Among the rather harmless viral infections is the children’s disease three-day fever. Mostly infants between six months and three years infect other children with this disease. Typical signs are high fever, skin rash and possibly febrile convulsions. An examination by a pediatrician is advisable.
What is three-day fever?
Three-day fever (exanthema subitum, roseola infantum, or sixth disease) is an acute, but predominantly harmless, viral infection. Preferentially, pediatric three-day fever occurs in infants from 6 months of age to 3 years of age. The main season for three-day fever is spring and autumn. Children ill with three-day fever suffer from a sudden high rise in fever. For the most part, there are no other symptoms of illness. The fever lasts 3 to 5 days and then drops abruptly. Afterwards, the skin rash typical of three-day fever develops. Often, only then can a definite diagnosis be made. After the disease, there is lifelong immune protection against three-day fever.
Causes
Two different human herpes pathogens are considered to be the causes of the disease three-day fever. Predominantly, herpes virus 6 (HHV-6) and only rarely herpes virus 7 (HHV-7) trigger three-day fever. The viral infection three-day fever is spread by a so-called droplet infection. The viruses are transmitted when coughing, sneezing or talking. However, using the same drinking vessel or cutlery can also cause infection. The viruses remain in the body for the rest of the person’s life after they have lived through three-day fever and are sometimes excreted in saliva. Thus, healthy individuals can then infect children. The incubation period, the time from infection to the onset of the disease, is about 3 to 15 days. Three-day fever is highly contagious. As a result, almost all children of kindergarten age have already experienced three-day fever.
Symptoms, complaints, and signs
Three-day fever typically causes a sudden rise in temperature from 39 to 41 degrees Celsius. The temperature rise occurs without apparent cause and persists for three to five days. After the fever has subsided, other symptoms appear. In one quarter of those affected, a blotchy bright red rash appears over the entire body. It is particularly intense on the torso, chest and neck. The small spots, which usually occur in groups, may combine to form large patches and eventually spread to the arms and legs. Often, the rash disappears on its own after hours or a day or two. Subsequently, or accompanying the skin changes, a number of other symptoms and complaints may occur. Many sufferers complain of eyelid swelling or vision problems. Coughing and shortness of breath may occur, as well as swollen throat lymph nodes. Intestinal inflammation also occurs in many cases. In one-third of cases, the disease causes a severe febrile convulsion in which the affected person becomes unconscious and cramps his or her arms and legs. The convulsion subsides after a few minutes. In infants, three-day fever is noticeable by a bulging fontanel, among other symptoms.
Course
For the most part, the illness of three-day fever begins violently. A rapid, high rise in temperature, not infrequently to as high as 41° body temperature, is characteristic of three-day fever. The fever lasts for about 3 to 5 days. After surviving three-day fever, the temperature suddenly drops. The rash typical of three-day fever develops. This small-spotted, rubella-like rash (exanthema) is often associated with itching. It mainly affects the chest, back and abdomen. With the appearance of the exanthema, the sufferer is no longer considered contagious. Rarely, complications of three-day fever occur. These then consist of vomiting and diarrhea, cough, inflammation of the middle ear, swollen eyes and cervical lymph nodes, and poplars on the palate and uvula. Any sequelae are not to be feared in three-day fever. In some children, however, fever and the typical rash are absent, and in this case three-day fever passes unnoticed.
Complications
Three-day fever is a common illness with which almost all children come into contact. It is harmless in most cases and does not lead to further complications. It usually involves severe fever and vomiting.The skin may also be reddened, usually there is a strong cough. In severe cases, inflammation of the tonsils or middle ear may occur. Three-day fever lasts about a week and does not lead to any particular complications if treated by a doctor. Treatment usually takes place with the help of medications. Even after the three-day fever has healed, red spots may appear on the skin. These are harmless and disappear after a few days. In the worst case, three-day fever can cause inflammation in the brain. If three-day fever occurs after an organ transplant, it can lead to a life-threatening condition. In this case, surgical interventions are often necessary. Mild medications and a healthy diet also speed up the healing of the disease. However, children should still see a doctor to avoid secondary damage.
When should you go to the doctor?
