Roseola Infantum

Roseola infantum (ro-see-O-luh in-FAN-tum) is a viral infection seen in young children that produces a rash and high fever.

What Is Roseola Infantum?

Also known as exanthem subitum (eg-ZAN-thum SU-bih-tum), roseola infantum is an acute ^* viral infection that mainly affects children between the ages of 6 months and 3 years and is characterized by high fever followed by a rash. The disease stems from infection with human herpesvirus (her-peez-VY-rus) type 6 (HHV 6) or human herpesvirus type 7 (HHV 7). Both of these are part of the same family of viruses as varicella zoster (var-uh-SEH-luh ZOS-ter), which causes chicken pox; Epstein-Barr (EPsteen BAR) virus, which causes mononucleosis ^* ; cytomegalovirus ^* ; and herpes simplex ^* virus.

How Common Is It?

HHV 6 and HHV 7 affect almost all children who are between 6 months and 3 years of age, but not all of these infections produce the illness recognized as roseola infantum. Roseola rarely is seen in children more than 4 years old, and the illness appears most often during the spring and fall.

Is Roseola Infantum Contagious?

Roseola spreads from person to person, most likely through tiny drops of fluid expelled from the mouth and nose of an infected child when he or she laughs, coughs, sneezes, or talks.

What Are the Signs and Symptoms?

Symptoms of roseola infantum usually appear between 5 and 15 days after exposure to the virus. Children may first have a mild respiratory tract ^* illness, followed by a high fever that can reach 105 degrees Fahrenheit and last from 2 to 5 days. When the fever subsides, a rash appears, starting on the trunk of the body and spreading to the limbs, face, and neck. The rash of raised red and pink splotches, which fade to white when pressed, lasts from 1 to 3 days. Additional symptoms of the infection can include tiredness, swollen eyelids, a runny nose, swollen lymph nodes ^* in the neck, and irritability. In up to 10 percent of children, the high fever associated with roseola infantum causes febrile seizures ^* .

How Is Roseola Infantum Diagnosed?

To diagnose roseola, doctors look for physical symptoms and signs such as rash and swollen lymph nodes, particularly those in the back of the scalp. A medical history may show that the child has been exposed to others with the disease at home or in a child care setting. Because the rash appears after the fever, roseola often is diagnosed after the child has begun to recover from the illness.

How Is the Infection Treated?

Most cases of roseola infantum respond well to treatment at home. Acetaminophen ^* can help lower a fever, and drinking lots of clear fluids can prevent dehydration ^* . Children usually feel ill only while they still have a fever and probably will be less active during that time. By the time the rash appears, a child's behavior may be almost back to normal.

Are There Complications?

Most cases of infection resolve in 4 to 6 days without additional problems. Seizures are the most common complication, but this does not mean that the child will have an increased risk of a long-term seizure problem. In rare cases, the disease may lead to the development of meningitis (meh-nin-JY-tis, which is inflammation of the membranes covering the brain and spinal cord) or encephalitis (en-seh-fuh-LYE-tis, which is inflammation of the brain).

Can Roseola Infantum Be Prevented?

There is no simple way for children to avoid exposure to HHV6 and HHV7 completely. Young children have lots of close contact with each other. Adults rarely contract this illness, possibly indicating that having roseola as a child provides lifelong immunity ^* to the viruses. Some children do experience a second bout of the disease, but this occurs infrequently. Like other viruses in this family, HHV6 and HHV7 can reactivate after the first infection and cause illness, but this happens primarily in people who have a weakened immune system.