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How do I know if my baby's rash is roseola?

What is roseola, how does it spread and how do you treat it? Here's what to look for and when to see a doctor if you suspect your baby's rash is roseola.

By Cameron French

How do I know if my baby's rash is roseola?

Photo: iStock

Melissa Murray isn’t a doctor, but she has picked up more than a little knowledge on the fly about roseola thanks to her sons, Rowan, 7, and Ryder, 3.

When Rowan was 18 months old, she knew something was up when the normally happy toddler became strangely irritable and lethargic.“We were trying to do everything we could to get him to crack a smile because he just seemed so miserable,” she says. “He didn’t want to eat, and he was sleeping a lot.”

Pretty soon, he had a fever, with his temperature rising as high as 38.9C (102F) over a period of two or three days. Murray treated the fever with ibuprofen and decided that the situation wasn’t yet dire enough to visit a doctor. But that all changed when the rash came.

“It wasn’t until the fever finally broke, and then he woke up the next day with this rash all over him, mainly on his torso, back and chest,” she says. “We were like, ‘No wonder he was irritable.’ We thought he just had a virus and didn’t know what it was.”

What is roseola, and is it contagious?

What he had was roseola—or human herpesvirus (HHV) 6—a viral infection that typically hits kids aged six months to two years old, but bigger kids and adults can get it too. It spreads through direct contact with saliva or through droplets from a cough or sneeze, so it can be easily passed from one person to another.

As with Rowan, it usually starts with a fever that lasts three to five days. While most children aren’t very sick during the fever stage, temperatures can rise above 39.4C (103F)and, in some rare cases, kids can suffer from related seizures or convulsions.

Roseola rash symptoms

When the fever ends, a rash takes over, with pinkish red spots on the torso, arms, legs and face. The rash can last anywhere from a few hours to two days and, though it may not look pleasant, is usually not itchy or painful.

With its long duration and physical symptoms, roseola is just the kind of thing that can make a parent who isn’t familiar with the condition a bit frantic.“I was a little concerned because I had never seen anything like that before,” says Murray.

How common is it?

While many parents may not have heard of the infection, roseola is very common, says Michelle Ponti, a paediatrician based in London, Ontario. “Typically, by age three, about 75 percent of children have been exposed, so it’s extremely common,” she says. “That’s not to say that everybody gets the high fever and rash, but it’s typical.”

What should I do to treat it?

While the fever and roseola rash can be alarming for parents, most children recover with no treatment. However, parents should be vigilant during the early stages of the infection and make sure that children drink plenty of fluids and get lots of rest, says Ponti. According to the Canadian Paediatric Society, you should take your child to a doctor if the fever exceeds 72 hours, or three days.

“I think the concern would be if a child has a high fever that isn’t getting better after several days,” she says. “Usually, in very young infants who are less than six months old, we would be more concerned about a high fever and they would definitely need to be seen by a physician.”

Children who have developed roseola should follow the typical precautions of someone who is sick—washing their hands frequently, covering their coughs and sneezes—though that can obviously be a challenge when dealing with an infant.

On Murray’s second time through roseola—this time with Ryder, when he was also 18 months old—she recognized the signs and played it cool.

“I didn’t even bother taking him to the doctor because I knew what it was and what to expect,” she says. “About four or five days after the rash appeared, it was totally gone.”