Roseola is an acute disease of infants and young children that is characterized by high fever followed by a rash that appears on trunk, limbs, neck and face

Exanthem subitu orThe disease is common in children 6 months to 2 years old. It is caused by a virus, called human herpesvirus 6 (HHV-6). It occurs most often in the spring and fall. The incubation period is 5 to 15 days. A fever lasting 3 (sometimes up to 5) days generally preceds the appearance of the rash and may be as high as 105 degrees Fahrenheit. Febrile convulsions may occur when the fever is high, especially when it is on the way up. Roseola typically begins with a high fever that responds well to acetaminophen. When the temperature is down the infant or child may behave as if well. Between the 2nd and 4th day the fever falls dramatically and a rash appears (often as the fever falls) on the trunk and spreads to the limbs, neck, and face. The rash lasts from a few hours to a day.

   

 Rubella is an infectious disease transmitted by the rubella virus. The signs of the disease are: swelling of lymph nodes in the neck and a skin rash which first appears on the face and then rapidly spreads to other parts of the body. The complications of rubella include encephalitis and joint pain. Infection with rubella during pregnancy can cause serious damage to the child, including cataracts, deafness, heart defects and mental retardation. There is no drug therapy for rubella. However, the disease can be prevented by immunization.

Three day measles; German measles or

The disease is caused by a virus that is spread through the air or by close contact. It can also be transmitted to a fetus by a mother with an active infection. The disease is usually mild and may even go unnoticed. Children may have few symptoms, but adults may experience a prodrome (warning symptom) of a fever, headache, malaise, runny nose, and inflamed eyes that lasts from 1 to 5 days before the rash appears. A person can transmit the disease from 1 week before the onset of the rash until 1 week after the rash disappears. The disease is not as contagious as rubeola (measles), therefore many people are not infected during childhood. Lifelong immunity to the disease follows infection. Epidemics may occur at about 6- to 9-year intervals. The risk factors are the unimmunized individuals.

The disease is potentially serious because of the ability to produce defects in a developing fetus if the mother is infected during early pregnancy. As many as 10 to 15% of women in their childbearing years are susceptible to infection. Congenital rubella syndrome occurs in 25% or more of infants born to women who acquired rubella during the first trimester ofpregnancy. Defects are rare if the infection occurs after the 20th week of pregnancy. One or more defects may occur in an infected fetus and include deafness, cataracts,microcephaaly,mental retardation,congenital heart defects and other defects. A miscarriage or stillbirth may occur. Risk factors include lack of immunization and exposure to an active case of rubella.

Rubella syndrome, or congenital rubella, is a group of physical abnormalities that have developed in an infant as a result of maternal infection and subsequent fetal infection with rubella virus. It is characterized by rash at birth, low birth weight, small head size, heart abnormalities, visual problems and bulging fontanelle.

Measles is an infectious disease transmitted by the measles virus. The signs of the disease are: fever, bronchitis, conjunctivitis and a skin rash which initially appears in the mucous membranes inside the cheeks and can later spread to the entire body. Complications of measles include: middle ear infection, pneumonia, encephalitis and appendicitis. There is no drug therapy for measles. However, the disease can be prevented by immunization.

Rubeola, or measles, is caused by the paramyxovirus. The infection is spread by droplets from the nose, mouth or throat of an infected person. The incubation period is 10 to 14 days before symptoms generally appear. An immunity to the disease occurs after vaccination, after active infection, and passive immunity of an infant whose mother is immune lasts most of the first year of life. Before widespread immunization, measles was very common during childhood so that 90% of the population had been infected by age 20. Measles cases have dropped by 99% in the U.S. and Canada after widespread immunization. Susceptible individuals are young infants as the maternal antibody decreases, and those who refuse immunization. Teenagers and young adults who have not received a second immunization are also susceptible.

Measles outbreaks still occur in the United States, usually among groups that do not believe in immunizations or in areas where immunization levels have fallen below the critical level. It is a fairly serious childhood infection that is recognized by the rash), Koplik spots, red eyes and photophobia, and coughing.

Koplik spots are seen with measles. They are small, white spots (often on an reddened background) that occur on the inside of the cheeks early in the course of measles may appear as irregular red spots with a minute, bluish white center opposite molars 2 days before rash

Mumps is an infectious disease transmitted by the mumps virus. The signs of the disease are: inflammation of the parotid (salivary) gland accompanied by a painful swelling below the ear. The complications of mumps include: inflammation of the testes and an elongated structure called the epididymis (possibly causing sterility in later life), meningitis and pancreatitis. There is no drug therapy for mumps. However, the disease can be prevented by immunization.

