticed by parents. A pinkish rash frequently develops on the body after the fever goes down. This typically indicates that the child’s recovery is almost complete.
Roseola can be unsettling, especially when there’s a high fever, but knowing what to look for and how to treat the symptoms can help reduce anxiety. The major goal of treatment is to maintain the child’s comfort while the virus is being treated.
- What is it?
- How it is transmitted?
- Signs
- Can there be complications?
- Age-related features of the disease
- Why is the disease so rarely diagnosed?
- Treatment
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What is it?
Roseola infantum, also known as roseola abruptio, sudden exanthema, pseudorubella, three-day fever and sixth disease are all numerous names for the same independent infectious disease. The disease is caused by a certain virus – herpes virus type 6. Medicine is well acquainted with five viruses of the herpesvirus family, which cause characteristic rashes on the lips (type one), on the genitals (type two), chickenpox (type three), infectious mononucleosis and chronic fatigue syndrome (type four) and cytomegaly (type five). Science does not yet know as much about the sixth, seventh and eighth herpes viruses as it would like, but it has already been established that it is the herpesvirus type six that causes roseola infantum. For the numbering of the pathogen in the system of classification of herpesviruses, the disease is called the “sixth disease”, and for the characteristic clinical signs of Rosool are often called “three -day fever”.
Any individual, regardless of gender, age, race, or nationality, can contract the virus. However, it seems to favor kids, and only those between the ages of six months and two years. Although older children are also affected by this infection, early childhood accounts for up to 95% of all cases of sudden exanthema.
At the age of up to a year, Rosoola has up to 45% of children, after a year, under the age of two years – up to 75% of the peanuts. Up to 80% of children transfer the ailment to 4 years, and in almost every teenager and adult (up to 93% of the population) antibodies to the “sixth” virus are found in the blood at any age throughout life throughout life. Speaking about Rosoola for the nursery, it should not be confused with Rosoola in the dermatological understanding of this term. In the first case, we are talking about a viral infectious disease, in the second – this is only a certain type of skin rashes, which happens with a wide variety of dermatological diseases. There is only one thing in common: a rash on the skin has a certain size – no more than five mm in diameter, it looks like pink spots with a small protrusion above the skin.
Roseola infantum is primarily found in two distinct seasons: spring and autumn. Like chickenpox, you only get sick with it once in your lifetime. A robust, lifelong immunity to the pathogen develops after the illness.
How it is transmitted?
Like all representatives of the herpesvirus family, VG-6, which causes roseola infantum, occurs once and for all. The virus, entering the human body, remains in it for life. While the child"s immunity is strong enough, the virus is dormant, does not indicate its presence in any way, but as soon as the body"s natural defenses weaken due to illness, vitamin deficiency, after surgery, the herpes virus "awakens". VG-6 has its own double-stranded DNA, and the virus"s favorite habitat is the cells of the immune system. It is due to the fact that the virus does not destroy the cell completely, but embeds its own DNA into it, that it exists in symbiosis with the body of its carrier for years and decades. The sixth type of virus has two varieties – BG-6A and BG-6B. The first type prefers to integrate into the cells of the nervous system and usually leads to some autoimmune diseases, although a direct connection has not yet been proven. Roseola infantum is caused by herpes simplex virus type 6B. Recent studies have shown that the causative agent of sudden childhood exanthema can also be the herpes virus type 7. But this only happens in 7% of cases.
The main way that this virus spreads is through airborne droplets. It is also possible to transmit through contact. It is highly contagious, spreads quickly, and is extremely contagious. Researchers believe that adults who carry the herpes simplex virus type 6 throughout their lives can become infected, although the precise mode of infection is still being studied by experts in the field. The infection takes five to fifteen days to incubate. The virus that has infected the child’s nasopharynx and larynx multiplies during this period without causing any symptoms; the child continues to act normally.
The child experiences a sharp and sudden rise in temperature when viral particles start to enter the bloodstream through tiny capillaries. This is the illness’s initial symptom.
Signs
Children"s sudden exanthema develops strictly in certain stages, and this is its main difference from any other viral infection. However, on the first day, when the child, after the end of the incubation period, rises sharply a high temperature (up to 40.0 degrees), there are no differences from SARS. To understand that the baby has Rosoeol, at this stage, a serological blood test or a PCR analysis must be done, which will show a high acute immunity reaction to the virus. Usually, everything is limited to temperature. There is no sore throat, no cough, no cold. The child does not have diarrhea, constipation, bloating and vomiting. Quite rarely blushes the throat, the eyelids slightly swelling. The temperature is difficult to reduce, quickly rises again. The child experiences intoxication against the background of such heat. He becomes lethargic, loses appetite, sleepiness increases, the baby is capricious. And exactly three days later the temperature goes away as suddenly as it appeared. And as soon as the parents breathe a sigh of relief, believing that the disease has receded, the second stage of the disease begins, in which the baby"s body is covered with a roseola-type rash. The rash usually appears within 10-20 hours after the body temperature becomes normal.
