Roseola, also known as sixth disease, is an infectious disease caused by certain types of human herpes viruses. Most infections occur before the age of three. Symptoms vary from absent to the classic presentation of a fever of rapid onset followed by a rash. The fever generally lasts for three to five days, while the rash is generally pink and lasts for less than three days. Complications may include febrile seizures, with serious complications being rare.It is caused by human herpesvirus 6 (HHV-6A, HHV-6B) or human herpesvirus 7 (HHV-7). Spread is usually through the saliva of those who are otherwise healthy. However, it may also spread from the mother to baby during pregnancy. Diagnosis is typically based on symptoms and does not need to be confirmed with blood tests (PCR or antigen). Low numbers of white blood cells may also be present.Treatment includes sufficient fluids and medications to treat the fever. Nearly all people are infected at some point in time. Males and females are affected equally often. The disease may reactivate in those with a weakened immune system and may result in significant health problems.The disease was first described in 1910 while the causal virus was determined in 1988. The name "sixth disease" comes from its place on the standard list of rash-causing childhood diseases, which also includes measles (first), scarlet fever (second), rubella (third), Dukes disease (fourth, but is no longer widely accepted as distinct from scarlet fever), and erythema infectiosum (fifth).
An exception is in people who are immunocompromised in who serologic tests with viral identification can be used to confirm the diagnosis.Roseola should be differentiated from other similar-appearing illnesses, such as rubella, measles, fifth disease, scarlet fever, and drug reactions. This differentiation may be determined based on symptoms. Prevention
Many viruses can cause Roseola and are shed by carriers without symptoms. Because of this and the fact that most children with the disease are not seriously ill, there is no particular method of prevention. Proper hygienic measures, like regular handwashing, can be implemented as a routine method of prevention. Those who have been exposed or infected have been shown to shed the virus for the rest of their lives. Because of this, there are no current guidelines regarding children staying home or away from child-care when infected. Treatment
Most cases of HHV-6 infection improve on their own. Because of this, supportive care is the mainstay treatment. The febrile phase can be managed using acetaminophen to control fever and prevent spikes in temperature which can lead to febrile seizures. In the case of febrile seizures, medical advice should be sought, and treatment aggressively pursued. Antiepileptic drugs are not recommended for patients who develop seizures from Roseola. Once children have entered the rash phase, reassurance is important as this indicates resolution of the infection.If encephalitis occurs in immunocompromised children, ganciclovir or foscarnet have inconsistently shown usefulness in treatment. Treatment of children who are immunocompromised centers around decreasing their levels of immunosuppression as much as possible.