Top 20 Vaccines You Should Know About
What Is Roseola?
Roseola is a common viral infection that mainly affects children under age 2, usually between the ages of 6 and 12 months. It's so common that almost all children in the U.S. Have had it by the time they turn 2. Although it's rare, older children and adults can also get it.
Doctors or other health care professionals might call it roseola infantum or exanthema subitum. You may also hear people calling roseola sixth disease. The simple explanation for that is that roseola was the sixth childhood rash (like measles) that scientists named.
Most of the time, roseola is nothing to worry about, and kids get better on their own.
The main symptoms of roseola are fever and a flat, red rash. The rash can last from a few hours to several days. (Photo Credit: Desislava Vasileva/Dreamstime)
Roseola is an infection caused by one of two viruses. Most often, it's caused by human herpesvirus 6 (HHV-6). Occasionally, it's caused by human herpesvirus 7 (HHV-7). When someone who has the virus talks, coughs, or sneezes, they spread infected droplets into the air, which your child can breathe in. These droplets can also land on surfaces, like a tabletop or a toy, contaminating them. If your child touches the contaminated area and then brings their hand to their nose or mouth, they can become infected too.
Unfortunately, it can take up to 15 days after getting infected to start showing symptoms -- and someone can be contagious before they are sick. That's one reason why roseola can spread so easily.
Older children and adults can get roseola, but it's rare. This is probably because once you've had roseola, it's unlikely that you will get it again. You'll have some immunity against it. Since most children in the U.S. Have roseola by the time they're 2 years old, it's likely you had also it and are now immune.
There is an exception to the immunity though. If you have a weakened immune system (are immunosuppressed or immunocompromised), you could get roseola again.
Your child might not have any symptoms for 5-15 days after getting the virus that causes roseola. When symptoms do appear, the first thing you'll usually notice is a sudden, high fever (over 103 F) that lasts or can come and go for 3-7 days. Other symptoms can include:
Roseola rash
About one-quarter of people with roseola develop a flat, spotty, reddish rash after the fever goes away. It first appears on the chest, back, and belly, and then spreads to the neck and trunk. It doesn't itch and may last just a few hours or a few days. Some people get the rash without having a fever.
Roseola vs. Measles rash
There are several childhood infections that cause rashes, and it can be hard to tell them apart sometimes. Measles is a much more severe infection than roseola, and it's much more contagious. If you're not sure about what might be causing your child's rash, speak with your doctor as soon as possible. There are differences between the two that you can look for:
Where the rash starts. If your child has roseola and develops a rash, it usually starts on the chest, back, and belly, and then it spreads. If your child has measles, the rash would start on their face and then spread downward.
Color of the rash. A roseola rash is red or pink. A measles rash is red or red-brown.
How the rash looks. If your child has a roseola rash, you'll see that each spot is separate -- the spots don't touch each other. The spots in a measles rash, however, join together.
Peeling. A roseola rash fades away while a measles rash gets flaky or peels.
Most times, doctors can tell if your child has roseola by looking at them and reviewing their symptoms. If there's a rash, the doctor will look at it to make sure it's not caused by another virus, like measles. Blood tests aren't usually done for a roseola diagnosis, but they can be, especially if your doctor wants to rule out another illness.
There's no treatment for roseola, and since it's caused by a virus, antibiotics won't help (they're only for bacterial infections). Your child's doctor will likely recommend treating the symptoms to help make your child more comfortable. If your child has a health condition or takes medications that suppress their immune system, speak with your child's doctor as soon as possible after they show signs of being ill because the doctor might recommend extra treatment.
If your child has a high fever or is uncomfortable, you can:
There really isn't anything to do for the rash since it's not itchy or painful.
If your child develops other symptoms or becomes very sick, their doctor might recommend an antiviral medication -- either foscarnet or ganciclovir.
Is roseola contagious?
Roseola is contagious, so you should keep your child away from others, at least until the fever goes away. Once it's been gone for at least 24 hours, they can play with other kids, even if they still have a rash.
There's no medical treatment for roseola, but there are some things you can do at home to help keep your child more comfortable.
Keep your child hydrated. Here are some helpful tips:
Make sure they get plenty of rest. Resting is the best way to wait out a virus. If your child has a fever, cover them lightly -- don't pile on the blankets.
Keep them comfortable. A cool cloth on the forehead can help your child feel less feverish and more comfortable. It used to be advised to give kids a cold bath if they had a fever, but that's not a good idea and isn't recommended anymore. Instead, you can give your child a sponge bath with a lukewarm cloth.