Children between the ages of 2 and 12 are most commonly infected, but the infection can occur in other age groups. The incubation period is usually 12 to 24 days.

VACCINE INFORMATIONThe MMR vaccine is a "3-in-1" vaccine that protects against measles, mumps, and rubella. Although single antigen (individual) vaccines have been developed for each component of the MMR, they are not readily available and usually used only for very specific situations. An example of such a situation would be if an outbreak of either measles, mumps, or rubella was occurring in a specific community and public health officials deemed it necessary to immunize infants 6 to 12 months old. Single antigen vaccines might be used because they pose less risk to children younger than the recommended age of 12 months for the MMR. For children 12 months or older and adults, the risks of giving the single antigen vaccine are presumed to be the same as giving the MMR.

The first shot is recommended at 12-15 months. Because the first shot may not provide adequate lifetime immunity to some individuals, a second MMR is recommended prior to school entry at 4-6 years or prior to entry into junior high at 11-13 years. Some states require a second MMR at kindergarten entry

Chicken Pox or Varicella = A highly contagious, usually mild childhood disease caused by the Herpes virus varicella-zoster virus, which also causes herpes zoster (shingles)).

Chickenpox is a viral disease characterized by itching and a skin rash with fluid-filled blisters that burst and form crusts. The onset of the chickenpox rash may be preceded by a day of mild fever and general malaise. The rash begins with a few small reddish bumps (papules) that quickly fill with fluid to form small blisters (vesicles). The vesicles appear in "crops", small groupings, first on the trunk then spreading to the extremities, face and scalp over a period of two to four days. The rash may spread into the mouth and other internal parts of the body. The vesicles break and a light brown scab or crust forms over the top. This crust gradually darkens to a dark brown before it finally falls off, usually within two weeks of the onset of the illness. It is characteristic to have more than one type of rash at the same timeChickenpox seldom causes scarring, but when it does, the scars most often occur around the eyes and consist of a small depression. Chickenpox lesions can become infected, usually from scratching and most frequently with staphylococcus. These secondary infections may be severe enough to require hospitalization.

Rash ofchickenpox

Chickenpox is spread from person to person by repiratory droplets, or by contact with articles freshly soiled by discharge from the lesions. It is contagious two days before the onset of the rash until six days after the appearance of the first lesions, or until all of the lesions are crusted over. The incubation period is 10 to 21 days. There is universal susceptibility to the virus in those not previously infected. Most children have been infected with the virus by the age of 10. After infection, lifelong immunity against recurrent infection is usually present. However, a person with a history of chickenpox may develop shingles (herpes zoster) later in life.

Prevention    Varicella zoster immune globulin (VZIG) may modify the severity of the disease, or prevent the disease if given within 96 hours after exposure to the virus. In general, this is reserved for high-risk individuals because the disease usually is benign. High risk individuals are those with no past history of chickenpox and who have a condition (such as depressed immune system, chemotherapy, AIDS, leukemia, lymphoma or organ transplant) and have been exposed to chickenpox.

Varicella vaccine is recommended between the ages of 12 and 18 months. (see immunization schedule) If a teenager is not known to have had Chicken pox, then blood can be drawn to see if he or she is susceptable to the disease, and if so the vaccine should be administered. Varicella vaccine has become a recommended childhood vaccine.

Treatment    General measures to relieve itching associated with skin lesions include cool water soaks or compresses, and bathing with one cup of baking soda added to a bathtub of lukewarm water. Topical preparations such as nonprescription calamine lotion, antihistamines, or other lotions containing camphor, menthol or phenol may be helpful. Fingernails should be trimmed to prevent scratching, which may lead to a secondary infections. Infant’s hands may be covered with a soft cotton or flannel mitten to prevent scratching (the hand should never be restrained).

DO NOT USE ASPIRIN! To reduce fever, use acetaminophen instead of aspirin. Aspirin use during a viral illness, particularly chickenpox, has been associated with a risk of developing Reyes syndome. A sedative given at night may be prescribed for sleep. The prescription drug acyclovir has been approved by the FDA for use in treating the symptoms of chicken pox in people over 2 years old. Although acyclovir usually is reserved for teenagers, because the disease is more severe in that age group. The drug should help reduce the severity of chickenpox symptoms, especially in older children and teenagers if taken within 24 hours of the rash’s first appearance. It may also be prescribed in severe cases or in people who areimmpunosuppressed. An alternative antiviral agent is vidarabine.

