I have recently seen several cases of roseola and don’t want this viral illness to be confused with measles. Roseola, also called exanthem subitum, is a viral illness which is typically seen in children between the ages of 7-13 months. 90% of cases of roseola occur in children under the age of 2 years. This viral illness is most often caused by human herpesvirus (HHV) type 6 (not the herpes that causes cold sores).
Children with roseola develop a fairly high fever (up to 104 degrees) which lasts for 3-7 days. Other symptoms besides the fever may include fussiness and decreased appetite. Some children may have mild upper respiratory symptoms, or swollen gland in their neck. For many children, when the fever is treated, they are fairly happy and playful.
The high fever seen with roseola ends fairly abruptly at which time a pinkish/red rash appears on the child’s chest (trunkal area) and then spreads over the body. It is at this time that parents (and grandparents) worry that their child has measles. Roseola is typically easily distinguished from measles by history alone, as the rash of roseola develops once the fever has resolved, and the child no longer appears ill. Children with measles are still sick when the rash appears, usually a day or 2 after their fever and symptoms have developed. The few children I have seen with measles looked very ill and uncomfortable and may be older. Young children with roseola are happy and playful once the rash appears. The rash may last anywhere from hours to days.
Roseola, like most viral illnesses, is spread through respiratory droplets after an infected person coughs, sneezes, or talks. Another person then comes in contact with the droplets and within 5-15 days after exposure they become ill. With young children who share “all” it is easy to see why roseola is a quite common childhood illness.
Roseola is seen year round, but may have peaks in spring and fall. Roseola is rarely seen in adults, so it is thought that having roseola in childhood may provide some lasting immunity.
The treatment for roseola is totally symptomatic. Fever control to help a child feel more comfortable, fluids for hydration and anything that just helps your child to feel better.
Once a child is fever free and the rash has developed they are no longer contagious.
Don’t confuse measles and roseola.....they are totally distinct illnesses. Remember you can prevent measles with the MMR vaccine. Roseola is just another one of those illnesses most children and parents must muddle through.
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