Roseola in Children
Roseola has beat social distancing! We are still seeing it just as often as ever.
Cause:
Human Herpes Virus 6 (HHV-6) spread through saliva of others into mouth of baby or toddler.
Most people catch this illness before the age of 2 years old when we tend to sample our environment by mouth.,
are kissed very often and tend to drink/eat after others in the household.
It can also be shed from toddler to toddler during the acute illness phase.
Once infected with HHV-6, we shed the virus through saliva for our lifetime.
Parents can pass this to their babies even though there are no symptoms in the parent!
Illness:
3-5 days of fever, often reaching 104 range, fussiness and slight congestion followed by a blanching head to
trunk rash that develops shortly after the fever resolves (within a day) and lasts for about 5-7 days.
Physical exam findings by the doctor can include mildly swollen glands on the back of the head or neck on Day
2-3 of the fever, some red ear drums without true pus behind the ear drums as in a bacterial ear infection, mildly
red throat, mild nasal congestion.
Laboratory tests when done could show a mildly low white blood cell count, mildly low platelets and white
blood cells in the urine. The urine culture would return negative if the only cause of the illness is Roseola.
Contagious time:
Children are most contagious during the days of fever. Once the rash appears, the load of virus shedding
(viremia) has dropped substantially and the child can return to usual activities 24 hours later.
Treatment:
None! Just supportive care such as fever control with fever reducers such as acetaminophen and ibuprofen.
We pretty much all catch this once in our lifetime.
When to contact your doctor:
1. High fever. For a baby < 3 months of age, 100.4 and for a baby- toddler age, 102F
2. Prolonged fever. Any age fever of 101 or more for 3 days or more.
3. Rash at the same time as fever- this is not roseola and needs further investigation.
4. Refusal to drink or taking so little that your child is not making wet diapers at least every 4-6 hours.