The sixth disease in children

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Catherine Le Nevez
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Fonte: shutterstock

The sixth disease

La sixth disease is a infectious disease which usually occurs in the children between 6 months and 2 years of age, of mild intensity and short duration, and generally without significant complications.

According to one of the latest proposed classifications, published in the journal Future Microbiology in 2022, the classics childhood rashes there are six:

  1. scarlet fever (bacterial),
  2. measles,
  3. rubella,
  4. chickenpox,
  5. megaloeritema o infectious erythema (the so-called fifth disease)
  6. critical rash (the sixth disease).

To these six classic diseases we can also add another one, which is syndrome hands-feet-mouth, also of viral origin.

In this article, we learn to recognize the symptoms e how the sixth disease is treated.


Sixth disease: photos to recognize it

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The sixth disease, common among children between six months and three years, is infectious and is caused by a virus. It begins abruptly with a high fever (39-40 ° C). It lasts three ...

Read also: Exanthematous diseases, symptoms and treatments

In this article

  • What is the sixth disease
  • The incubation period of the sixth disease
  • Symptoms of the sixth disease
  • How is the sixth disease treated?

What is the sixth disease

It's a exanthematous disease of viral origin that affects young children, usually between 6 months and 2 years. It often occurs in spring and autumn and in 90% of cases it affects children under the age of two.

It is also called critical rash because it occurs after the rapid onset of fever or exantema subitum. Subitum in Latin means rapid, in fact the rash changes rapidly.

Other names she is known for:

  • roseola,
  • roseola babes
  • critical rash,
  • sudden death
  • o three-day fever.

It is of viral origin so it is not treated with antibiotics. There is no vaccine for sixth disease.

What causes it

The sixth disease is caused by human herpes virus 6 (HHV-6) or, less frequently, by HHV-6.

How it is transmitted

The sixth disease is transmitted by contact with mucus or saliva of those who are infected or by air, with droplets emitted by coughing, sneezing or just talking.

It is most contagious during the febrile phase. 

The best way to prevent it is to wash your baby's hands well.

The incubation period of the sixth disease

The incubation lasts from 8 to 14 days and usually the disease is not repeatable.


Exanthematous diseases (PHOTO)

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Exanthematous diseases: chicken pox, rubella, scarlet fever, fifth and sixth diseases: mainly affect children Red spots, itchy blisters, cough and sometimes even fever: these are ...

Symptoms of the sixth disease


  • high fever (even up to 40 ° C)
  • sore throat
  • cough
  • a runny nose
  • lack of appetite
  • Diarrhea
  • flat pink rash (with fever gone)

In many cases the disease is asymptomatic. In cases where symptoms occur, these are characterized by an initial phase with high fever, which can last up to four or five days and then suddenly disappear.

There may also be a sore throat, cough, runny nose, loss of appetite and diarrhea. After a few days appears, when the fever has disappeared, a rash rosy and flat, similar to that of measles.

Spots (2 to 5 mm) fade to white when touched, and individual spots may have a slight "halo" around them. The rash it mainly spreads to the neck, face, arms and legs.

How long does it last

The rash lasts from a few hours to 1-2 days and is often not itchy.

Be careful not to confuse it with other diseases that cause rashes such as:

  • measles
  • scarlet fever
  • rubella
  • chickenpox
  • hands feet mouth

Answers to the most common questions from parents

Can adults get sixth disease from children?

Adults can rarely become infected. It is possible, but rare.

Should I put any cream on the baby's rash?

No, the rash will heal on its own.

How is the sixth disease treated?

The sixth disease does not require specific therapy. The pediatrician can prescribe antifebrili.

The sick child should still be kept at rest, and always well hydrated.

When to see your doctor

Here are the conditions in which it would be appropriate to consult your doctor

  • it is lethargic 
  • he does not drink
  • has no improvement in fever after 48 hours
  • has seizures lasting more than five minutes

Why is it called the sixth disease?

Before advances in microbiology, the exanthematous diseases they were believed to be six (that's why sixth disease).

The classic childhood rashes are:

  • measles
  • scarlet fever
  • rubella
  • fourth disease
  • fifth disease
  • sixth disease

Sources for this article:

National Health Service information material

NCBI, Roseola Infants (Sudden Rash, Sixth Disease), Tessa B. Mullins; Karthik Krishnamurthy.

The Royal children hospital, Melbourne

Questions and answers

How does the sixth disease manifest itself?

After a period of 8 - 14 days of incubation of the virus, the symptoms of the sixth disease begin with a high fever, which sometimes reaches 41 ° C, accompanied by sore throat, cold, conjunctivitis, vomiting, catarrhal phenomena, diarrhea, nausea , mood modulation, irritability and swelling of the pharynx.

How do you get the sixth disease?

The sixth disease is not particularly contagious and spreads through the drops of liquid from the nose and throat of infected people. These drops are expelled when the infected person talks, laughs, sneezes or coughs.

Can you go out with the sixth disease?

Better to keep the sick child at rest and always well hydrated.

Read also: Exanthematous diseases: the fifth disease

  • exanthematous diseases
  • infectious diseases
  • sixth disease symptoms
  • critical rash
  • 3-5 children years
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