The nature of the rash is quite bright – it is small, pinpoint, its individual elements do not merge with each other. Each element is bright, pink, slightly protruding above the skin without purulent, watery or other "heads" on each element. The rash covers the stomach, legs, arms, back of the baby, can be observed on the head, face, neck. It does not peel, does not itch, does not cause any inconvenience to the baby. If you press on the rash with your finger, it brightens for a few seconds, and then becomes bright pink again. In addition to the rash, parents may notice slightly enlarged lymph nodes. They are not inflamed, their palpation does not cause pain to the child. The nodes are hard and dense to the touch.
It is crucial to realize that the child’s fever can spread the herpesvirus type 6 to adults and children who have never had it before, if at all. The child can safely contact anyone when the skin rash appears, indicating that they are not contagious and are in the second stage of the disease.
The skin rash can linger for up to five days. Then, over the course of a week or so, they gradually start to lighten, turn pale, and eventually vanish entirely. There are no marks, pigmentation, or peeling where the rash was. Occasionally, there might be areas that are still brighter than the surrounding skin tone, but these usually go away on their own in a few weeks.
Can there be complications?
In most cases, herpes infection of the sixth and seventh types does not cause any complications in either children or adults. But this is true only for those who have a normal immune status. If a child has been diagnosed with HIV, if there are other congenital or acquired immune and autoimmune diseases, if the child has recently undergone an organ transplant, then complications are likely, but not obligatory. In this case, the likelihood of meningitis and meningoencephalitis increases. In an ordinary healthy child, the only type of complications with roseola can be the consequences of improper care in the first period of infection, that is, with high fever. High fever quickly leads to overheating of the body, to its dehydration. The younger the child, the more dangerous a high fever is for him.
There won’t be any bad effects if you appropriately respond to the child’s temperature, administer antipyretics on time, give them lots of water, check their temperature every three hours, and call an ambulance if the fever becomes severe.
Recent research indicates that preventing febrile seizures is nearly impossible. Therefore, even if they follow all the proper procedures, parents should keep a careful eye on their child during the duration of the first herpes infection period, especially while the child’s temperature is high.
When a young child contracts roseola, a common viral infection, they usually experience a sudden high fever followed by a pink rash. Even though the illness frequently goes away on its own, parents should make sure their child gets enough water and treat symptoms like fever appropriately. It’s also critical to know when to consult a doctor, particularly if symptoms worsen or don’t go better after a few days.
Age-related features of the disease
- a rash with roseola appears strictly after a three-day fever;
- it is not associated with changes in diet, the influence of allergens;
- the rash does not cause discomfort to the child.
Pictures with descriptions will make it easier to tell apart. Compare the two images. First, a rash caused by allergies. It tends to blend in with the surrounding area, swelled locally. Rosa bambina is the second. The rash is not edematous or confluent; it is separate.
Roseola is rare up to six months of age because the infant is shielded by innate maternal immunity, a collection of antibodies the mother gave to the child while it was developing intrauterine. After that, the innate immunity deteriorates, which makes roseola much more common starting at six months of age.
The disease typically progresses more severely in children over the age of three than in infants in terms of the degree of intoxication against the background temperature. Furthermore, the likelihood that the infection will progress atypically increases with the child’s age. When a child reaches the age of seven, the illness can progress nearly asymptomatically, either without a temperature or without a skin rash. In children under the age of three, the temperature can last anywhere from one to two days.
Why is the disease so rarely diagnosed?
It is challenging to locate a child or adult worldwide who has not experienced roseola in childhood, but it is also challenging to locate a child whose medical record includes such a record. Why? Roseola presents a paradox since pediatricians are not trained to recognize sudden exanthema, also known as "sixth disease." This does not imply that during their time at a medical university, they overlooked the pertinent chapter in the textbook. The peculiarities of the disease itself are to blame for the poor diagnosis, as parents seek medical attention as soon as the first symptoms, including a high fever, appear.
Upon examination, the doctor concludes that there are no respiratory issues. If, however, he notices a red throat, he becomes even more certain that the illness is viral and immediately notes ARVI on the patient’s card. You ask, because there’s no cough or runny nose, why? And the second thing that any pediatrician will tell you is that he wrote "ARVI with an atypical course" on the card in addition to the words "ARVI." The doctor’s conscience is unclouded; in fact, fever is a hallmark of viral infections. The unusual symptom is not having a cough.
How much more precisely is newborn roseola identified on the fourth or fifth day, when the infant’s body is covered in a recognizable, picturesque rash? The issue is that the child has already been prescribed so many medications at the pediatrician’s request—from antivirals to antipyretics and antihistamines—that calling the same doctor to report the rash is now considered an allergic reaction to the drugs.
