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Roseola in children: what is the “sixth disease”

Roseola in children is an acute disease that infants are susceptible to. Normally, it passes on its own in 6 days, hence the name “sixth disease”. Roseola or sudden exanthema is one of the most mysterious childhood diseases on the planet. A few decades ago, its symptoms were attributed to other diseases. It was possible to study it in detail only in the 20th century. Until now, neither scientists nor doctors have been able to prove the role of any of the pathogens. However, it is known that most cases of roseola in children are a primary infection caused by herpes virus types 6 and 7. It usually develops at an early age. This is due to the fact that up to 12 months of life, antibodies to this virus have 60-90% of children, and by 3-5 years – already 100%.

Causes of Roseola
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Sudden exanthema can develop at any time of the year. Most often, it attacks the children’s body in the spring and autumn. Unlike other exanthems, with this type of disease it is rarely possible to prevent a child from contact with sick people. Like other herpes viruses, exanthema pathogens are transmitted through touch, hugs, kisses, the common use of household items and personal hygiene.

Symptoms of roseola in children
Roseola in children is an acute disease that infants are susceptible to. Normally, it passes on its own in 6 days, hence the name “sixth disease”. The peak of the disease occurs in 6-15 months of life. Perhaps due to the fact that up to 6 months, mother’s milk reliably protects the baby from infections. Classical sudden exanthema for a short time causes unique symptoms that allow you to correctly diagnose the disease. The prodromal period is usually not pronounced, however, minor symptoms can sometimes be observed:

mild inflammation of the pharynx;
slight hyperemia of the mucous membranes;
discharge from the nose;
conjunctiva or eardrum injection;
the cervical enlarges slightly, less often, the occipital lymph nodes;
some children have swelling of the eyelids.
Visual examination during the prodromal period often fails to identify symptoms that clearly indicate roseola. The onset of the disease is indicated by a sharp rise in body temperature from 37.9 to 40 degrees Celsius (usually 39). Very rarely, children become moody and refuse to eat, most babies feel good. Convulsions may occur in 5-10% of children with fever.

Rare symptoms include a runny nose, sore throat, stomach, or diarrhea. In Asian countries, children with sudden exanthema often find ulcers in the soft palate and tongue – the so-called Naga spots.

Elevated body temperature persists for several days, then a critical decrease is observed. Sometimes the temperature drops slowly and returns to normal after 1-1.5 days. The first 12-24 hours after a decrease in temperature are characterized by the appearance of a characteristic rash.

The size of the rashes with sudden exanthema is from 2 to 5 mm. They have a pink tint and distinct borders. First, the rash appears on the body, after which it spreads to other parts of the body – neck, face, arms and legs. It does not bother the child, does not cause itching or discomfort, therefore, it does not need to be processed. It disappears completely within 1-3 days. In some children, the rashes are not at all noticeable and persist only for several hours.

Diagnostic Methods
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The main reason for the diagnosis of roseola is its identification as an independent disease. Although the symptoms and signs give a more or less concrete picture, the diagnosis of such serious diseases as pneumonitis, encephalitis (caused by herpes viruses of types 6 and 7) will help to start antiviral therapy faster. An effective diagnostic method is a blood test. The absence of Ig G in infants over 6 months of age along with virus replication is 100% evidence of primary infection.

Children with sudden exanthema get to the doctor in one of two stages: with a high fever without a rash or with a rash, but without a fever. Before the appearance of external characteristic features, many conditions can be mistaken for a roseola. Although with the well-being of the child (even at elevated temperature), the absence of significant discomfort, a rather sharp decrease in temperature and the subsequent appearance of a rash, it is simply impossible to make a different diagnosis. Sometimes, but very rarely, one of the signs is not enough, therefore, the diagnosis is complicated.

Roseola is similar to a number of diseases that have similar symptoms. The disease is often confused with rubella, measles, scarlet fever, an allergy to drugs and erythema infectious.

The main differences of roseola
Rubella, unlike roseola, does not have a prodromal period and always starts the same way – with an increase in the occipital and ear lymph nodes. Lymphadenopathy is not characteristic of this disease. But if it occurs, then the occipital nodes increase more often than the ear.

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