Roseola (Sixth Disease) In Pregnancy: Safety And How To Treat It

Roseola, known as roseola infantum, exanthema subitum, or sixth disease, is a viral infection caused by human herpesvirus 6 (HHV-6, particularly subtype B) and less often by human herpesvirus 7 (HHV-7). This post talks about the symptoms of roseola in pregnancy, its risks, and prevention.

Infections mostly occur in infants below two years of age and rarely in adults (1). The infection resolves, but the virus may stay latent in the body. The body’s immune status changes during pregnancy, making it infection-prone. Reactivation of latent virus or a new exposure from an infected person during pregnancy may cause roseola.

Can Pregnant Women Get Roseola?

There are only a few reports of roseola infections in pregnant women in the scientific literature, showing that it is not a very common infection during pregnancy (2).

Roseola in pregnancy was first mentioned in a case report in the year 1992 (3). Subsequently, in 1999, a study reported cases of reactivation of latent roseola virus during pregnancy where the risk of transfer of maternal infection to the fetus was estimated to be one percent (4).

As roseola is a common childhood infection, most adults already have antibodies against it. Thus, most pregnant women have HHV-6 and HHV-7 antibodies, which may be transferred to the fetus, protecting the newborn for some time (5).

Can Roseola During Pregnancy Harm The Fetus?

Roseola is most likely to be harmless for your baby. Since roseola infection is rare during pregnancy, there is insufficient data to conclude its effects on the growing fetus. Most experts consider it harmless, while few isolated reports of adverse effects on fetal health have been reported (2). First infection or reinfection with HHV-6 in the first trimester of pregnancy may cause spontaneous abortion. A study on women who had miscarried between six to 12 weeks of gestation revealed an association with roseola infection (6). Another study investigated 73 cases of fetal death and found two to be due to HHV-6 infection (7).

There is evidence that the HHV-6 virus may get integrated with human chromosomes (chromosomally integrated or ciHHV-6) and become a hereditary infection. Latent infections often reactivate when immunity is compromised due to conditions such as AIDs (acquired immunodeficiency syndrome), cancer treatment, or bone marrow or organ transplant (8). The infection may be transmitted to the baby during childbirth or via the placenta. A study on 57 newborns with congenital (presence of disease at birth) HHV-6 infection showed the infection might have detrimental effects on neurodevelopment by the time they reach 12 months of age (9).

HHV-6 meningitis (inflammation of the membranes surrounding the brain) was reported in a premature infant with multiple congenital anomalies. Other complications in newborns with congenital infection with HHV-6 may include fever with seizures, liver disease (hepatitis), and spleen and heart inflammation. However, no transmission has been reported via breast milk (8).

What Are The Symptoms Of Roseola Infection?

Roseola virus may spread via droplets of respiratory secretions from cough or sneeze or traces of saliva from an infected person found on contaminated surfaces. Symptoms usually begin four to ten days after exposure and may include the following (10).

• Fever that lasts for three to five days
• Swollen eyelids
• Sore throat with swollen glands such as the tonsils
• A raised red rash (as fever starts to subside) appears on the trunk and neck and spreads to the face, arms, and legs
• Rash may last up to two days or may not appear at all

How To Treat And Prevent Roseola Infection During Pregnancy?

There is no specific treatment for roseola infections. If you have fever or rash during pregnancy, you should immediately consult a doctor and get diagnosed. Medications may be used for supportive therapy, such as antipyretics for fever. A vast majority of the cases are mild and self-limiting (get resolved on their own) and can be managed with rest and by taking plenty of fluids. The rashes do not form pus and do not require treatment (1).

Roseola is contagious, and there is no vaccine to prevent it. However, you can protect yourself from the infection by adopting the following measures.

• Do not come in close contact with people with symptoms of common cold and fever.
• Take precautions, such as washing your hands frequently, if a child you are caring for has a fever. Remember that roseola infection may or may not produce the classical rash.
• Avoid sharing food or drinks with multiple people.

Roseola infection is unlikely but not impossible during pregnancy and has shown very low fetal risk. However, you should communicate any incidence of fever or rash to your doctor to rule out serious infections and not self-medicate with OTC products. Timely diagnosis could help initiate appropriate interventions, preventing any undesired effects on you or your growing baby.

References

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Reviewer

Dr. Indira VijayakrishnanMBBS, DGO, MRCOG

   

Dr. Indira Vijayakrishnan is a consultant Ob/Gyn at Amar Maternity and Fertility Centre in Attingal, Kerala with over 10 years of experience. She is in charge of the Amar Centre for Advanced Reproduction.An expert in obstetric sonology, Dr.

Read full bio of Dr. Indira Vijayakrishnan