Classic Childhood Infectious Rashes
Transmission of and Immunization against Viral Exanthems
An infection that causes the skin to erupt in a rash covering most of the body is called an exanthem. Historically, childhood examthems were all lumped together as one disease. Then early physicians made the distinction between measles and pox. As medical knowledge progressed, more childhood rashes were singled out; resulting in a kind of ‘rash by number system’.
Classic Childhood Infectious Rashes
Initially six distinct childhood exanthems were identified from what was once called the “measles.” As identified, each of these became known by number. Measles and scarlet fever were the first two to be separated. Rubella (German measles) was then identified and called “third disease”; atypical scarlet fever was “fourth disease”; erythema infectiosum “fifth disease,” and roseola “sixth disease.” Scarlet fever and atypical scarlet fever are Streptococcal bacterial infectious diseases. The others listed are viral.
Today, there are many recognized exanthems. This article series covers some of the virus mediated rashes most commonly encountered during childhood; those caused by DNA viruses (chickenpox, erythemia infectiosum, roseola) and those caused by RNA viruses (rubella and rubeola).
Transmission and Prevention of Exanthems
Chickenpox
Caused by the Varicella zoster virus, this exanthema is extremely contagious, and can be spread by direct contact, droplet transmission, and airborne transmission. Once a person contracts the virus, the viral genetic material is permanently integrated into the DNA of infected human cells, and can later reemerge as shingles if the immune system is stressed or suppressed.
Nearly 100% effective against moderate to severe infection, and up to 90% effective against mild chickenpox, the variclla vaccine is recommended in two donses. It is recommended that receive their first inoculation between 12 – 18 months of age and then again between ages 4 and 6. All adults without evidence of immunity to varicella also need the vaccine, administered as two doses.
Erythemia infectiosum
Also known as Fifth’s disease, this viral exanthem is spread by contact with respiratory secretions. There are no vaccines currently available, and no treatment is usually required for infected children other than medication to control fever and possible joint pain.
Rubella
Commonly called German measles, this RNA virus is spread through the air or by close contact. This Togavirus can also be transmitted from infected mother to fetus. If this occurs within the first 20 weeks of pregnancy, the child may be born with congenital rubella syndrome, which manifests as a range of birth defects.
Rubella and rubeola vaccines are typically given as part of the MMR vaccine, which protects against measles, mumps, and rubella (German measles) or the more recent MMRV vaccine (MMR plus varicella (chickenpox) vaccine.
Rubeola
Measles virus is spread by contact with respiratory droplets from the nose, mouth, or throat of an infected person. As, indicated above, the MMR and MMRV vaccinations protect against this viral infection. Vaccination is recommended between 12 and 18 months of age and again between ages 4 and 6.
Roseola
The human herpesviruses (HHV-6 and HHV-7) that cause roseola infantum can be spread through fecal-oral contact or airborne droplets. Careful hand washing is the one of the simplest methods for preventing infection with Roseolavirus.
Other than a high fever, children infected with this virus do not usually become seriously ill. Thus, there has been no vaccine developed to prevent roseola.
This article is for informational purposes only and is not meant to be used for the diagnosis or treatment of infectious disease. If you or your loved ones are sick, please see a doctor, not a computer.
Sources
The Immunization Schedule page of the CDCs website provides many printable files of child and adults immunization schedules.
National Library of Medicine, Medline Plus
Bauman, R. (2005) Microbiology. Pearson Banjamin Cummings.
Park Talaro, K. (2008) Foundations in Microbiology. McGraw-Hill.
