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Three-day-fever (roseola infantum)

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What is three-day-fever? © NetDoctor/Justesen
Reviewed by Dr John Pillinger, GP

What is three-day-fever?

- The disease also has other names; Roseola infantum, exanthematous fever, and three-day-rash.
- Although most small children catch it, it is one of the lesser-known children's diseases that causes a rash.
- It is only seen in children from the age of six months to three years and it is highly contagious.

How is three-day-fever contracted?

The cause of the disease is unknown but it is probably due to a virus, which is transferred through the respiratory tract.

The incubation period - from infection to symptoms appearing - is 10 to 15 days.

The child is probably infectious during the whole period of the disease and maybe even before the high temperature.

What are the symptoms of three-day-fever?

- It begins with a sudden high temperature up to 40ºC. The temperature lasts for about three days.
- In some cases febrile fits follow the high temperature. These may seem very dramatic and alarming. Febrile fits are not caused by the three-day-fever as such, but are due to the sudden high rise in temperature.
- The rash appears when the temperature suddenly drops again after about three days. It usually begins on the body and spreads to the arms and legs. It is seldom seen in the face.
- The rash consists of pale, reddish spots, perhaps with small heads. It lasts for about 12 to14 hours. Then it is over.

How is three-day-fever different from other childhood diseases?

It is important that parents of small children know the disease and its characteristic symptoms. It is necessary to distinguish it from other children's diseases, particularly measles.

- Three-day-fever does not begin with cold-like symptoms as measles does. At first there is only a high temperature.
- In measles, the temperature runs high again when the rash appears. With three-day-fever, the temperature drops to normal when the rash appears.
- The rash characteristically begins on the body and seldom appears on the face. Both measles and German measles appear on the face to begin with.

How does the doctor make the diagnosis?

The typical course of a three-day-fever followed by a rash is so characteristic for this children's disease that it is not hard to recognise it from the above symptoms.

How is three-day-fever treated?

There is no need for medication. Make sure that the child drinks plenty of fluids in the three days that the temperature lasts. The rash is not particularly itchy.

Children can go back to childcare when their temperature has returned to normal.

Future prospects

The disease follows the course described above. There are no known complications and it is a self-limiting condition. Catching it once gives lifelong immunity.



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