Roseola: A viral illness that causes fever, rash

Fever is always a frightening symptom in a young baby. Babies can get fever at the start of a cold, or fever can be a sign of a more serious illness such as a urinary tract infection. When your baby has a fever, it is usually a good idea to check in with your pediatrician.

There are many viruses that young children get that cause fever. Often we do not know which virus is striking, since we do not usually do viral cultures when children get ill. Viral cultures are uncomfortable for babies (probes in the nose), expensive, and inconvenient (many times the cultures are done at the hospital rather than in doctors' offices). We do try to decide if the illness is viral or bacterial, based on how the child looks, what the history of the illness is, and what the physical exam shows. This information helps us decide how to treat the illness. For example, antibiotics only work on illnesses caused by bacteria.

There is an illness caused by a herpes virus (#6) that is characterized by a distinct progression of symptoms. Usually, the illness, known as Roseola, strikes infants and toddlers and is characterized by high fever for several days with no other symptoms except fussiness. The fever breaks after several days and a fine red rash spreads over the entire trunk of the child. The rash can last one to two days and the baby may continue to be very irritable. Once the rash disappears, the illness is over and the fussiness disappears.

Treatment for Roseola is fever management with ibuprofen or acetaminophen and lukewarm baths. There is no treatment for the rash. The rash is usually not itchy, but you can always apply moisturizer if the rash is dry. It is important that the child gets lots of fluids since a fever causes him to lose extra fluid. Eating solids is not as important, as children can go for several days without eating as long as they stay well hydrated. If the fever returns after the rash, it is most likely that the illness is not roseola, and your doctor should be notified. Diagnosing roseola is challenging because we can not know what the illness is until the rash appears.

Roseola is contagious, and it is helpful to other parents if you let the child's contacts know what he has.

Has your baby or toddler had Roseola? What were the symptoms? How long did the fussiness last?

Dr. Victoria McEvoy graduated from Harvard Medical School in 1975 and is currently an Assistant Professor of Pediatrics at HMS. She is the Medical Director and Chief of Pediatrics at Mass General West Medical Group. She has practiced pediatrics for almost thirty years. She has been married to Earl for thirty six years and raised four children. She currently enjoys writing, traveling, reading, almost all sports, and spending time with her two grandsons.

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