Archive for the ‘Roseola In Children’ Category

Adults Roseola Information

What is roseola?

Roseola is a mild illness caused by a virus infection. Roseola has a sudden onset and short duration, and it most commonly affects young children. Roseola is most common in children 6 to 24 months of age. The average age at onset is around 9 months. Less frequently, older children, teens, and (rarely) adults may be infected.

What virus causes roseola?

Roseola is primarily caused by a virus called human herpesvirus 6 (HHV-6) and less commonly by human herpesvirus 7 (HHV-7).

How is roseola spread?

Roseola is spread from person to person, most likely by transfer of oral secretions. Roseola is not very contagious. The incubation period between exposure to the virus and onset of symptoms is nine to 10 days. Humans are the only natural hosts for HHV-6 and HHV-7. Unlike other viral infections, roseola occurs throughout the year without seasonal variation.

Roseola Introduction:

Roseola is a usually mild viral infection that is common among children. Most cases occur between the ages of 6 months and 3 years, and more than 75% of children have had roseola by the time they are 2. Roseola often starts with a high fever, usually followed by a distinctive rash just as the fever breaks. High fever can cause complications, so parents should watch their children’ s temperatures carefully and keep in contact with their pediatrician. Treatment is usually aimed at bringing down the fever and making sure the child stays hydrated. Adults can sometimes get roseola, too.

Signs and Symptoms:

•     Sudden high fever (103 – 106 °F), which usually lasts 3 – 4 days. Your child will most likely remain alert in spite of the fever.
•     High fever can cause febrile seizures. Although you should take your child to the emergency room if he has a seizure, they usually are not harmful, and go away when the fever goes down.
•     A rash appears as the fever goes away and lasts 3 – 4 days. It may look like measles or rubella, with small rose-colored bumps. The rash usually appears first on the trunk of the body. It may spread to the neck, arms, and legs but rarely to the face.
•     Fatigue, irritability, decreased appetite, and swollen eyelids.
•     Breathing problems, ear infections, and diarrhea can also occur.

What Causes It?

Roseola is caused by the human herpes virus 6 (HHV-6) and, occasionally, human herpes virus 7. These are not the same herpes viruses that cause cold sores or genital herpes. Roseola is spread through saliva and respiratory secretions, so coughing and sneezing can spread the virus. The incubation period is 5 – 15 days. It is contagious, whether or not the child has a rash.

What to Expect at Your Provider’s Office:

Your child’s health care provider will look for the rash and may take blood to check for other conditions and complications. Your health care provider will take your child’s temperature and talk to you about how to treat your child’s roseola at home.

Treatment Options:

There is no cure for roseola. Most treatments reduce fever, letting the infection run its course. Most children get better within a week.

Exanthema subitum:

Exanthema subitum (meaning sudden rash), also referred to as roseola infantum (or rose rash of infants), sixth disease (as the sixth rash-causing childhood disease) and (confusingly) baby measles, or three-day fever, is a disease of children, generally under two years old, although it has been known to occur in eighteen year olds, whose manifestations are usually limited to a transient rash (“exanthem”) that occurs following a fever of about three day’s duration.

It is frequently called roseola, although this term could be applied to any rose-colored rash.

Until recently, its origin was unknown, but it is now known to be caused by two human herpesviruses, HHV-6 (Human herpesvirus 6) and HHV-7, which are sometimes referred to collectively as Roseolovirus. There are two variants of HHV-6 and studies in the US, Europe and Japan have shown that exanthema subitum is caused by HHV-6B which infects over 90% of infants by age 2. Some research indicates that babies congenitally infected with the HHV-6A virus can have inherited the virus on a chromosome

Signs and Symptoms

A child with roseola typically develops a mild upper respiratory illness, followed by a high fever (often over 103° F or 39.5° C) for up to a week. During this time, the child may appear fussy or irritable and may have a decreased appetite and swollen lymph nodes (glands) in the neck.

