As a pediatric nurse you would think I am used to dealing with sick kids and that you always have the answers. Well, it is completely different when it is your own child. You want to know what your child has and how to fix it right away, and unfortunately, most of the time that just can’t happen.
This is exactly what happened to me over the past week and a half!
So, what is roseola anyway?
Roseola is also known as sixth disease (as it is the sixth rash causing disease in children), exanthem subitum, and roseola infantum. It is a viral illness that usually affects kids from 6 months to 2 years of age. It is a very common illness, so common in fact that most children have had roseola by the time they enter kindergarten. There are anywhere from 200,000 to 3 million cases reported each year (MayoClinic).
Roseola is very contagious while the child has a fever, but once the fever breaks, it is no longer contagious. It can be spread when the child coughs, talks, or sneezes sending droplets into the air. Sharing eating utensils and cups can also spread it.
What are the signs and symptoms and how do I know if my child has roseola?
Usually the first sign of roseola is a high fever, not associated with any other issue such as ear infections, or other infections. The fever is usually higher than what would be expected with teething, usually fevers are over 101 degrees F and even higher that 103 degrees F. The fever can last several days to a week. Due to the fever, the child may be fussy, irritable, or not eat as well as usual.
The fevers can rise rapidly, causing a febrile seizure. This is not always the case, but it does happen on occasion. Febrile seizures cannot always be prevented, but you want to treat fevers as they appear. Signs of a febrile seizure include jerking twitching movements and loss of consciousness. If you suspect your child has had a febrile seizure, seek emergency medical help right away.
The fever usually abruptly ends, and at the same time a rash appears on the trunk. The rash is pinkish-red and flat, usually concentrated on the chest, abdomen, and back, but can also spread to the arms, legs, and face.
Now, is where it gets tricky. Everyone wants to know what is wrong with his or her child the minute we discover a fever. If you disagree with that, well then you are a liar, sorry. We want to know how to make our child feel better and take the pain away. The bad part is, there is no way to know if your child has roseola until the rash appears, sorry. There is no test to determine if your child has roseola, it is a process of elimination, if the doctor rules everything else out, then it is most likely your child has roseola and it is just a wait and see game.
Can you prevent it? How long does it last? What do I do if my child has roseola?
There is no known way to prevent roseola, you can try to prevent it just like you try to prevent colds, but this is still no guarantee. You can make sure you wash your child’s hands, make sure you watch what they put in their mouth, and so on. But again, there is no known way to prevent roseola.
The duration is just like any other cold. It can last up to two weeks. The fever lasts a few days to a week; if it lasts longer then you should see your child’s doctor. Once the fever breaks, the rash can last from a few hours to a few days.
You can treat the fevers at home as needed with acetaminophen (Tylenol) or ibuprofen (Motrin). Never give a child Aspirin because of the risk of Reye’s Syndrome, which can lead to liver failure and death.
Your child can become dehydrated because of the high fevers. During this time you want to make sure your child is getting adequate hydration. You can do this by offering liquids several times during the day. I recommend offering something such as pedialyte (I suggest strawberry, as that is the only flavor my daughter liked), as it has the electrolytes your child needs. Water is a good alternative, but if your child is not eating, she is not getting the electrolytes she needs as well. Just ensure your child is having a few wet diapers, if you have concerns call you doctor. I also recommend staying away from milk products if your child has a high fever (if you have ever cleaned up milk vomit, you know why).
Do I need to see a doctor?
Typically the answer is no, in most cases roseola can be treated at home with rest, fluids, and fever treatment. As I stated earlier, roseola cannot be diagnosed with medical tests, it is just ruling out everything else.
When medical treatment is needed, it is because the child will not drink, is lethargic, or has a febrile seizure. In these cases treatment includes IV fluids and medicines to decrease the fever. Antibiotics cannot treat roseola because it is a virus, not bacteria, that causes the infection.
My Personal experience.
So, I know this whole post makes it look like I have it all together and that I know all the answers! Thanks, I will take that as a compliment, but I will tell you what, it is still rough on a nurse. Even though I knew as a nurse I was doing all I could, I still hated that I didn’t have an answer.
My daughter just developed a fever out of nowhere, 102.8, with no other symptoms. She wasn’t pulling her ears, she was still eating just fine, and drinking pedialyte (as I refused to give her milk, I have cleaned up too many milk vomits!). I was planning on going to my sister’s graduation party and I didn’t want to get the other kids there sick. Then, the day before the party, she broke out into a rash! Sweet relief!
I hope this information can help just one parent get through this!
Have you ever dealt with roseola? How did you deal with it?