Roseola is a viral infection affecting young children. It causes a skin rash of a pinkish color after the child has been racked by high fever for a couple of days. The multiple rash spots tend to turn white when touched. Individual rashes may have lighter rings of pink around them like halos. The spots start out on the trunk of the body, then spread to the neck, face, arms, and legs. It is a fairly common disease in children between 3 months to 4 years of age.
Symptoms and Alternative Names
Roseola is also referred to as “exanthemsubitum”, the “sixth disease” or “roseola infantum.” It is a highly contagious disease and spreads in a manner similar to the common cold virus. Symptoms associated with the disease include:
- High fever usually over 103 degrees Fahrenheit
- Skin rash follows after fever breaks
- Redness of eye
- Swollen eyelids
- Sore throat
- Runny nose
- Cranky and irritable
- Loss of appetite
- Mild diarrhoea
- Swollen glands in the neck
- Swollen lymph nodes in the back of the scalp
The toddlers start off with very fast rising fever, that may in some cases cause convulsions. The convulsions are known as febrile seizures. They occur in about 15% of children who suffer from Roseola. A febrile seizure may cause the child to lose consciousness, twitching in the limbs, and loss of bladder or bowel control. Seek immediate medical attention if the toddler suffers a seizure.
The virus that causes Roseola is called Human Herpes Virus 6 or HHV-6. It belongs to the Herpes Simplex Virus family. The incubation period of the disease is between 5 and 15 days. That is how long it takes after exposure to the contagious virus for the disease to set in and symptoms to be visible.
Most toddlers will develop the typical pink spotty rash once the fever abates. The rashes can be difficult to distinguish from other childhood infections such as measles, rubella, and scarlet fever. Once infected by the virus, the toddler will usually develop an immunity to it. Roseola seldom affects the toddler twice.
Since the infection is viral in nature, antibiotics cannot be used to treat it. Most mild cases last between three to seven days and clear up automatically. Toddlers can be cared for at home and need not be hospitalized for mild Roseola infections.
Let the toddler get enough rest, but there is no need to force them to sleep in bed. Give them plenty of fluids to drink so that they don’t get dehydrated. Use paracetamol to ease the fever. Sponge baths and wet cloth placed on the forehead will also help keep the fever in check. Keep the room cool and use a lightweight sheet for covering them in bed.
Bring the toddler in for a check up if he has a seizure or loses consciousness at any time. If the child seems disoriented, drowsy, or confused, you may like to speak to the attending doctor about his lack of responsiveness. Other possible complications arising from Roseola include aseptic meningitis and encephalitis.
Prevention and Prognosis
The Roseola infection spreads through the air when the toddler sneezes or coughs, sending out tiny droplets. These droplets can be inhaled by other children causing the infection to pass on. The droplets may also land on surfaces which other children may touch and then touch their nose or mouth, thus transferring the viral infection.
Roseala is most contagious when the child is suffering from fever. Once the rash breaks out on the skin, the disease is no longer as contagious. The best way to prevent the spread of Roseala is to isolate the toddler in a single room. Ensure that other children do not enter that room. This will eliminate accidental transmission.
For the care giver, it is important to make sure that the surfaces in the sick room are continuously disinfected. Also wash the hands of the toddler frequently with warm water and soap. The tissues used by the toddler should be disposed of in a sanitary manner. Keep the eating utensils, plates, and cups for the toddler separate. Adults with a healthy immune system are rarely likely to be affected by the virus.
For immunocompetent toddlers who have a normal immune response, Roseola is a once-in-a-lifetime infection. They develop an immunity to the virus after recovering from the infection and never get it again. Those who are immunosuppressed, and have a weakened immune system may have complications during the infection. It could also become chronic and lead to a fatal viral progression. This is rare. Most cases clear up from a week to ten days after infection.
Reviewed by Susha Cheriyedath, MSc