Roseola is a viral illness in young children, most commonly affecting those between the ages of 6 months and 2 years. Roseola is probably caused by more than one virus. The most common cause appears to be human herpesvirus 6 (HHV-6). It occurs mostly in children under the age of 3. It occurs mostly in the spring and fall. Roseola occurs throughout the year. Roseola begins with a high fever that generally responds well to acetaminophen. Between the 2nd and 4th day of illness, the fever falls dramatically, and a rash appears (often as the fever falls) on the trunk and spreads to the limbs, neck, and face. The rash lasts from a few hours to 2 days. Roseola is most commonly seen in children between 6 months and 3 years of age. Most children will have had roseola by the age of 2 years. Roseola is rarely seen in adults, as infection during childhood probably confers lifelong immunity to the disease. Roseola is spread from person to person via respiratory fluids or saliva of infected individuals. In most cases, particularly if fever is low, the child is well. In about 5-15% of young children, high fevers may trigger febrile seizures.
Roseola typically isn’t serious. The disease usually resolves without complications. Measures should be taken to control a fever. There is no specific vaccine against or treatment for exanthem subitum, and most children with the disease are not seriously ill. A child with fever should be given plenty of fluids to drink, and acetaminophen or ibuprofen to reduce their temperature. Medications to reduce fever, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others). Most people have antibodies to roseola by the time they’re of school age, making them immune to a second infection. Adults who never contracted roseola as children can become infected later in life, though the disease tends to be mild in healthy adults. The main concern is that infected adults can pass the virus on to children. In some cases, a child may be infected with the virus and never develop the rash. Less commonly, the rash may appear without a preceding fever. The fever of roseola lasts from 3 to 7 days, followed by a rash lasting from hours to a few days.
There is no specific treatment for roseola. Rest, maintaining fluid intake and paracetamol for fever is all that is usually required. Lukewarm baths or sponges can also be used to help reduce fever. Antiviral medication ganciclovir (Cytovene) to treat the infection in people with weakened immunity. Never give aspirin to a child or teenager with a fever as this can increase the risk of Reyes syndrome, a rare, but potentially fatal, liver and brain disorder. Do not use ice, cold water, alcohol rubs, fans, or cold baths. Acetaminophen (such as Tylenol) or ibuprofen can help to reduce your child’s fever. Avoid giving aspirin to a child who has a viral illness because the use of aspirin in such cases has been associated with the development of Reye syndrome, which can lead to liver failure and death. Acetaminophen and cool sponge baths may be given. If convulsions occur, call your health care provider, or go to the closest emergency room.