Recently, I’ve seen several cases of roseola, and I don’t want this viral illness to be confused with measles.
Roseola, also called exanthem subitum, is a viral illness typically seen in children between the ages of 7 and 13 months; 90 percent of cases occur in children under the age of 2 years. Roseola is most often caused by human herpes virus (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 three to seven days. Other symptoms may include fussiness and decreased appetite. Some children may have mild upper respiratory symptoms, or swollen glands in their neck. For many children, once the fever is treated, they’re 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, then spreads over the body. It’s at this time that parents 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 two after their fever and symptoms have developed. The few children I’ve seen with measles looked very ill and uncomfortable. 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 five to 15 days after exposure they become ill. With young children who share “all,” it’s easy to see why roseola is a quite common childhood illness.
Roseola is seen year round, but can have peaks in spring and fall. It’s rarely seen in adults, so it’s thought that having roseola in childhood may provide some lasting immunity.
The treatment for roseola is totally symptomatic: fever control to help the child feel more comfortable, fluids for hydration, and anything else that just helps your child feel better.
Once a child is fever free and the rash has developed, they’re no longer contagious.
Roseola and measles are totally distinct illnesses. You can prevent measles with the MMR vaccine. Roseola is just another one of those illnesses most children and parents must muddle through.
Dr. Sue Hubbard is a pediatrician, medical editor and media host. Submit questions at kidsdr.com.