Children should be kept home from school or day-care until all of the blisters have broken and scabbed over, and they feel well enough to participate in normal activities.

ComplicationsChickenpox is normally a mild disease. But it can be serious and lead to complications in these high—risk groups:

•Newborns and infants •Teenagers •Adults •Pregnant women •People whose immune systems are impaired by disease or suppressed by drugs

The most common complication from chickenpox is a bacterial infection of the skin. The next most common problems are pneumonia and encephalitis (inflammation of the brain), both of which can be very serious if not treated.

Chickenpox early on in pregnancy can result in birth defects such as limb deformities. The great threat to the baby, though, is when the mother develops chickenpox a week before birth. Then it can cause a serious, life—threatening infection in the newborn. A pregnant woman who's not immune to chickenpox and has prolonged exposure to a person with the disease should consult with her physician about the risk to herself and her unborn child.Anyone who has had chickenpox as a child is at risk for a latent complication called shingles. After an infection some of the varicella—zoster virus may remain and hide in nerve cells. Many years later the virus can reactivate and resurface as shingles — a painful band of short—lived blisters. About one in five adults who've had chickenpox experience shingles, usually after age 50. Children can develop shingles but do so less often than adults. Rarely, a person with shingles can pass along the chickenpox virus to others who aren't immune.Shingles can lead to its own complication — a condition in which the pain of shingles persists long after the blisters disappear. This complication, called postherpetic neuralgia, is not contagious.

Complications   of Chicken pox •Women who acquire chickenpox early in pregnancy are at risk for congenital malformations in the fetus (rare). •Newborns are at risk for severe infection if their mothers are not immune. (They are considered one of the high risk group who should receive VZIG.) •Secondary infections of blisters (vesicles) with staphylococcus or streptococcus bacteria may occur. •Encephalitis occurs in less than 1 out of 1,000 cases and tends to occur late in the disease or one to two weeks after the skin lesions have healed. •Reyes Syndrome,pneumonia,myocarditis, and transient arthritishave also been reported as complications of chickenpox. •Cerebellar atazia may appear during the convalescent phase or later. Cerebellar ataxia is characterized by a very unsteady walk.

Fifth Disease or Parvovirus B19; Erythema infectiosum; Slapped cheek

Fifth disease is caused by the human parvovirus B19 agent. It occurs most often during the spring with localized outbreaks in preschoolers or school-age children and adolescents. It is spread by respiratory secretions and the duration of the illness is usually five days. However, the rash may recur for several weeks and may be brought on by exposure to sunlight, heat,exercise, fever, or emotional stress.

Erythema infectiosum usually begins with bright red cheeks producing a "slapped-cheek" appearance. Following this, a rash appears on the extremities and trunk. The rash fades centrally giving a lacy (reticulated) appearance to the rash. The rash fades over a period of 1-2 weeks. This illness is seldom associated with fever.

Parvovirus B19 is thought to cause other disease manifestations. In healthy adults it may be responsible for an infectious arthritis (particularly in women). In individuals with AIDS (or other immunocompromised persons) it may produce a profound anemia. This form of anemia is called 'transient aplastic crisis'.

The incidence of parvovirus B19 infection is unknown, but studies suggest that 40% to 50% of adults have antibodies to the virus. This indicates a high degree of infection, and also suggests that many infections go unnoticed.

Erythema infectiosum usually begins with bright red cheeks producing a "slapped-cheek" appearance. Following this, a rash appears on the extremities and trunk. The rash fades centrally giving a lacy (reticulated) appearance to the rash. The rash fades over a period of 1-2 weeks. This illness is seldom associated with fever.

Poliomyelitis is a disease transmitted by the polio virus and characterized by paralysis of the nerves in the spinal cord. The first signs of the disease include: fever, reddening of the throat, nausea, vomiting and headache. Later the patient may experience a sensation of "pins and needles" in the legs and even paralysis. In rare cases, the diaphragm is paralyzed and the patient cannot breathe unaided. There is no drug therapy against poliomyelitis; however, the disease can be prevented by immunization with polio vaccine.

Poliomyelitis is a communicable disease caused by viral infection and occurs through direct contact with infected secretions. Polio is found worldwide, but immunization has reduced the incidence. Clinical polio affects the central nervous system (brain and spinal cord). Disability is more common than death.

