Roseola
medical conditions

Roseola

Explore the available health information, treatment context, and integrative evidence for Roseola.

Background
  • Roseola (also known as sixth disease, exanthema subitum, roseola infantum, baby measles, or three day fever) is a type of viral infection that is characterized by a sudden onset of high fever followed by a rash. Roseola is caused by two forms of the herpes virus. The infection can occur at any time of the year and usually is not serious.
  • Roseola is a common infection that is rare in adults and usually affects young children between the ages of six months and three years. Approximately 77 percent of children develop roseola by two years of age.
  • Treatment is usually supportive and aimed at relieving symptoms until the infection clears on its own. Some doctor's may prescribe the antiviral medication ganciclovir (Cytovene®) for patients with weak immune systems. The infection usually goes away within one week of developing a fever.
Risk Factors and Causes
  • Older infants between the ages of six and 12 months have an increased risk of developing roseola because antibodies they received while in their mothers' womb may have faded. Antibodies are an important part of the immune system because they identify harmful substances that enter the body and trigger other immune cells to destroy the invading substance.
  • Research suggests that babies who are breastfed are less likely to develop infections (especially lung infections, ear infections, and diarrhea) during their first year of life than babies who are fed formulas. This is because the mother's breast milk contains important antibodies, enzymes, fats, and proteins that help boost the baby's immune system.
  • Human herpes virus 6 (HHV6) and human herpes virus 7 (HHV7): Roseola is usually caused by HHV6, but it can also be caused by HHV7. These two forms do not cause cold sores and genital herpes infections; they cause several days of fever followed by a rash.
  • Roseola is contagious and can be spread by contact with an infected person's respiratory secretions or saliva. Activities such as laughing, sneezing, talking, or coughing may spread roseola. Also, individuals can spread roseola when they have a fever, even before showing signs of a rash. Adults who were not infected as children may become infected with roseola. However, roseola does not spread as quickly as other conditions, such as the chickenpox.
Signs and Symptoms
  • General: Symptoms of roseola usually appear within one to two weeks after becoming infected with HHV6 and HHV7. However, the signs of infection are often too mild to be noticeable.
  • Fever: Roseola usually begins with a sudden, high fever often greater than 103° F and lasts for about three to seven days. Children may develop slightly sore throats or runny noses along with or before the fever begins. Swollen glands in the neck are often typical symptoms that occur with fever.
  • Rash: Once the fever has improved, a rash may develop on many areas of the body and can last anywhere from several hours to several days before fading. The rash consists of many small pink spots or patches, which are usually flat but can also be raised. Additional characteristics include a white ring around some of the spots. The rash usually starts on the chest, back, and stomach areas and then spreads to the neck and arms. Additionally, the rash usually isn't itchy or uncomfortable.
Diagnosis
  • Physical exam:
    Roseola is usually difficult to diagnose until the fever drops and the rash appears. The doctor will often take a detailed medical history and perform a physical examination. Additionally, signs and symptoms may be similar to other illnesses such as the common cold or an ear infection so these infections should be ruled out.
Complications
  • General: Individuals do not usually experience complications from roseola. Children usually have a complete and rapid recovery within one week of developing a fever.
  • Compromised immune system: Individuals with weak immune systems who develop roseola may have a greater risk of experiencing pneumonia or encephalitis (life-threatening inflammation of the brain).
  • Dehydration: Patients should drink plenty of fluids to prevent dehydration.
  • Febrile seizure: A febrile seizure occurs when an infant or young child develops a seizure or convulsions when he/she has a fever higher than 102 °F. Children with roseola occasionally experience febrile seizures when the body temperature rises rapidly. Symptoms may include shaking or jerking of the arms or legs, fixed stare, eyes rolling back, heavy breathing, drooling, bluish skin, and loss of consciousness. However, the seizures usually finish quickly and are rarely harmful. Patients who experience any of these symptoms should be taken to the emergency department of a nearby hospital immediately.
Treatment
  • General: Roseola goes away on its own. Since roseola is a virus, antibiotic treatment is generally not an option. Patients receive treatment to reduce symptoms of the roseola until the infection clears up on its own. The goal of treatment is to reduce the high fever. Most children fully recover from roseola within one week after the fever begins. Antivirals such as Cytovene® may be used in children with weak immune systems.
  • Fluids: Children infected with roseola should drink plenty of water and other clear fluids, to prevent dehydration. Patients may also benefit from drinks that contain electrolytes, including Pediatric Electrolyte®, Pedialyte®, or Enfalyte®. Individuals should avoid diuretics, such as caffeine, because they worsen symptoms of dehydration.
  • Fever-reducing medications: Fever reducing medications such as acetaminophen (Tylenol®) or ibuprofen (Motrin®, Advil®) can be used. Use of aspirin should be avoided since it has been associated with the development of Reye syndrome, a condition linked with the use of aspirin in children that may cause sudden brain damage and liver failure.
Prevention
  • There is no vaccine to prevent roseola. Infected children should avoid contact with others.
  • When children are exposed to roseola, they may develop some lasting immunity to it. This means that the body is able to recognize the roseola virus quickly if it enters the body in the future. As a result, the immune system quickly attacks the virus and prevents individuals from becoming infected. In other words, patients who are infected with roseola are not likely to become infected again in the future.
References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  • Caserta MT, Mock DJ, Dewhurst S. Human herpesvirus 6. Clin Infect Dis. 2001 Sep 15;33(6):829-33. Epub 2001 Aug 10.
    View Abstract
  • Cleveland Clinic. . Accessed April 27, 2009.
  • Leach CT. Human herpesvirus-6 and -7 infections in children: agents of roseola and other syndromes. Curr Opin Pediatr. 2000 Jun;12(3):269-74.
    View Abstract
  • Lyall EG. Human herpesvirus 6: primary infection and the central nervous system. Pediatr Infect Dis J. 1996 Aug;15(8):693-6.
    View Abstract
  • Meade RH 3rd. Exanthem subitum (roseola infantum). Clin Dermatol. 1989 Jan-Mar;7(1):92-6.
    View Abstract
  • Millichap JG, Millichap JJ. Role of viral infections in the etiology of febrile seizures. Pediatr Neurol. 2006 Sep;35(3):165-72.
    View Abstract
  • Natural Standard: The Authority on Integrative Medicine. . Copyright 2009. Accessed April 27, 2009.