What are viral exanthems?

A viral exanthem is an eruptive skin rash that is often related to a viral infection. Immunizations have
decreased the number of cases of measles, mumps, rubella, and chickenpox, but all viral skin infections
require clinical care by a physician or other healthcare professional.

The most common childhood viral exanthems include the following:

 Measles (rubeola)
 Rubella (German measles)
 Varicella (or chickenpox)
 Fifth disease
 Roseola

Immunizations have decreased the number of cases of measles, mumps, rubella, and chickenpox, but all viral
skin infections require clinical care by a physician or other healthcare professional. Each of the viral exanthems
listed here have a distinct pattern, which can aid in the diagnosis.

Measles (or Rubeola)

What is measles (rubeola)?

Rubeola, also called 10-day measles, red measles, or measles, is a very contagious viral illness that results in
a distinct rash. It is spread from one child to another through direct contact with discharge from the nose and
throat, or via air-borne droplets from an infected child. Measles is a highly contagious disease that usually
consists of a rash, fever, and cough.

What causes measles?

The measles virus, which causes the disease, is classified as a Morbillivirus. It is mostly seen in the winter and
spring, but measles is preventable with proper immunization.

The measles vaccine is usually given in combination with the mumps and rubella vaccine. It is called the MMR
and is usually given when the child is 12 to 15 months old and then again between 4 and 6 years of age.

What are the symptoms of measles?

After exposure to the disease, it can take between 8 to 12 days for a child to develop symptoms of rubeola.
Children are contagious 1 to 2 days before the onset of symptoms and 3 to 5 days after the rash develops. This
means that children can be contagious before they even know they have measles.

During the early stages of measles (which lasts between 1 to 4 days), symptoms usually resemble those of an
upper respiratory infection. Each child may experience symptoms differently, however. Common symptoms
may include:
  Hacking cough
 Redness and irritation of the eyes
 Fever
 Small red spots with white centers on the inside of the cheek (these usually occur two
days before the rash on the skin appears)
 A deep, red, flat rash that starts on the face and spreads down to the trunk, arms, and
legs. The rash starts as small distinct lesions, which then combines to form one big rash.
After 3 to 4 days, the rash will begin to clear, leaving a brownish discoloration and skin
peeling

The most serious complications from measles include the following:

 Ear infections
 Pneumonia
 Croup
 Inflammation of the brain

The symptoms of rubeola may resemble other skin conditions or medical problems. Always consult a physician
for a diagnosis.

How is rubeola diagnosed?

Measles is usually diagnosed based on a complete medical history and physical examination of the child. The
lesions of rubeola are unique, and usually allow for a diagnosis simply on physical examination. In addition, a
physician may order blood or urine tests to confirm the diagnosis.

The most serious complications from measles include the following:

 Ear infections
 Pneumonia
 Croup
 Inflammation of the brain

The symptoms of rubeola may resemble other skin conditions or medical problems. Always consult a physician
for a diagnosis.

What is the treatment for rubeola?

Specific treatment for measles will be determined based on:

 The child's age, overall health, and medical history

 Extent of the disease
  The child's tolerance for specific medications, procedures or therapies
 Expectations for the course of the disease
 Child or parent’s opinion or preference

Aspirin and the Risk of Reye Syndrome in Children

Do not give aspirin to a child without first contacting the child'sphysician. Aspirin has been associated with
Reye syndrome, a potentiallyserious or deadly disorder in children. Pediatricians and otherhealthcare providers
recommend that aspirin (or any medication thatcontains aspirin) not be used to treat any viral illnesses in
children.

Because measles is caused by a virus, there is no cure for rubeola. The goal of treatment is to help prevent the
disease, or decrease the severity of the symptoms.

 Increased fluid intake

 Acetaminophen for fever (DO NOT GIVE ASPIRIN)

Prevention of Rubeola

Since the widespread use of the rubeola (measles) vaccine, the incidenceof measles has decreased by 99
percent. About 5 percent of measles aredue to vaccine failure.

If the child was exposed and has not been immunized, the physician can give the vaccine to the child within 72
hours to help prevent the disease.

Other ways to prevent the spread of rubeola include:

 Children should not attend school or daycare for 4 days after the rash appears
 Confirm that the child's contacts have been properly immunized

Roseola
What is roseola?

Roseola is a contagious viral illness that is marked by a high fever and a rash that develops as the fever
decreases.

What causes roseola?

Roseola is likely caused by more than one virus, but the most common cause is the human herpesvirus 6
(HHV-6). Roseola occurs mostly in children under the age of 3, and occurs more often in the spring and fall.

What are the symptoms of roseola?

It can take between 5 and 15 days for a child to develop symptoms of roseola after being exposed to the
disease. Children are most contagious during the period of high fever, before the rash occurs.
The following are the most common symptoms of roseola. However, each child may experience symptoms
differently.

 High fever that starts abruptly

 Fever (may last three to four days)
 Irritability
 Swelling of the eyelids
 Rash (as the fever decreases, a pink rash, with either flat or raised lesions, starts to
appear on the trunk and then spreads to the face, arms, and legs.)

What are the complications of roseola?

The most serious complication of roseola is febrile seizures. As the child's temperature rises, there is a chance
that the child will have a seizure.

The symptoms of roseola may resemble other skin conditions or medical problems. Always consult a physician
for the proper diagnosis.

How is roseola diagnosed?

Roseola is usually diagnosed based on a medical history and physical examination of your child. The rash of
roseola that follows a high fever is unique, and often the diagnosis is made simply on physical examination.

Aspirin and the Risk of Reye Syndrome in Children

Do not give aspirin to a child without first contacting the child'sphysician. Aspirin has been associated with
Reye syndrome, a potentiallyserious or deadly disorder in children. Pediatricians and otherhealthcare providers
recommend that aspirin (or any medication thatcontains aspirin) not be used to treat any viral illnesses in
children.

What is the treatment for roseola?

The specific treatment for roseola will be determined based on:

 The child's age, overall health, and medical history

 Extent of the disease
 The child's tolerance for specific medications, procedures, or therapies
 Expectations for the course of the disease
 Child or parent’s opinion or preference

Since it is a viral infection, there is no cure for roseola. The goal of treatment for roseola is to help decrease the
severity of the symptoms. Treatment may include increased fluid intake or acetaminophen for fever (DO NOT
GIVE ASPIRIN).