Roseola Illustration:

The high fever often ends abruptly, and at about the same time a pinkish-red flat or raised rash appears on the trunk and spreads over the body. The rash’s spots blanch (turn white) when you touch them, and individual spots may have a lighter “halo” around them. The rash usually spreads to the neck, face, arms, and legs.

The fast-rising fever that comes with roseola triggers febrile seizures (convulsions caused by high fevers) in about 10% to 15% of young children. Signs of a febrile seizure include.

Background:

Human herpesvirus 6 (HHV-6) is the virus that most commonly causes the childhood disease roseola. It was first isolated in 1986. Two genetically distinct variants have been discovered: human herpesvirus 6A (HHV-6A) and human herpesvirus 6B (HHV-6B). HHV-6B has been associated with a variety of viral illnesses, including exanthem subitum (roseola infantum), mononucleosis syndromes, focal encephalitis, and pneumonitis.The virus is spread through saliva and possibly by genital secretions. This virus shows the closest homology with cytomegalovirus and human herpesvirus 7 (HHV-7).

HHV-6 infection in infants is the most common cause of fever-induced seizures. Infection in adults is seen primarily in immunocompromised hosts who have undergone solid organ transplants or in those with HIV infection.Reactivation of latent HIV infection attributable to HHV-6 infection has been reported.No prophylaxis or treatment for infection with HHV-6 presently exists. The great majority of HHV-6 infections are silent or appear as a general mild febrile illness.

The child with HHV-6 usually does not appear seriously ill during this disease. HHV-6 infection is much more serious in adults and can lead to organ involvement (usually presenting as gastrointestinal symptoms or hepatitis), encephalitis, or death.

To elucidate the role of HHV-6 and HHV-7 in pityriasis rosea (PR), their DNA load in plasma, peripheral blood mononuclear cells (PBMCs), and tissues was evaluated using a calibrated quantitative real-time polymerase chain reaction assay.In addition, HHV-6– and HHV-7–specific antigens in skin were evaluated by immunohistochemistry and anti–HHV-7 neutralizing activity using a syncytia-inhibition test. HHV-6 and HHV-7 DNA were found in 17% and in 39% of PR plasmas, respectively, but in no controls. HHV-6 levels in PBMCs were not higher in PR patients than in controls. HHV-6 and HHV-7 antigens were detected only in PR skin (17% and 67% of patients analyzed, respectively), presumably indicating a productive infection. These and other data strongly suggest a causal association between PR and active HHV-7 or, to a lesser extent, HHV-6 infection.

The reactivation of herpesviruses, including HHV-6 and EBV (Epstein-Barr virus), is linked with a potentially serious drug eruption known as DRESS (drug reaction with eosinophilia and systemic symptoms). A report of high-level HHV-6 viremia associated with the onset of Stevens-Johnson syndrome suggests an association.

Related eMedicine articles include Human Herpesvirus Type 6 (from Infectious Diseases section), Roseola Infantum, Encephalitis, and Pityriasis Rosea.

Vaccines and treatment:

There is no specific vaccine against or treatment for exanthema subitum, and most children with the disease are not seriously ill. A child with fever should be given plenty of fluids to drink. Paracetamol/acetaminophen or ibuprofen could be given to reduce their temperature (but never aspirin, due to the risk of Reye’s Syndrome).

A small percent of children acquire HHV-6 “subclinically”; in other words, they show no outward sign of the disease. Exanthema subitum occurs in approximately 30% of children during primary HHV-6 infection [7]. Others may be debilitated enough that a doctor’s opinion is required to confirm the diagnosis, and particularly to rule out other more serious infections, such as meningitis or measles. In case of febrile seizures, medical advice is essential.

Most children recover fully from roseola within a week of the onset of the fever. With your doctor’s advice, you can give your child over-the-counter medications to reduce fever, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others). However, don’t give aspirin to a child who has a viral illness because aspirin has been associated with the development of Reye’s syndrome, which can be serious.

There’s no specific treatment for roseola, although some doctors may prescribe the antiviral medication ganciclovir (Cytovene) to treat the infection in people with weakened immunity. Antibiotics aren’t effective in treating viral illnesses, such as roseola.