Exanthema subitum
Encyclopedia
Exanthema subitum 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. Current research indicates that babies congenitally infected with the HHV-6A virus can have inherited the virus on a chromosome.
(39–40 °C; 102.2-104 °F). This can cause, in rare cases, febrile convulsions (also known as febrile seizure
s or "fever fits") due to the sudden rise in body temperature, but in many cases the child appears 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. 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 and can show signs of mononucleosis
.
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
).
It is likely that many children acquire exanthema 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 seizure
s, medical advice is essential.
Exanthem
An exanthem is a widespread rash usually occurring in children. Exanthems can be caused by toxins or drugs, microorganisms, or can result from autoimmune disease.It can be contrasted with an enanthem.-Types:...
) 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
Exanthem
An exanthem is a widespread rash usually occurring in children. Exanthems can be caused by toxins or drugs, microorganisms, or can result from autoimmune disease.It can be contrasted with an enanthem.-Types:...
") 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
Roseolovirus
Roseolovirus refers to both Human herpesvirus 6 and Human herpesvirus 7, both members of the Betaherpesviridae subfamily of herpesvirus. They can both cause the childhood disease of roseola.-External links:* , New York Times* *...
. 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. Current research indicates that babies congenitally infected with the HHV-6A virus can have inherited the virus on a chromosome.
Clinical features
Typically the disease affects a child between six months and two years of age, and begins with a sudden high feverFever
Fever is a common medical sign characterized by an elevation of temperature above the normal range of due to an increase in the body temperature regulatory set-point. This increase in set-point triggers increased muscle tone and shivering.As a person's temperature increases, there is, in...
(39–40 °C; 102.2-104 °F). This can cause, in rare cases, febrile convulsions (also known as febrile seizure
Febrile seizure
A febrile seizure, also known as a fever fit or febrile convulsion, is a convulsion associated with a significant rise in body temperature...
s or "fever fits") due to the sudden rise in body temperature, but in many cases the child appears 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. In contrast, a child suffering from measles
Measles
Measles, also known as rubeola or morbilli, is an infection of the respiratory system caused by a virus, specifically a paramyxovirus of the genus Morbillivirus. Morbilliviruses, like other paramyxoviruses, are enveloped, single-stranded, negative-sense RNA viruses...
would usually appear more infirm, with symptoms of conjunctivitis
Conjunctivitis
Conjunctivitis refers to inflammation of the conjunctiva...
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 and can show signs of mononucleosis
Infectious mononucleosis
Infectious mononucleosis is an infectious, widespread viral...
.
Vaccines and treatment
There is no specific vaccineVaccine
A vaccine is a biological preparation that improves immunity to a particular disease. A vaccine typically contains an agent that resembles a disease-causing microorganism, and is often made from weakened or killed forms of the microbe or its toxins...
against or treatment for exanthema subitum, and most children with the disease are not seriously ill. A child with fever
Fever
Fever is a common medical sign characterized by an elevation of temperature above the normal range of due to an increase in the body temperature regulatory set-point. This increase in set-point triggers increased muscle tone and shivering.As a person's temperature increases, there is, in...
should be given plenty of fluids to drink. Paracetamol
Paracetamol
Paracetamol INN , or acetaminophen USAN , is a widely used over-the-counter analgesic and antipyretic . It is commonly used for the relief of headaches and other minor aches and pains and is a major ingredient in numerous cold and flu remedies...
/acetaminophen or ibuprofen
Ibuprofen
Ibuprofen is a nonsteroidal anti-inflammatory drug used for relief of symptoms of arthritis, fever, as an analgesic , especially where there is an inflammatory component, and dysmenorrhea....
could be given to reduce their temperature (but never aspirin
Aspirin
Aspirin , also known as acetylsalicylic acid , is a salicylate drug, often used as an analgesic to relieve minor aches and pains, as an antipyretic to reduce fever, and as an anti-inflammatory medication. It was discovered by Arthur Eichengrun, a chemist with the German company Bayer...
, due to the risk of Reye's Syndrome
Reye's syndrome
Reye's syndrome is a potentially fatal disease that causes numerous detrimental effects to many organs, especially the brain and liver, as well as causing a lower than usual level of blood sugar . The classic features are liver damage, aspirin use and a viral infection...
).
It is likely that many children acquire exanthema 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
Meningitis
Meningitis is inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. The inflammation may be caused by infection with viruses, bacteria, or other microorganisms, and less commonly by certain drugs...
or measles
Measles
Measles, also known as rubeola or morbilli, is an infection of the respiratory system caused by a virus, specifically a paramyxovirus of the genus Morbillivirus. Morbilliviruses, like other paramyxoviruses, are enveloped, single-stranded, negative-sense RNA viruses...
. In case of febrile seizure
Febrile seizure
A febrile seizure, also known as a fever fit or febrile convulsion, is a convulsion associated with a significant rise in body temperature...
s, medical advice is essential.
Local terms
| Belgium | Driedagenkoorts "three-day fever" or zesde ziekte "sixth disease" (Dutch) - "Roséole" (French) |
| Finland | Vauvarokko "baby measles" (Finnish) |
| Germany | Dreitagefieber "three-day fever" (German) |
| Greece | Αιφνίδιο εξάνθημα "sudden rash" (Greek) |
| Iceland | Mislingabróðir "measles' brother" (Icelandic) |
| Italy | Sesta malattia "sixth disease" (Italian) |
| Norway | Fjerde barnesykdom "fourth disease" (Norwegian) |
| Philippines | Tigdas Hangin "wind measles" (Tagalog) |
| Poland | Trzydniowa goraczka "three-day fever" (Polish) |
| Singapore/Malaysia | Jia3 Ma2 假麻 "false measles" (Chinese) |
| Turkey | Altıncı hastalık "sixth disease" (Turkish) |
| Vietnam | Sốt phát ban "baby rash" (Vietnamese) |
See also
- Human herpesvirus 7Human herpesvirus 7Human herpesvirus 7 is one of eight known members of the Herpesviridae family, also known as human herpes virus. HHV-7 is a member of Betaherpesviridae, a subfamily of the Herpesviridae that also includes HHV-6 and Cytomegalovirus . HHV-7 often acts together with HHV-6, and the viruses together...
- Endogenous retrovirusEndogenous retrovirusEndogenous retroviruses are sequences in the genome thought to be derived from ancient viral infections of germ cells in humans, mammals and other vertebrates; as such their proviruses are passed on to the next generation and now remain in the genome....
- List of cutaneous conditions
- Roseola Infantum - Pubmed Health
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