Roseola
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Roseola

My baby has a spotty, pinkish-red rash on his stomach. Could it be roseola? If your baby recently had a fever and now has a spotty, raised or flat, rosy-pink rash, it could be roseola, also called roseola infantum.

Roseola is a fairly mild and common viral illness that usually strikes children between 6 months and 3 years of age. Roseola is caused by a kind of herpes virus, although not the type that's sexually transmitted.

What are the symptoms of roseola? It's possible to have the virus without having noticeable symptoms. But roseola usually starts out with a sudden, relatively high fever, often above 103 degrees Fahrenheit.

The fever typically lasts three to five days and may end abruptly, followed by the telltale rash. The rash may last for days or only hours.

The rash is pink and may have small flat spots or raised bumps. These spots may have a lighter "halo" around them and may turn white if you press on them.

The rash isn't itchy or uncomfortable, and contact with the rash itself doesn't spread the illness. It's usually seen on the trunk and neck, but it can extend to the arms, legs, and face.

If your baby has roseola, he may also be irritable and tired and have mild diarrhea, a decreased appetite, and swollen eyelids. The lymph nodes in his neck and at the base of his skull may also be a bit enlarged. In general, children with roseola don't appear especially ill, considering how high their fevers get.

About 10 to 15 percent of children with roseola have a febrile seizure. If this happens, your baby may become unconscious and jerk his arms, legs, or facial muscles for two or three minutes. He may also lose control of his bladder or bowels.

Although frightening, fever-induced seizures in young children are seldom serious and rarely harmful. If you can, try to time the length of the seizure. Your baby's doctor will want to know how long the episode lasted.

Should I call the doctor?
Yes. Ask your baby's doctor what her guidelines are for calling when your baby has a fever. (A well-child visit is a good time to do this.)

She may suggest, for example, that you call if your baby is 2 months or younger and has a fever of 100.4 degrees F or higher; if he's 3 to 6 months and has a fever of 101 degrees F or higher; and if he's 6 months or older and has a fever of 103 degrees F or higher.

Call the doctor if your baby has an unexplained rash or a febrile seizure. The doctor will ask about your baby's symptoms, and she may want to take a look at him.

How should I treat roseola?
There's no specific treatment for roseola. Like most viral illnesses, roseola just needs to run its course. The most important thing you can do is make sure your baby rests and gets plenty of liquids.

Ask your doctor about ways to safely bring down your baby's fever. She may suggest children's acetaminophen or a lukewarm sponge bath.

Never give a child aspirin. It can trigger Reye's syndrome, a rare but deadly disease.

Is roseola contagious?
Yes, especially among young children. Roseola is spread by saliva or respiratory droplets — when an infected person sneezes or coughs, for example — or by fecal-oral contact. Because a child is contagious before he has symptoms, there's often no way to avoid exposure.

Make sure that all family members — especially those taking care of your baby — wash their hands frequently. (This is a good idea even in the fever stage because you don't know that you're dealing with roseola until you see the classic rash.)

To play it safe, keep your child home from daycare and away from others while he has a fever. It's probably wise to keep him home until the rash is gone, although he'll be less contagious once he has the rash than he was when he had the fever.

The good news: Once your child has had roseola, he'll probably have lifelong immunity to it.

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