Babies are often associated with being adorable and many people would agree that no matter what or how the baby does, this little human never fails to catch people’s hearts. Parents would understand that taking care of a baby is a big responsibility. Medical conditions that can affect babies should be paid attention and such conditions need to be addressed as soon as possible. In this DoctorOnCall’s article, we will learn about roseola as one of the many diseases that is common in children.
Roseola is a disease caused by the human herpes virus type 6B and possibly type 7. This disease is also known as exanthema subitum and sixth disease. It commonly affects children between 6 months and 3 years old. Most children will have had roseola by the age of 1. It is rare to see roseola in adults as most roseola infection has already occurred during childhood and this resulted in lifelong immunity against the disease. It is uncommon for repeated attacks to occur.
Roseola in humans is spread via the saliva of a person with no symptoms. It is a contagious condition that is easily spread through infected respiratory secretions. Incubation period for roseola is approximately 9 to 10 days after exposure. This means that a person is likely to have symptoms 9 to 10 days following exposure to the virus.
In many cases, children do appear well or have no symptoms. Symptoms typically begin with high fever of more than 40 degrees. Fever lasts around 3 to 5 days. While the child is having fever, they may also have other symptoms such as fatigue, red eyes (conjunctivitis), irritability, loss of appetite or difficulty feeding the child (anorexia), cough, diarrhoea, swollen eyelids and swollen glands in the neck. These symptoms last for 3 to 5 days before a rash appears. Rash in roseola is presented as pinkish-red spots, patches or bumps that start on the chest, abdomen and back. The rash will then spread to the face, neck and arms. This rash normally fades and disappears within 2 days. Unlike many rash, rash in roseola typically not itchy or causes discomfort in a child. Similar spots do occur in the mouth on the soft palate known as Nagayama spots. In some cases, a child affected by roseola may never have a rash. It is less common for the rash to appear without fever following first. High fever may trigger febrile seizures in a small number of young children.
Due to the fact that roseola is mild and is considered as self-limiting, diagnosis is usually made solely based on the history and physical examination. A self limiting disease is a disease that tends to go away on its own even without treatment. It is unlikely for laboratory tests to be done but sometime is needed to rule out other diseases that may cause symptoms similar to roseola.
There is no specific treatment for roseola. Treatment aims to keep the child hydrated and free from fever. Allowing a child to have enough rest, drinking lots of fluids and keeping their fever away with paracetamol or ibuprofen is enough to support the child’s immune system in fighting the disease. Since roseola can be highly infectious, it is best to keep the child at home while they are still having fever. This is the period of time where roseola is considered to be most contagious.
Parents might wonder if roseola is a serious disease. Roseola can be considered as not serious disease as it is a self-limited disease with very few long-term adverse events. Complications are rare with roseola in most children. Most common complication is febrile seizures triggered by the high fevers from the roseola. It can be alarming when the seizure occurs for the first time. Signs of febrile seizures include loss of consciousness, jerking or twitching movements in the arms, legs or face for 2 to 3 minutes, irritability and wet or soiled paint when the toilet-trained child is still unconscious. Seizures are typically brief. It is advisable to bring the child to doctors once the febrile seizures happen.
Reactivation of the virus can occur in immunosuppressed patients. Children with cancer and recipients of transplants are at risk for reactivation. Bone marrow failure, myocarditis, pneumonitis, hepatitis and meningoencephalitis can occur, but are very rare. In these severe cases, the illness can be treated with antivirals.
In essence, roseola is a viral disease caused by human herpes virus 6 and 7. It can spread easily via infected respiratory droplets even in children with no symptoms. It is considered a self-limiting disease and rarely causes poor outcomes. It is best for children with roseola symptoms to get checked by a doctor, especially if fever is too high of more than 40 degrees, fever that lasts more than a week and rashes that persists without improvement for more than 3 days. Emergency care should be given to children with febrile seizures.
