Roseola is a viral infection, typically mild, that can show up in young children. It's caused by a strain of the human herpes virus but is not an STD. The illness can be very contagious and is often spread from child to child through a sneeze, a cough, or saliva. Parents who teach their kids to wash up after using the bathroom have the best chance of keeping roseola (and many other viral infections) away.
Possible symptoms include a rapidly rising fever that can reach 103 degrees or higher and last three to five days, a sore throat, runny nose, and cough. Once these symptoms subside, the illness leads to the development of a rash. "The rash can vary in appearance and typically fades within 24 to 48 hours, but can last up to a week," says Rana Khaznadar, M.D., assistant professor in the general pediatrics division at the University of Tennessee Health Sciences Center and LeBonheur Children's Hospital in Memphis. The rash targets the chest, back, and belly first and then can spread to the face, arms, and legs. It can be flat to slightly bumpy, red, and have a patchy or spotted appearance, says Dr. Khaznadar. The red areas blanch, meaning they temporarily lose their redness when you press on them.
Roseola can be tricky to spot, depending on the age of your child. It's more prevalent in kids under 2 years, and young children are more likely to have the full range of symptoms, explains Dr. Khaznadar. If your child is older than 2, roseola might simply show up as a cold. "An older child's immune system can react to viruses differently," says Dr. Khaznadar. "[An older kid] could acquire the roseola infection and you'd never know it because [his] immune system is more mature than an infant's."
A rare symptom--brought on by a rapid rise or fall of body temperature--is a febrile seizure. "Febrile seizures rarely harm the child," says Dr. Khaznadar. "But if your child has a seizure, you should always go to the emergency department." A doctor will want to examine your child for a seizure disorder or serious infection, such as meningitis.
Treating the Symptoms
"Although roseola is benign, if your child has an extremely elevated temperature and appears ill, you should still see your doctor," says Dr. Khaznadar. "It could be some other condition; the roseola diagnosis cannot be made until the fever has gone away and the rash has appeared." If it is roseola, the doctor will not prescribe antibiotics because the infection is viral. Your best bet is to focus on treating the symptoms. For the fever, acetaminophen and ibuprofen can help. (Just be sure to confirm dosage with your pediatrician if your child is less than 1 year old.) You don't need any cream for the rash, since it doesn't itch. "But make sure your child is getting plenty of fluids and is urinating regularly," says Dr. Khaznadar. If you're concerned about dehydration, or lack of energy or appetite, it's time to head back to your pediatrician. Any child exhibiting symptoms that last longer than five days should get checked out again. Keep your child out of day care or school while she has a fever and runny nose or congestion.
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