Note that most pediatricians do not even consider the possibility that this is not an allergy at this point. This occurs as a result of roseola infantum being taught only in theory in medical schools; in actual practice, students are not exposed to roseola. As a pediatrician, what do you expect from someone who has never seen roseola?
Perhaps hospitals and universities would have a more somber attitude toward this illness if it posed a risk to infants. However, there is no risk associated with the disease, and no particular treatment is needed. Therefore, since there won’t be any dangerous consequences from the medical "mistake" in this case, its failure to detect it is not a crime.
Treatment
As you may have already surmised, the illness resolves itself without the need for any particular medical intervention. Once that week has passed, the symptoms do not recur. Consequently, it is the responsibility of parents throughout the entire treatment process to produce a child with these conditions so that the body heals more quickly. The child needs to be in bed, drink lots of warm fluids, avoid stress, and eat light food that won’t take up a lot of energy to digest.
You must make sure the baby drinks a lot of water because dehydration during hyperthermia poses the greatest risk to him. If he refuses to drink, make him use a disposable syringe, guiding the stream of liquid along his cheek to reduce spitting. In the event that he refuses to drink and regurgitates everything, you should call for an ambulance and check the infant into a hospital. In the hospital, the child will receive intravenous solutions or water through a tube to prevent dehydration.
However, the majority of parents manage to accomplish the duty of giving their child a drink on their own. What is available to give? Rosehip decoction, still mineral water, tea, compote, and regular clean drinking water are some examples of homemade fruit drinks.
The key is that the liquid should be at room temperature rather than too hot or too cold to allow the body to absorb it more quickly.
Feed your kid when they ask to. Do not force him to eat if he does not ask for it. When a baby is sick, it is preferable to remove all complementary foods from their diet and give them only breast milk or formula. Children older than one year old should also be fed light meals like porridge, vegetable puree, and soups that won’t strain their bodies too much.
Even in the winter, the sick person’s room should be ventilated for ten to fifteen minutes every hour. The ideal air temperature for a sick child with a high fever is roughly 21 degrees Celsius, so try not to overheat the space.
Attempt to remove all warm blankets and clothing from the child. You can prevent hyperthermia by letting him sleep in his underwear beneath a light sheet. If the child is experiencing discomfort due to a high temperature, age-appropriate antipyretic medications such as "Paracetamol" can help lower the temperature. You can give your child medications from the non-steroidal anti-inflammatory drug (NSAID) family, like Ibuprofen, if these drugs are ineffective.
However, experts advise against giving them unless the child has trouble with high fevers; in other situations, it is preferable to avoid taking medications as much as possible because a high body temperature is necessary for the body to mount a more potent immune response.
The skin rashes that will show up in three days don’t require lubrication. They don’t hurt, itch, or produce any unpleasant sensations. A baby’s mother is the only one who requires medical attention when the baby has a pink rash because she can’t look at her son with that kind of rash without getting shivers. Valerian is okay for mom.
Even if the pediatrician knows the child has roseola, if they still prescribe antiviral medication, explain why. The sickness will persist for the full duration of time regardless of whether the infant drinks the homeopathic "Anaferon." Several antiviral medications have also not proven to be effective against the majority of viruses, including the herpes virus type 6, in tests; thus, parents are free to choose whether or not to treat roseola with them. Give your child no medication if you don’t want to; nothing bad will happen. Unless the producers of antiviral medications with dubious efficacy suffer a loss of revenue.
The only antiviral medication that might be accessible is "Acyclovir," but it is advised to take it as tablets in cases of extreme illness and as ointments for skin rashes, primarily for the comfort of parents. It doesn’t really matter if you smear the rash or not; it will go away on the fifth or sixth day, not before.
You can bathe the child once the fever has cooled down, but be careful not to rub him with a washcloth and check that the water is not too hot. Once the temperature drops, you can also take the child for a walk. He is no longer infectious, even with the rash.
Symptoms of Roseola in Children | Principles of Treatment |
Sudden high fever lasting 3-5 days | Monitor temperature and provide fluids |
Fever may trigger mild seizures | Consult a doctor if seizures occur |
Fever drops, and a pink rash appears on the body | No specific treatment needed for the rash |
Child may seem irritable or tired | Ensure rest and comfort |
Runny nose, mild cough, or swollen eyelids | Treat symptoms with child-safe medications |
It’s critical to identify roseola in kids to ensure a speedy recovery. The characteristic rash follows the high fever, which usually goes away quickly even though it can be concerning. In order to keep the child comfortable during this time, parents should maintain their composure and offer supportive care.
Even though the condition frequently goes away on its own, it’s always a good idea to keep an eye on symptoms and consult a doctor. Crucial measures for managing roseola at home include treating the fever, providing lots of fluids, and putting the child to sleep.
In the end, roseola is a common childhood illness from which the majority of kids recover without any issues. Parenting during this time can be done with confidence and care if you are aware of the symptoms and stay informed.