Three-day fever

Introduction

Three-day fever - also known as exanthema subitum, roseola infantum or three-day fever exanthema - is a viral infection that usually affects children between the ages of six months and three years. Three-day fever is a typical paediatric illness that occurs frequently and is harmless in most cases and is caused by herpes viruses, which are transmitted by droplet infection.

The illness begins with a sudden rise in temperature of up to 40 °C. The fever stops abruptly. The fever stops as abruptly as it started, followed by a skin rash that also subsides without any consequences.

In rare cases, those affected suffer febrile convulsions. However, these are also usually harmless. Three-day fever is treated with antipyretic medication if necessary. Three-day fever cannot be prevented and there is no vaccination.

Symptoms

The symptoms of a three-day fever appear suddenly. The illness begins with a high fever of up to 40 °C and lasts for three to four days. Subsequently, the fever stops abruptly; however, the child's general condition is usually good. In rare cases, febrile convulsions may also occur, but these are usually harmless. A short fever-free interval of 12 to 24 hours is followed by the rash typical of three-day fever. This is fine-spotted, pink, does not itch and disappears after one to two days.

Course

Three-day fever has a typical course and subsides completely within five to seven days without any consequences. The fever is followed by the characteristic skin rash. Young patients are only infectious during the fever phase.
In rare cases, a three-day fever can lead to complications such as febrile convulsions, vomiting, diarrhoea, swollen eyes, coughing or swollen lymph nodes in the neck.
Children who have contracted three-day fever have lifelong immunity.

Causes

Two herpes viruses (HHV-6, more rarely HHV-7) are primarily responsible for three-day fever. The viruses are transmitted by droplet infection, for example through coughing, sneezing or spitting. The incubation period - the time between infection and the appearance of the first symptoms - usually lasts nine to ten days (HHV-6)

Diagnosis

Doctors diagnose three-day fever based on the age of the child, the medical history and the rash. As the disease usually has a typical course - a sudden rise in temperature followed by a rash - specialists can also diagnose three-day fever easily by telemedicine when the rash appears.
As (high) fever in children can also indicate a serious illness, it is advisable to contact a doctor from the second day (or even earlier if the general condition is poor). Babies under three months of age must always be assessed by a doctor immediately if they have a fever of 38 °C or more.

Treatment

The treatment of three-day fever is aimed at alleviating the symptoms. Antipyretic medication is used if necessary. As the body loses fluids during a fever, sick children should also drink plenty of fluids.

Prevention

Three-day fever cannot be prevented; there is no vaccination.