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.
Prognosis
Children infected with roseola generally have a good prognosis. Most recover without intervention and without long-term effects. Epidemiology
Between the two types of human herpesvirus 6, HHV-6B has been detected much more frequently in hosts. HHV-6B has been shown to affect about 90% of children before the age of 3. Out of these, 20% develop symptoms of roseola, also known as exanthem subitum.Roseola affects girls and boys equally worldwide year-round. Roseola typically affects children between six months and two years of age, with peak prevalence in children between 7 and 13 months old. This correlates with the decrease in maternal antibodies, thus virus protection, that occurs at the age of 6 months. Out of all emergency department visits for children between the ages of 6 months and 12 months who have fever, twenty percent of these are due to HHV-6.Many children who have been exposed and infected can present without symptoms, which makes determining the incidence within the population difficult. History
John Zahorsky MD wrote extensively on this disease in the early 20th century, his first formal presentation was to the St Louis Pediatric society in 1909 where he described 15 young children with the illness. In a JAMA article published on Oct 18, 1913 he noted that "the name Roseola infantilis had an important place in the medical terminology of writers on skin diseases" but that descriptions of the disease by previous writers tended to confuse it with many other diseases that produce febrile rashes.