Although three-day fever is usually a harmless disease, a doctor should still be consulted. This can also significantly speed up the child’s recovery and prevent other complications. The doctor should be consulted if the child suffers from fever and also rash. The rash itself can occur in different regions of the body and cause unpleasant discomfort. Likewise, if the child’s temperature becomes very high, a doctor must be consulted. This can reach up to 41 degrees in three-day fever. To prevent scarring or bleeding, the child must not itch. In this case, treatment by a doctor is also useful to relieve the itching. Furthermore, in addition to visiting the doctor, the child should not be brought into contact with other children so as not to infect them. Further treatment is necessary if the child with three-day fever also suffers from earache, as this can often cause a middle ear infection to develop. The patient’s life expectancy is usually not affected by three-day fever.
Treatment and therapy
Three-day fever largely heals without treatment. Drug treatment is used only to relieve symptoms. Antipyretic agents, such as acetaminophen, are suitable for this purpose. Depending on the age of the child, these are administered as drops, syrup or suppositories. Alternatively, fever-reducing calf compresses can be applied. Due to the high body temperature in three-day fever, more fluid evaporates through the skin. Therefore, it is important that young patients drink enough to compensate for fluid loss. Light, non-warming clothing prevents heat accumulation. Particularly due to the rapid rise in body temperature during three-day fever, some children are prone to febrile convulsions. In this case, the fever level must be closely monitored. In this case, it is especially important not to let the body temperature rise too high. If a febrile convulsion occurs, care must be taken to ensure that the child cannot injure himself or herself and that breathing is not impeded. In this case, a doctor will decide on the prescription of anticonvulsants. No vaccine has been developed against three-day fever.
Outlook and prognosis
Three-day fever has a favorable prognosis. Normally, relief of symptoms occurs within a few days. Following the name of the disease, a cure occurs after only three days. The sick children suffer very suddenly from the typical symptoms of three-day fever. Recovery is equally rapid until freedom from symptoms is achieved. Consequential damage is not to be expected with this childhood disease. Drug treatment is often not required, since it does not change the favorable course of the disease. The prognosis deteriorates as soon as complications arise. In the most unfavorable case, a febrile convulsion sets in. This leads to dehydration of the organism if fluid intake is insufficient. Dehydration represents a life-threatening condition for the child that must be treated as quickly as possible. Febrile convulsions should be treated by administering medication to help the fever resolve quickly. The healing process can be shortened with a healthy and balanced diet. In addition, rest and relaxation help. Stress, hectic and restlessness are to be avoided during the illness so that no other influencing factors exert a negative influence. Some children develop inflammatory diseases.These do not alter the prognosis of three-day fever, but they do delay the otherwise very rapid recovery.
Follow-up
Follow-up care generally aims to prevent the recurrence of disease and to stop complications as a result. However, physicians cannot pursue this objective in the case of three-day fever. After a single infection, immunity is established. This means that people cannot repeatedly suffer from the typical symptoms. This protection extends for the rest of the person’s life. Since it is mainly children who contract three-day fever, they need not fear any symptoms as they grow older. In addition, doctors want to support patients in their daily lives through scheduled examinations. Aids such as therapies and medications are provided for this purpose. This point also shows that follow-up care is unnecessary. On the one hand, this is because three-day fever has subsided after three to four days. Then the patient is also no longer considered contagious. On the other hand, the symptoms often take such a mild course that they are not even noticeable. After a three-day fever, there is therefore no need for any conceivable follow-up examinations. Children have to live through the viral disease once. To date, there is no vaccine against infection. If a sudden febrile condition occurs, parents should definitely keep their children at home. They will otherwise infect peers.
Here’s what you can do yourself
Three-day fever can weaken children, but it is basically non-threatening, assuming a normal course of fever. In the context of self-help, therefore, everything is favorable that somewhat alleviates the weakness caused by the fever and helps the body to regenerate. On the one hand, parents should pay attention to sufficient fluid intake. Fever, which lasts for several days, is hard work for the body, which is supported with sufficient fluids. This also protects against the threat of dehydration, which would make a stay in hospital necessary. On the other hand, physical rest is to be ensured when children are plagued by three-day fever. The circulation is stressed by the fever. Self-help for the body is thus everything that spares it during this phase or at least prevents further unnecessary stress. Parents can make sure that the child gets enough rest. Bed rest is not absolutely necessary if the child feels as well as possible. However, care should be taken to ensure regular phases of rest and relaxation. Physical exertion such as sports should be avoided in cases of three-day fever. Three-day fever cannot always be clearly diagnosed. In the case of unclear course of fever and other in the case of added symptoms, parents should not try to wait in the context of self-help without diagnosis, but better promptly present the child to the doctor.