Most children recover from roseola in about a week. The fever can last from 3 to 5 days. If they get a rash, this can last anywhere from a few hours to a few days.
If your child seems to be getting worse or has a seizure, take your child to an emergency department or call 911. If your child isn't better after a week, contact your doctor.
Most children recover from roseola infection within a week without any complications. But, as with all illnesses, there can be some complications.
Febrile seizures
About 10% to 15% of young children who have roseola have febrile seizures. These are seizures that are caused by the high fever. They usually last from a few seconds to 15 minutes. Some may last longer. During one of these seizures, your child may:
Febrile seizures can be frightening, but they are typically harmless. But if the seizure lasts longer than 5 minutes, you should call emergency medical services. In either case, contact your doctor right away, even if the seizure is short.
Rare roseola complications
More serious complications are rare. If they do happen, it's usually among children who have problems with their immune system, such as those with cancer or who have had an organ transplant. These include:
Unlike some other childhood diseases like measles or chickenpox that have vaccines, there is no roseola vaccine. The only way you can try to prevent roseola is by good and regular hand washing and avoiding people who are infected with the virus.
Roseola is such a common childhood viral infection that almost all children in the U.S. Have had it by the time they turn 2 years old. There is no roseola treatment and most children recover from the virus quickly. Although complications are rare, around 10% to 15% of children who have high fevers from roseola have febrile seizures. If you are worried about your child or they have seizures with fever, contact your doctor as soon as possible or go to the emergency room.
What can roseola be mistaken for?
Because of the rash and fever, some people might mistake roseola for measles. However, the rash is different and measles is a much more serious infection.
Can adults get roseola from a child?
It is possible for an adult to get roseola from a child, but it's rare. Most adults had roseola when they were young, and this makes them immune to getting it again. However, if the adult has a suppressed immune system, they could get it a second time.
Can kids go to school with roseola?
Children with roseola shouldn't go to school because they can spread the infection. Once the fever is gone, they should be OK to go back to school.
Is it OK to bathe a baby if they have roseola?
It's best to give a sponge bath with lukewarm water to help your baby be more comfortable if they have roseola.
How do you soothe roseola rash?
Roseola rashes aren't itchy or sore, so there is no need to soothe them.
Ebola: How A Killer Disease Was Stopped In Its Tracks
A health worker monitors the temperature of a traveller from the DR Congo
One of the world's deadliest viruses, Ebola kills up to half of those it infects. But despite appearing to have all the hallmarks of a potential epidemic, the latest outbreak developed in a very different way.
It was the ninth Ebola outbreak to hit the Democratic Republic of Congo in a decade, killing 29 people and leaving at least 60 children orphaned.
While one death is too many, the West Africa epidemic of 2014-16 claimed more than 11,000 lives and it is hoped that later this week the most recent outbreak will be declared officially over by the World Health Organization.
The relatively small number of deaths follows the use of an experimental vaccine, which may have saved hundreds, or even thousands of lives.
Fragile health system
Although the outbreak began in a remote area, there was a real danger that large numbers could be infected.
It appeared close to neighbouring Central African Republic and the Republic of Congo - a vast area with a great ebb and flow of people and a fragile health system. It is also an area linked by river and road to the capital Kinshasa - home to 10 million people.
When the virus returned in 2018, it could be quickly deployed, once the DRC government had approved its experimental use. This vaccine is designed for use against the Zaire strain of Ebola, which caused both this outbreak and the previous one.
Scientists and health workers set to work tracking all potential transmissions since the first case had been reported.
Front-line health workers, people in contact with confirmed Ebola cases, and their contacts all needed to be given the vaccine.
However, keeping the vaccine safe and making sure it reached the right people was not a straightforward task.
The vaccine must be kept extremely cold, at minus 70C.
This is difficult and expensive to do in a remote environment with unreliable electricity. Alongside the vaccine, fridges and generators had to be flown into the region by helicopter.
Isolation and treatment facilities had to be built, mobile laboratories set up and local laboratory technicians trained to test samples and confirm cases of Ebola.
Gaining consent
For the vaccine to be effective, it had to be given to the right people.
Health workers spoke to patients, their families and the wider community to dispel rumours, build trust and avoid panic.
This, they explained to community leaders, was not a mass campaign.
Vaccinations were given to the Ebola patient, plus a "ring" of friends, family and contacts - as well as healthcare workers and people involved in burials. All had to give their consent.
