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Roseola Infantum: Causes, Symptoms and Treatment

Roseola, also known as roseola infantum, is a common childhood illness caused by a viral infection. An infection is typically accompanied by a high fever that usually lasts for about a week. Once the fever breaks, a child tends to develop a distinctive skin rash that can last from a few hours to several days. Children from the ages of six months to three years are most likely to contract roseola. However, the illness may sometimes occur in older children and, in rare cases, also in adults who have never contracted roseola as children.

Causes of Roseola

The cause of roseola are two closely related viruses, i.e., human herpesvirus type 6 and type 7. Children who develop this condition usually do so when their immune system is compromised. This especially occurs after having a minor upper respiratory illness. Patients with roseola are contagious and may spread the virus through expelling drops of fluid into the air while coughing, sneezing, talking or laughing.

Symptoms of Roseola

Although roseola typically causes symptoms, children with a very mild case may not show any signs at all. When symptoms occur, the first sign of infection is a substantial fever (up to 40 degrees Celsius or 104 degrees Fahrenheit). The fever usually lasts about three days, though sometimes it may last for as long as ten days. The child usually becomes fussy and irritable, lacks appetite, has a sore throat and a runny nose and swollen lymph nodes in the neck. Fatigue, mild diarrhea and swelling of the eyelids may also accompany fever. Less often, the fever may trigger frightening convulsions known as febrile seizures.

The fever typically breaks suddenly after several days and a raised, pinkish-red rash usually begins to appear on the child’s trunk. It spreads across the body, especially to the neck, face, arms and legs. This rash does not itch or cause discomfort. Individual spots may turn white when touched and they often have a lighter “halo” surrounding them. The rash may last anywhere from a few hours to several days. Symptoms of roseola in healthy adults tend to be much milder than those in children.

Diagnosing Roseola

Parents should consult a doctor anytime a child has a fever over 39.5 degrees Celsius (103 degrees Fahrenheit), or a fever that lasts more than a week, or a rash that remains after three days. The doctor will perform a complete physical examination and, in rare cases, may order a blood test to confirm the presence of antibodies associated with roseola. This may be necessary in instances when the child does not develop the rash typically associated with roseola to exclude the presence of other childhood illnesses, such as common cold or ear infection, which can mimic the initial symptoms of roseola.

Treatment of Roseola

In most cases, roseola is mild and does not require any special treatment. The illness will pass on its own over time. The main aim of treatment is to reduce high temperature. This can be best achieved by applying a towel soaked in lukewarm water to the child’s body. If necessary, paracetamol (acetaminophen) or ibuprofen may be given to help reduce fever. However, parents should consult with a doctor before giving their child any medications. Furthermore, it is important that children with roseola get plenty of rest and drink plenty of clear fluids to prevent dehydration that may occur as a result of the fever. In case of a seizure, immediate emergency care is required.

Children with compromised immune systems are at greater risk of developing health complications (e.g., severe infections) from roseola. The doctor may, therefore, prescribe antiviral medications for children that are considered immunocompromised.

Most children make a quick and full recovery from roseola and, once they recover, they rarely develop the disease again. Adults rarely contract roseola and, if they do, they usually develop a mild form of the illness. However, they may pass the virus onto their children.

The only way to prevent children from contracting roseola is to keep them away from people infected with the disease. However, this may not be easy, as patients are contagious before they experience symptoms.

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