| Roseola | |
|---|---|
| Classification and external resources | |
 electron micrograph of HHV-6 |
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| ICD-10 | B08.2 |
| ICD-9 | 057.8 |
| DiseasesDB | 5857 |
| MedlinePlus | 000968 |
| eMedicine | emerg/400 derm/378 ped/998 |
| MeSH | D005077 |
Exanthem 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,[1] 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.[2]
Until recently, its origin was unknown, but it is now known to be caused by two human herpesviruses, HHV-6 (Human Herpesvirus Six) and HHV-7, which are sometimes referred to collectively as Roseolovirus. There area two variants of HHV-6 and studies in the US, Europe and Japan and shown that exanthema subitum is caused by HHV-6B which infects over 90% of infants by age 2. Current research indicates that most babies congentially infected with the HHV-6A virus inherited the virus on a chromosome.[3]
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Clinical features
Typically the disease affects a child between six months and two years of age, and begins with a sudden high fever (39–40 °C). This can cause, in rare cases, febrile convulsions (also known as febrile seizures or "fever fits") due to the sudden rise in body temperature, but in many cases the child appears and acts normal. After a few days the fever subsides, and just as the child appears to be recovering, a red rash appears. This usually begins on the trunk, spreading to the legs and neck. The rash is not itchy and may last 1 to 2 days.[4] In contrast, a child suffering from measles would usually appear more infirm, with symptoms of conjunctivitis and a cough, and their rash would affect the face and last for several days. Liver dysfunction can occur in rare cases.
The rare adult reactivates with HHV-6 can show signs of mononucleosis.[5]
Vaccines and treatment
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. Paracetamol/acetaminophen or ibuprofen could be given to reduce their temperature (but never aspirin, due to the risk of Reye's Syndrome[6]). Fever reduction is usually not needed, because fever is a normal and useful reaction of the body, and if it does not exceed 40.0 °C, harmless. The rash is not particularly itchy and needs no special lotions or creams.
It is likely that many children acquire exanthem subitum "subclinically"; in other words, they show no outward sign of the disease. 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.
Local Terms
Philippines: Tigdas Hangin (Tagalog)
Finland: Vauvarokko "baby measles" (Finnish)
Iceland: Mislingabróðir "Measles' brother" (Icelandic)
See also
References
- ^ Zerr DM, Meier AS, Selke SS, et al. (February 2005). "A population-based study of primary human herpesvirus 6 infection". N. Engl. J. Med. 352 (8): 768–76. doi:. PMID 15728809. http://content.nejm.org/cgi/content/abstract/352/8/768.
- ^ exanthema subitum at Dorland's Medical Dictionary
- ^ Universal childhood virus is inherited in DNA, newscientist.com
- ^ Roseola – Topic Overview, webmd.com
- ^ Stoeckle MY (2000). "The spectrum of human herpesvirus 6 infection: from roseola infantum to adult disease". Annu. Rev. Med. 51: 423–30. doi:. PMID 10774474. http://arjournals.annualreviews.org/doi/abs/10.1146/annurev.med.51.1.423?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dncbi.nlm.nih.gov.
- ^ What is the role of aspirin?, reyessyndrome.org
External links
- MedlinePlus encyclopedia entry on "roseola"
- Links to roseola pictures, Hardin MD/Univ of Iowa
- Newly Found Herpes Virus Is Called Major Cause of Illness in Young, New York Times
- HHV-6 Foundation
- DermNet viral/roseola
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