Baby

My 16-month-old has been diagnosed with "baby measles." (She was vaccinated at 12 months.) I can't find any information on it. What's the difference between red measles and baby measles?

Red measles, or rubeola, is a serious viral disease that is almost always prevented by the vaccine children receive at 12 to 15 months. The symptoms are high fever, cough, runny nose and red eyes, followed by a rash a few days later. The rash usually begins on the face and spreads over the entire body. Rubeola is contagious three to five days before symptoms occur, and up to four days after the rash appears. It can have major complications, such as pneumonia, encephalitis and convulsions.

Baby measles, or roseola, is caused by a different virus and is very common in children from six to 24 months of age. (It's rare before four months and after four years.) Children who have baby measles may have very high fevers but are surprisingly well and active, although their appetite may be down. The rash doesn't appear until the fever goes down and it's then that your child gets cranky.

It's hard to diagnose roseola before the rash comes out; swollen glands on the back of the head near the nape of the neck give one clue. Unfortunately, many kids are given antibiotics unnecessarily just to treat the fever. Then, when the rash appears, it looks like there's an allergy to the antibiotic. Children should not be given antibiotics unless we know what we are treating. The exception is in very young infants under three to four months, and only after tests are done and the child has been closely followed.

Roseola is contagious, but not very serious. I always thought the most serious part of it was the damage to parents' mental health: first dealing with the high fever; second, coping with a miserable child once the rash breaks out. My sympathies.

Paediatrician Diane Sacks spent 20 years at the Hospital for Sick Children in Toronto, and is currently on staff at North York General Hospital.

Novemebr 2001