Roseola, also called sixth disease, roseola infantum, or exanthema subitum, is a common childhood viral infection characterized by a high fever and skin rashes.
Nearly 90% of the cases occur in children younger than two years, and roseola is responsible for 10-45% of febrile illnesses in young children in the US. It is a contagious but self-limiting disease that can be treated symptomatically in most children.
Read this post to know about the causes, symptoms, complications, diagnosis, treatment, and prevention of roseola in children.
Risk Factors And Causes Of Roseola In Children
Roseola in children is often caused by human herpesvirus 6 (HHV-6) and less frequently by human herpesvirus 7 (HHV-7). Usually, most children get roseola infection before four years of age, and children younger than two years are commonly affected.
Infants and children may get the virus from close contact with asymptomatic family members and caregivers and direct contact with an infected person’s respiratory secretions or saliva. Roseola rarely affects older children since most have already had the illness at a young age.
Symptoms Of Roseola In Children
The symptoms of roseola may appear five to 15 days after a child has been exposed to the virus. The signs and symptoms may vary in each child; however, the following signs and symptoms are commonly seen in children with roseola.
- Sudden onset of a high fever that lasts three to four days
- Cold-like symptoms such as runny nose, cough, or sore throat
- Loss of appetite
- Swollen eyelids
- Skin rash after fever
- Swollen glands
Roseola rash appears after the fever subsides. You may initially notice a flat or raised pink rash on the trunk (tummy, chest, and back), which may then spread to the face, arms, and legs. Usually, the skin rashes in roseola fade within two days without leaving any marks on the skin.
How Long Is Roseola Contagious?
Most roseola symptoms may last for three to five days, and the child is most contagious during this period, meaning they can spread the disease to other children or anyone after the onset of the symptoms until the rash occurs. A child is no longer contagious 24 hours after the fever subsides, even if the rash is present.
Complications Of Roseola In Children
Roseola usually does not cause serious complications. However, high fever may result in febrile seizures in some children. Children with high fever can also experience dehydration if they do not drink enough water during the illness. In a few cases, roseola can lead to ear infections in some children.
Can Children Get Roseola Twice?
The immune system develops antibodies against the roseola virus after the initial infection. Due to this, most children get roseola just once in their life. These antibodies can prevent viruses from causing diseases.
However, children with weakened immune systems may get roseola infection more than once since their immune system may not develop a proper defense against the disease.
Prevention Of Roseola In Children
There is no vaccine or medications to prevent roseola. However, frequently washing the hands may help prevent roseola and many other common childhood infections. Practicing cough and sneeze etiquette may also prevent the spread of the disease.
Ensure you do not send your child to school if they have a fever or any other symptoms of roseola, and avoid exposing your child to another child with the infection.
When To Call A Doctor?
You may contact the pediatrician if your child develops severe breathing problems and signs of pneumonia. High degree fever may also require treatment to prevent seizures in children. Seizures, signs of dehydration, fatigue, or itchy or painful rashes are also indications you need to seek medical care.
Although roseola is not a severe disease, you may seek pediatrician help to prevent complications and exclude other conditions.
Diagnosis Of Roseola In Children
A complete health history and the symptoms may help doctors in diagnosis. The onset and characteristics of skin rash and other symptoms may help the doctors confirm the diagnosis.
However, the diagnosis can often be confused with other conditions, such as rubella or measles. In rare cases, a blood test is ordered to identify antibodies to roseola in a child’s body.
Treatment For Roseola
There is no specific cure for roseola. The treatment options may depend on the child’s age, health status, and severity of symptoms. Antiviral medications such as Cytovene (ganciclovir) are often prescribed for children with weakened immune systems.
Fever medications are prescribed for children with a high fever. Skin rash due to roseola does not require specific care since it does not cause any discomfort. Always remember that antibiotics are not used for treating roseola since it is a viral disease.
Children with roseola can return to school or childcare centers 24 hours after the fever subsides, even if they have skin rashes since they are no longer contagious.
Home Remedies For Roseola In Children
The following home remedies may help ease the symptoms of roseola in children.
- Give them plenty of water to prevent dehydration.
- Provide soft foods if your child has a sore throat.
- Give fever medications, such as acetaminophen (Tylenol), as per the doctor’s advice.
- Dress them in cotton or lightweight clothing to prevent excessive sweating during fever.
Do not give ibuprofen to children younger than six months and aspirin to children of all ages to treat fever.
Consult a pediatrician or family physician to confirm the diagnosis of roseola since the symptoms, including skin rashes, may resemble other medical issues. And do not delay medical care for roseola in immunocompromised children since they may require medical therapy. All in all, the prognosis of roseola infantum is excellent, and the disease is self-limiting.
- Tessa B. Mullins and Karthik Krishnamurthy. (2021). Roseola Infantum.
- Roseola in Children.
- Roseola symptoms & causes.
- Roseola Infantum.
- Roseola Infantum.
- Testing & diagnosis for roseola in children.
- Roseola Infantum.
- When your child has roseola.
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