Roseola, sixth disease or exanthema subitum in Latin, is an infectious disease found in older infants and toddlers, between the age of 6 months and 2 years. Its cause is the human herpes virus called HHV 6, which is part of the group of herpes viruses that cause cold sores, chickenpox and shingles. Although roseola is highly contagious, it is not dangerous in any way and in most cases it runs its course without any serious complications.
The Cause and Transmission of Roseola
The cause of roseola is the herpes virus 6, part of the herpes viruses. Herpes viruses are a diverse group of viruses that can cause more or less serious illness. Herpes viruses are many and are very widespread in our population. Statistically, more than 90% of people are infected but whether the disease manifests itself depends on several factors. HHV 6, or human herpes virus 6 is the virus that causes roseola to develop. Transmission of this virus during roseola usually occurs with direct contact with the ill or tiny droplets from the saliva of family members. Rarely is the illness transmitted by air. The virus is also found in urine, breast milk and genital secretions in women. After the infection has run its course, the virus is not destroyed but stays in the body.
Symptoms of Roseola
The incubation period for roseola, i.e. the time between the virus's entry into the body and the onset of symptoms, is between 5 and 12 days. The first symptoms of roseola appear very soon after, such as a high fever reaching 40°C (104°F). Other symptoms of roseola are irritability, sleeplessness, loss of appetite, and sometimes even mild flu-like symptoms such as a cough and runny nose. Some children experience swollen lymph nodes in the head and neck. Later these symptoms are replaced by a red rash on the torso, sometimes spreading to the arms, legs and neck. This rash does not itch and unlike the similar fifth disease, the skin on the head is not affected. The rash looks similar to that of measles or rubella, where tiny red spots are visible, which is why it is important to be able to distinguish these diseases from each other in order to ensure correct treatment. Other than the rash, which typically lasts a few days, some patients affected by roseola can experience a sore throat or persistent swollen lymph nodes.
Complications of Roseola
Though roseola is not usually dangerous, relatively serious complications can develop, endangering the child. The most common complication is febrile convulsions, muscle spasms caused by a high fever. These convulsions can lead to breathing difficulties and possible suffocation of the child. Rarely can a child develop aseptic meningitis, infectious mononucleosis, malignant blood disorder, swelling of the liver or swelling of the meninges.
A diagnosis of roseola is based primarily on the clinical course of the disease. Making a diagnosis is not always easy as there are similar childhood illnesses with similar rashes such as measles and rubella. It is also necessary to exclude toxic skin eruption, i.e. allergic reactions, most often occurring at this age after the administration of antibiotics for an unexplained fever. A diagnosis of roseola is possible to confirm with a blood test and collection of blood serum.
Treatment of Roseola
Treatment of roseola is based on reducing symptoms and focussing on its cause. Medication to lower fever, antipyretics, are administered and cold compresses are recommended in case of a high fever. Because the rash does not itch, no creams or ointments are necessary. Plenty of fluids, bed rest and isolation from other children are necessary until the rash disappears. In the case of febrile convulsions, cold compresses, a higher dose of antipyretics and diazepam upon a doctor's recommendation should be administered. In the case of febrile convulsions or with a fever higher than 39°C (102°F) a doctor should be consulted to recommend appropriate medication.