Roseola

My child has a spotty, pinkish-red rash on his stomach. Could it be roseola?

If your child recently had a fever and now has a spotty, raised or flat, rosy-pink rash, it could be roseola, also called roseola infantum or sixth disease.

Roseola is a fairly mild and common viral illness that usually affects children between 3 months and 4 years of age. It's caused by a herpes virus (though not the type that's sexually transmitted).

What are the symptoms of roseola?

It's possible for a child to have the virus without seeming ill, but roseola usually starts with a sudden, relatively high fever (between 102 and 105 degrees F). The fever typically lasts for three to seven days and may end abruptly, followed by the telltale rash.

The rash may last for days or only hours. It's pink and may have small flat spots or raised bumps. These spots may have a lighter "halo" around them and turn white if you press on them. The rash isn't itchy or uncomfortable, and contact with the rash doesn't spread the illness. It usually shows up on the trunk and neck but can extend to the arms, legs, and face.

© Scott Camazine / Science Source

Other symptoms of roseola can include:

• Irritability
• Sleepiness
• Mild diarrhea
• Poor appetite
• Swollen or droopy eyelids
• Runny nose
• Sore throat
• Cough
• Swollen lymph nodes in the neck or base of the skull

Some children may have a febrile seizure as their fever spikes early in the illness. If this happens, put your child on the bed or floor and turn his head to the side so any vomit or saliva can drain. Your child may become unconscious and jerk his arms, legs, or facial muscles for two or three minutes. He may also lose control of his bladder or bowels.

Although fever-induced seizures in young children can be frightening for parents to watch, they are seldom serious or harmful. But it is important to call your child's doctor as soon as possible after the seizure. Also, try to observe how long the seizure lasts, if possible, because the doctor will want to know.

Call 911 if the seizure does not stop after five minutes.

Should I call the doctor if I think my child has roseola?

Yes. It's a good idea to check with the doctor if your child has a fever and a rash. The doctor will ask about your child's symptoms and, depending on your child's age and symptoms, may want to examine her.

What's the treatment for roseola?

There's no specific treatment for roseola. Like most viral illnesses, it just needs to run its course. The most important thing you can do is make sure your child rests and gets plenty of liquids to avoid dehydration.

If your child is uncomfortable, the doctor may suggest giving him children's acetaminophen (or ibuprofen if your baby is at least 6 months old) to bring down the fever.

Another way to try to reduce your child's fever and make him more comfortable is by sponging him down with lukewarm (not cold) water or giving him a lukewarm bath. And instead of toweling him off, let him air-dry – the evaporation of water from the skin helps to bring down body temperature. Your child may shiver and feel cold while he's wet, but these can be effective ways to relieve the discomfort of the fever without using medicine.

Note: Never give a child aspirin. It can trigger Reye's syndrome, a rare but potentially fatal disorder.

Is roseola contagious?

Yes, and it spreads very easily among young children through saliva or respiratory droplets – like when an infected child sneezes or coughs, for example. It also spreads by fecal-oral contact, such as when an infected child doesn't wash her hands after going to the bathroom. Because a child is contagious before she has symptoms, there's often no way to avoid exposure.

Make sure all family members, especially those who take care of your child, wash their hands frequently. (This is an especially good idea in the fever stage because you don't know that you're dealing with roseola until you see the classic rash.)

To play it safe, keep your child home from daycare and school, and have her stay away from other people when she has a fever. After the fever has been gone for 24 hours, it's safe for your child to be around others, even if the roseola rash appears.

The good news: Once your child has had roseola, she'll probably have lifelong immunity to it.