Roseola: What is It? What You Can Do If Your Child Has it

Right now, my 11-month old daughter has roseola. She is cranky, miserable, and sure that I can fix it. (But I can’t.)
Since I didn’t know roseola existed before my first baby got it, I thought I’d share what I’ve learned with new parents.

Roseola is a highly contagious childhood virus that most commonly affects children between 6 months and 3 years of age. It is sometimes referred to as sixth disease or roseola infantum. Roseola is most contagious during the fever period.
Unfortunately, this is also the time when most parents do not know their baby or child has roseola and so exposes other young children.

Roseola is characterized by 3-4 days (but up to a week) of a high fever, often over 103 Farenheit. The highest temperature I documented with my daughter was 103.5 rectally.

Generally, the child has no other symptoms during this time. Occasionally, the child may have experienced a slight upper respiratory illness prior to the fever. I noticed my baby had a runny nose for a few days prior to the fever. Other symptoms are crankiness, fussiness, loss of appetite and sleeping less. Since this is an age when many babies are teething, some of those symptoms are attributed initially to cutting teeth. In my baby’s case, she is cutting her one-year molars, so I brushed aside the crankiness, runny nose, and even the fever when it first appeared.

The biggest risk of roseola is febrile seizures. These are seizures brought on by the fast-rising fever that roseola brings. Some signs of a febrile seizure include:

– 2 or 3 minutes of jerking or twitching of the arms, legs or face
– unconsciousness
– losing control of bowels or bladder

Febrile seizures brought on by roseola are only thought to affect 10-15% of young children with this virus.

By the 2nd or 3rd day of these high fevers (or sooner) most parents are going to put in a call to their pediatrician’s office. The doctor will check ears and throat first. They will also take a little blood to check for elevated white count that would indicate an infection or bacterial illness. Most likely, the doctor will also request a urine sample since a UTI is also characterized by high fever with few other symptoms. If the child is too young to “give” a sample in a cup, a urine collection bag will be used.

Once strep, ear infection ,or UTI are ruled out and the white count is not elevated, you will hear something like “It appears to be a little virus. Treat the symptoms, keep the child comfortable. Call us if the fever lasts for 2 or 3 more days or if it gets higher.” I didn’t like hearing that the first time either. But a virus just needs to run its course.

You can give your baby or young child acetaminophen every 6-8 hours, and ibuprofen every 4 hours. Your doctor can help you determine the correct dosage. This will help lower the fever and keep your baby more comfortable.

The defining characteristic of roseola appears after the fever has dissipated. Usually this is within 3-4 days. It was on the 4th day with my daughter. You will notice a rash begin to appear on your child’s skin. On both of my children, the rash showed up first on their face, and spread to their neck, waist, diaper area and trunk. I didn’t notice any rash on arms or legs though it can appear there in many cases of roseola.

The rash is pinky-red blotches, similar in appearance to heat rash. The rash can either be raised or flat and sometimes individual spots have a lighter ring around them.

In my experience, though no doctor warned me of this, after the roseola rash appears is when the baby or child is the most fretful, uncomfortable, and difficult to soothe or console. Since roseola is a viral rash, I often wonder if it’s itchy. Neither of my children were at an age to verbalize their discomfort when they had the virus. But a nice, cool bath can help. Continue the acetaminophen and/or ibuprofen as directed by your doctor. I also call the doctor’s office to confirm the diagnosis of roseola so the illness will appear in the child’s chart.

After 3 or 4 days of the rash, it begins to diminish and your baby or child returns to their usual self. They may be a bit hungrier for a few days. After all, it’s hard to eat when running a high fever or covered in a rash. Both my girls were extra tired for a few days after the rash dissipated as well. It was just as hard to sleep with the high fever and rash of roseola. But a few days of catching up, and the baby or child usually shows no signs of having had roseola or sixth disease.

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