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Roseola infantum is a common illness in preschool-aged children with a classic presentation of fever lasting 3 to 7 days followed by rapid defervescence and the appearance of a blanching maculopapular rash.
- Roseola affects children from 3 months to 4 years of age. The peak age is 7 to 13 months.
- 90% of cases occur in the first 2 years of life.
- No gender predilection
- Roseola can occur throughout the year; outbreaks have occurred in all seasons.
- The virus that causes roseola infantum is usually transmitted via respiratory secretions or fecal–oral spread.
- Good hand hygiene is recommended.
- Outbreaks in hospitals have been reported, and standard infection control precautions are recommended.
- Incubation period is 5 to 15 days.
- The typical pattern of rash that appears as the fever disappears may represent virus neutralization in the skin.
- The major causes of roseola are human herpesvirus 6 and 7 (HHV-6 and HHV-7).
- HHV-6 was first associated with roseola infantum in 1988.
- HHV-6 and HHV-7 account for 20–40% of unexplained febrile illness in emergency department visits by febrile infants 6 months to 2 years of age.
- Almost all children will acquire a primary infection and be seropositive for HHV-6 by the age of 4 years.
- ~30% of children infected with HHV-6 will present with the classic manifestations of roseola.
- Roseola-like illnesses have been associated with a number of different viruses, including:
- Enterovirus (coxsackievirus A and B, echoviruses)
- Adenoviruses (types 1, 2, 3)
- Parainfluenza virus
- Measles vaccine virus