Roseola is a common, but mild, infection that is caused by the herpes virus, specifically human herpes virus 6 and 7. This herpes virus that causes roseola is different from the one that causes genital herpes, although they are part of the same family of viruses. Roseola is spread from person to person by oral and respiratory sections. It is spread into the air when an infected person sneezes, talks, laughs, coughs, by sharing utensils or cups, or by touching someone who may have wiped their noses, coughed into their hands, touched their mouths or noses. Even if an infected person is not showing signs or symptoms of roseola, they can still transmit the virus from person to person. Roseola is most often seen in children aged 6 months to 3 years.

What are the signs and symptoms of roseola?

Once your child comes into contact with someone infected with roseola, it takes about a week or more for them to start to show signs of the infection. Some children may not show any symptoms at all. Below are some of the signs and symptoms that your child may show:

• Fever – This is usually the first sign of roseola, a sudden high fever greater than 40⁰C (104⁰F), which lasts about 3-5 days.
• Rash – This usually begins after the fever begins to subside. The rash looks like many small pink spots or patches. They can be flat or slightly raised, but do not itch. The rash begins on the torso (chest, abdomen, back) and then spreads to the face, and extremities (arms & legs). The rash lasts about 4-5 days.

Although less common, your child may also experience:

• Sore throat
• Runny nose
• Cough
• Swollen lymph nodes
• Swollen eyes
• Swollen fontanelle (soft spot) in infants
• Fatigue
• Irritability
• Decreased appetite
• Mild diarrhea

How is roseola diagnosed?

Roseola is diagnosed by your doctor or nurse practitioner through taking a thorough history and performing a physical exam. A definitive diagnosis of roseola cannot be confirmed until the fever subsides and a rash appears. In the meantime your doctor or nurse practitioner may perform other tests to ensure the fever is not caused by something else, like blood, urine or other tests.

How is roseola treated?

Like most viral illness, roseola cannot be treated with antibiotics. The best thing a parent can do for their child is to manage their symptoms and keep them comfortable. The following may be helpful for your child:

• Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to reduce the fever. Do not give your child aspirin.
• Keep your child well hydrated
• Dress your child in loose, light clothing to prevent their temperature from increasing.
The best defence against roseola is practicing good hand hygiene to prevent the spread of infection from one person to another.

When should you see a doctor or nurse practitioner?

Best to see your doctor or nurse practitioner if your child:

• Is not drinking fluids
• Has a fever is above 40⁰C (104⁰F)
• Has a seizure
• Has a fever that lasts longer than 5 days
• Rash doesn’t improve after a few days
• Rash begins to look purple or blood coloured
• Has a weak immune system from another underlying medical condition

– Dr. Christina Cesareo and Dr. G Paul Dempsey

[Featured image: Vincent Hu]


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