The three-day fever (Exanthema subitum) is an acute, highly contagious viral disease caused by herpes viruses. Characteristic is suddenly rising, high fever, which lasts three to four days. Subsequently, a rash forms, which disappears after a few days. Find out more about the three-day fever here.
Three-day fever: description
The three-day fever, also known as three-day fever (or 3 days fever) or Roseola infantum, is a usually harmless virus infection with herpes virus. It occurs mainly in babies and children between the 6th and 24th month. Almost all children came into contact with the virus at the age of three. The three-day fever does not occur seasonally, children can get infected with it year-round.
Three-day fever: baby
At birth, the mother’s antibodies are passively transferred to the newborn, which provides limited nest protection from the three-day fever in the first few months of life. Because of this, the three-day fever rarely occurs before the third month of life.
Three-day fever: adults
The three-day fever is rare in adults – most of them have already gone through their illness in infancy. If so, then it manifests itself by flu-like symptoms, comparable to those of Pfeiffer’s glandular fever (mononucleosis). In adults with a weakened immune system, so-called pneumonitis can occur in which the lungs become chronically inflamed.
As with any infection with herpes viruses, the viruses remain in the body for life. Doctors call this a latent infection. However, this can be active again – but only in very rare cases, when the immune system is severely impaired.
Three-day fever: symptoms
The typical symptoms of the three-day fever are suddenly rising temperatures of 39 ° C to 41 ° C – no apparent cause. As the name suggests, the fever lasts about three days. For some children, the fever can last up to five days, then the temperature returns to normal within a few hours.
Three-day fever: rash
After the fever has subsided, develops in about a quarter of those affected very quickly (subito) a fine blotchy red rash (rash) on the whole body. The rash in three-day fever affects mainly the body trunk and the neck. The spots can unite and thus become larger. Later, the rash can spread to arms and legs. Furthermore, it occurs on the mucous membranes, mainly on the soft palate.
In many cases, the three-day fever rash disappears abruptly, as it has come, that is, in hours to a maximum of two days.
In addition to the fever and rash, children may also experience other symptoms, but these usually resolve as soon as the rash has disappeared:
- swollen eyelids
- Irked eardrums
- to cough
- Swollen cervical lymph nodes
- Prevaulted fontanelle (in the infant)
In older children, the three-day fever – as in adults – may resemble the Pfeiffer’s glandular fever.
Three-day fever: Febrile convulsion
In about one third of cases of infection, the three-day fever may also be accompanied by a febrile convulsion. The child loses consciousness and twitches rhythmically with both arms and legs. This looks very disturbing, but most of the febrile convulsion stops after a few minutes and remains without consequences. Nevertheless, after such an incident, the pediatrician should urgently be consulted.
In very rare cases, three-day fever can lead to complications such as meningitis, pneumonia, hepatitis or retinal inflammation.
Three-day fever: causes and risk factors
The causative agents of the three-day fever are herpesviruses (human herpesvirus type 6, more rarely type 7). In herpesvirus type 6 (HHV 6), there are the two subgroups (serotypes) A and B, with only the B variant having pathological value. About 10 to 30 percent of the diseases are caused by HHV 7. The difference between the two pathogens is the average age of onset. While HHV 6 leads to a three-day fever, especially around the ninth month of life, HHV 7 triggers the disease much later, around the age of 26 months.
Three-day fever: infection
The herpes virus is mainly transmitted through the saliva – so the three-day fever is contagious to a high degree. The virus may also be transmitted via a droplet infection when sneezing, coughing or talking. Even healthy children and adults who have come into contact with the virus can continue to transmit it.
Very rarely is an infection by organ transplantation, blood transfusions, sexual intercourse or breast milk. If the child has become infected, the three-day fever breaks out after about five to fifteen days (incubation period).
Three-day fever: examinations and diagnosis
For every infection with a high fever and unclear cause in your child, you should consult a doctor of paediatrics in order to detect serious diseases at an early stage. Especially if he is feverish for more than three days, feels very ill or has a very high fever.
To diagnose if you have a three-day fever, the doctor will ask you for the medical history and then do a detailed examination. Possible questions of the doctor can be:
- When and how quickly did the fever occur?
- How high is the fever? When was the last time you had a fever?
- Since when did you observe the rash?
- Does the child scratch the rash?
- Have you seen a febrile convulsion? Was the child conscious? Describe the incident accurately.
In a typical course, the three-day fever can be clearly diagnosed based on the symptoms. However, the doctor can examine the blood for better diagnostics, for example atypical course. The blood picture shows increased white blood cells (leukocytosis) during the fever phase. As soon as the fever subsides and the rash occurs, the white blood cells (leucopenia) appear in the blood picture.
More specifically, the three-day fever can be diagnosed with the detection of specific IgM antibodies or HHV IgG antibodies with specific tests. HHV 6 detection in blood, urine, saliva and nerve water takes place with the polymerase chain reaction (PCR).
A positive finding must always be interpreted together with the symptoms. Because traces of the viruses are also detectable in people who have already gone through the disease.
In a febrile convulsion, it may be necessary to exclude meningitis (meningitis), even if it is rare. The doctor performs a lumbar puncture, in which nerve water is taken from the spinal canal (spinal canal).
Three-day fever: similar diseases
It is important to know the three-day fever with its typical course in order to distinguish it from other similar illnesses that cause fever or rash. This is especially true for measles, rubella and allergic skin reactions to drugs (drug rash).
For example, the three-day fever does not start with the symptoms of cough, runny nose, and photosensitivity, as is the case with measles.
In measles, body temperature rises as opposed to the three-day fever when the rash starts. In the three-day fever, however, the body temperature drops back to normal when the child gets the rash.
The typical rash of three-day fever spreads first on the trunk and rarely on the face. In measles and rubella it is the other way around.
Three-day fever: treatment
The three-day fever is treated purely symptomatically. If the temperature rises above 38.5 degrees Celsius during a three-day fever, you can treat your child with an abdominal or calf wrap or give him antipyretic medication such as acetaminophen after consultation with the pediatrician. Children with a three-day fever usually feel better then.
Also, little clothing (for example, only diaper and body) helps to regulate body temperature. Make sure that your child drinks enough, because the babies and toddlers in particular lose a lot of fluids due to the fever.
Febrile convulsions are probably the result of the sudden increase in temperature. If they occur, you should place your child on the floor so that he can breathe freely and does not hurt himself. Call your doctor immediately and report the incident, even if the seizure was brief and the child subsequently recovered. He may recommend having the child hospitalized in the hospital.
As a general rule, consult your pediatrician if he is feverish for more than three days, feels very ill or has a very high fever.
Three-day fever: disease course and prognosis
The prognosis is favorable for the three-day fever. It usually passes quickly and the children recover quickly after the fever has subsided. For many, the disease does not take the typical, described course. The virus infection triggers only a weakened form of the three-day fever, which often goes unnoticed.
If a febrile convulsion occurs, this is often perceived as life-threatening. But: Febrile convulsion is not part of the epilepsy and leaves no permanent damage to the child.
By the end of the second year, almost all children have undergone this viral infection – noticed or unnoticed. As a rule, the three-day fever leaves a lifelong immunity – exceptions are extreme situations for the immune system, such as an organ transplant.
There are no effective immunoglobulins against the three-day fever. Therefore can not be vaccinated against it. At the Roseola rarely occur complications.