Diphtheria is an infectious disease transmitted by the diphtheria bacterium. The signs of the disease are: fever, reddening and swelling of the throat and tonsils with the formation of grayish-white exudates which bleed when scratched and cause a sweetish offensive breath. The complications of diphtheria include: inflammation of the cardiac muscle, difficulty in swallowing, and paralysis of the facial muscles, extremities and diaphragm - resulting, in severe cases, in cessation of breathing - and kidney damage. Diphtheria antitoxin may be injected to combat the toxin released by the diphtheria bacterium. The disease can be prevented by immunization

The disease may be mild and go unrecognized, or it may become progressive. If toxin enters the bloodstream the patient may develop inflammation of the heart muscle (myocarditis) which is the most commonly seen and most worrisome complication. Toxic effects on the nervous system may cause temporary paralysis

Symptoms   •Sore throat, which may range from mild to severe with painful swallowing, hoarseness. Drooling suggests that airway obstruction is about to occur. •Fever and chills. •Bloody, watery (serosanguineous) drainage from nose. •Croup-like (barking) cough. •Stridor, difficulty breathing or rapid breathing. Absent breathing (apnea) may occur. Bluish coloration of the skin may be caused by lack of oxygen. •Skin lesions can be seen in cutaneous diphtheria (usually seen in the tropics).

Note: In subclinical cases there may be no symptoms.

Pertussis or whooping cough is an infectious disease transmitted by the bacterium Bordetella pertussis. The signs of the disease are: coughing fits accompanied by a loud "whooping" sound as the child inhales, and vomiting. The complications of whooping cough include: pneumonia and brain damage caused by oxygen deficiency. The disease can be treated with antibiotics or prevented by immunization.

Whooping cough is one of those diseases most people think is history - but the dangerous germ that can leave sufferers gasping for air is making a comeback.The cough so strong it can break a rib once hit mostly babies and toddlers, but now it's striking more and more teen-agers and young adults. Apparently the whooping cough vaccinations Americans get as babies eventually can wear off.

So experts warn new parents to keep infants away from anyone who's coughing, even as scientists study whether millions of Americans should start getting booster doses of whooping cough vaccine just as many get regular tetanus shots

Tetanus is an infectious disease transmitted when the Clostridium tetani bacillus enters open wounds. The signs of the disease are: muscle spasms throughout the entire body, lockjaw, paralysis of the respiratory muscles and even cessation of respiration. A tetanus antitoxin can be injected against the toxin produced by the tetanus bacterium. The disease can be prevented by immunization.

Symptoms    Spasms and tightening of the jaw muscle (hence the name lockjaw)

•Stiffening of the neck & other muscles•Spasms of the neck and other muscles •Stiffness of the chest muscles •Stiffness of the abdominal muscles Spasms and stiffness of the back muscles, often causing arching (opisthotonos) •Tetanic seizures (painful, powerful bursts of muscle contractions) •Irritability •Fever

Scarlet fever is an infectious disease

transmitted by the Streptococcus bacterium. The signs of the disease are: high fever, reddening of the throat and tonsils, punctuate exudate on the tonsils, strawberry tongue and a skin rash which starts on the chest and rapidly spreads to the arms and legs. The complications of scarlet fever include: inflammation of the cardiac muscle, kidneys and middle ear. Scarlet fever can be treated with antibiotics.

Haemophilus influenzae Type b is a bacillus which can cause blood poisoning, throat infections with swelling of the larynx and meningitis in children. The infection caused by this bacillus can be treated with antibiotics or prevented by immunization.

This picture shows the organism Haemophilus influenza. Infections caused by Haemophilus influenza usually occur in children under 6 years old and are extremely serious. Haemophilus (type B) is responsible for meningitis, periorbital cellulitis, buccal cellulitis and epiglottitis, septic arthritis, osteomyelitis, pericarditis, and bacteremia. The small organisms live within cells (intracellular) as shown in this picture. (Courtesy of the Centers for Disease Control.)

Hepatitis A and B is an inflammation of the liver caused by the hepatitis A and hepatitis B viruses. Hepatitis A can be transmitted by infected food or water or by failure to observe hygienic precautions. Hepatitis B can only be transmitted directly by the blood, urine, feces, milk or semen of an infected individual. In both forms of the disease, several months may elapse between the time of infection and the first signs of the disease. The signs of the disease include: high fever (for hepatitis A), nausea, vomiting, abdominal pain, diarrhea or constipation, and jaundice of the skin or eyes. Hepatitis A is the milder form of the disease and usually lasts no longer than 3-4 weeks. Hepatitis B, in contrast, may become chronic and result in liver damage. A complete recovery is also possible with this form, however.There is no direct drug therapy for hepatitis. However, there are vaccines against both forms of the disease.