Identifying and finding all the people suspected Ebola patients had been in contact with was a major challenge because of the location.
Health workers had to travel by motorbike to places where there are no paved roads.
Despite these challenges, there has been high uptake rate and an estimated 98% of those eligible were vaccinated.
What is Ebola?
Co-ordinated attempt
Health visitors travelling by motorbike through a remote area of DRC for a follow-up meeting with a contact
While the vaccination may have helped to save lives, better public health measures also played a crucial role in containing the outbreak.
Treatment centres and isolation zones were set up to reduce the spread of the virus and face-masks, gowns and gloves were used.
Safe burial practices also helped to limit transmission of the virus, as did screening of passengers at international and domestic ports and airports.
There has also been work to reintegrate survivors with their community because in former outbreaks survivors were sometimes ostracised by their families and neighbours.
Lessons for the future
In the three months since the outbreak began, more than 3,000 people in the region have been vaccinated.
As a result of its use - and the other precautionary measures - the epidemic is likely to end quicker than might have been expected.
But unfortunately this isn't the end of the road for Ebola, as we know it is a disease that will continue to appear in future.
Two years after it was first tested, the vaccine still works, but we don't yet know how long-lasting the protection will be.
More than one Ebola vaccine is needed, so we're not reliant on just one manufacturer.
It would also be helpful to have options for different situations - such as a single shot vaccine for quick protection and booster vaccines when there isn't an outbreak.
Researchers need to find out more about what works and why, so more lives can be saved.
To do that, we need to stop thinking of these outbreaks as isolated events - introducing a long-term programme of research and response into every Ebola outbreak.
And while Ebola is high profile, we also need to remember it isn't the only disease that could lead to an epidemic.
It's impossible to predict what the next epidemic will be, but we can be better prepared.
At-risk countries need tools and support to strengthen their health systems and monitor disease, so that they are ready before an outbreak and can save as many lives as possible.
Dr Josie Golding is the Epidemic Preparedness & Response Lead at the Wellcome Trust, a global charitable health foundation. Follow her at @BeakerH
Epidemic In New Orleans
In 1905 the final yellow fever epidemic in the United States took place in New Orleans, the city that had seen some of the nation's worst outbreaks. Though the danger of mosquitoes transmitting the disease had been established in 1900, five years later the city was still unprepared.
A Deadly BreachAt the time, New Orleans continued to operate a quarantine system, fumigating ships and sanitizing clothing and bedding on board. In the spring, a smuggler's ship loaded with bananas avoided the quarantine. In June cases of yellow fever began appearing near the Mississippi River in an Italian immigrant community, many of whom unloaded banana boats from Central America. The city declared an emergency on June 22, after 100 people had contracted the disease, including 20 who died.
Breeding GroundDespite the conclusions of the U.S. Army Yellow Fever Board in 1900, many people in New Orleans still did not take the threat of mosquitoes seriously. Residents got their water from wooden cisterns, a breeding ground for the insects. Dr. Quitman Kohnke, the head of the New Orleans health board, beseeched the city to address the mosquito issue. "Even if you are not positive that the mosquito is the only source of the transmission of yellow fever," he told physicians, "give your city the benefit of the doubt in this important and vital matter." After the outbreak began, New Orleans finally mobilized.
Attacking the MosquitoOn August 4, local officials asked for federal assistance, and President Theodore Roosevelt assigned Walter Wyman, the surgeon general of the U.S. Public Health and Marine Hospital Service, to the public health campaign. Workers employed the techniques that had recently proved successful in Havana, another frequent location of yellow fever. They fumigated the city, screened cisterns and destroyed breeding grounds for mosquitoes. Fines were instituted against residents who failed to comply with public health measures. After Archbishop Placide Louis Chapelle died from yellow fever, holy water in St. Louis Cathedral was found with mosquito larvae. The priests emptied the containers. Still, the epidemic was not immediately stopped.
The Last ThroesOn August 12, 100 people fell ill from the disease. Yet by September the numbers of victims diminished. Further evidence that mosquitoes transmitted the disease surfaced at Charity Hospital, which reported that no other patients or medical personnel became infected from the approximately 100 cases of yellow fever treated there. The public health campaign to address yellow fever was working in a city that fewer than 30 years before had lost thousands to the disease. October would mark the end of the epidemic, with 452 deaths recorded in New Orleans. The year would also mark the last time a yellow fever epidemic plagued the United States, though the disease remains a problem elsewhere in the world.
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