Roseola, also known as Sixth Disease or roseola infantum, is a common viral illness that primarily affects young children. This mild infection typically resolves on its own without specific medical treatment, with most children experiencing it by the age of two years.
Recognizing Roseola
Roseola often begins with a sudden, high fever, frequently reaching between 103°F (39.4°C) and 105°F (40.6°C). This initial fever phase usually lasts for three to five days. Despite the elevated temperature, children with roseola might appear relatively active and well. Some children may also experience additional symptoms like a sore throat, runny nose, mild cough, swollen eyelids, or swollen lymph nodes in the neck.
The fever then abruptly disappears. Shortly after the fever breaks, a distinctive rash typically emerges, though some children may have a high fever without developing a rash. This rash consists of small, pink, flat, or slightly raised spots. It commonly starts on the chest, back, and belly, then spreads to the neck, arms, and sometimes the face and legs. The rash is generally not itchy or painful and usually fades within hours to a few days.
Supporting Your Child During Roseola
Managing a child with roseola focuses on keeping them comfortable as the illness runs its course. Fever-reducing medications like acetaminophen or ibuprofen can help alleviate discomfort. It is important to administer the correct dosage based on the child’s weight, not age, and to consult with a pediatrician for guidance. Aspirin should not be given to children under 18 years old due to the risk of Reye’s syndrome.
Ensuring adequate hydration is important, especially with a high fever. Encourage the child to drink plenty of fluids such as water, breast milk, formula, or oral rehydration solutions. Allowing the child ample rest is also beneficial during their recovery. While the rash is typically not itchy, dressing the child in light clothing can promote comfort. It is important to remember that roseola is a viral infection, so antibiotics are not effective.
When Medical Help is Needed
While roseola is generally a mild illness that resolves on its own, certain signs indicate the need for medical attention. Contact a healthcare provider if the fever persists for more than five days, or if it returns after the rash has appeared. A fever that does not respond to fever-reducing medication also warrants a call to the doctor.
Signs of dehydration, such as decreased urination, a dry mouth, or a lack of tears, require prompt medical evaluation. Although frightening, a febrile seizure (convulsions due to a rapid rise in temperature) can occur in about 10% to 15% of children with roseola. If a child experiences a seizure, place them on their side and do not attempt to restrain them; seek immediate emergency care, especially if it is their first seizure. Other concerning symptoms that necessitate medical help include extreme lethargy, irritability, unresponsiveness, difficulty breathing, or a rash that appears blistered, is painful, or does not fade when pressed.