Sophie developed one of the classic childhood exanthem (rash), roseolo infantum, after nursing a fever two days ago. Initially we dismissed it as a result of teething. On the first day of the febrile presentation (fever), we had 4 doctors and a nurse – two of them, mothers, too – over at our house, and everyone sort of concurred. That probably lulled me into a false sense of security. We gave her a supp (suppository; that means up the a**), and later a liquid dose of paracet (paracetamol; Panadol) which is supposed to be TDS (administered three times a day), and happily returned to our marathon steamboat session.
Her temperature fluctuated over the next 24 hours, but eventually came down. The gastrointestinal symptoms (diarrhea) also ceased. That was when I noticed red blotches on her face and arms. Initially, I assumed they were heat rash. When it got worse today – she looked like she was in a battle, and probably lost – we hauled her off to the clinic for a second opinion. First opinion was from Dr Soong aka ‘Baba’: “…it is a viral infection…’ (as if that means anything to me). Second opinion from Dr Fitchett aka ‘real Doctor working in a clinic’: “…it is a viral infection…’. OK, OK, but what does that mean?? For the record, Baba was smugly happy because he was right.
There is no medication for the condition; we just have to monitor it to make sure it does not get much worse. Apparently, this condition is especially prevalent in Japanese, Morroccan, Ecuadorian and Malaysian babies (Malaysia boleh!). At least Sophie is exhibiting normal behaviour – sleeping & eating well, and most importantly, screaming & wailing well.
The following are extracts from www.drgreene.com:
Roseola is a mild viral illness with a fever followed by a rash. It is caused by human herpesvirus 6 (HHV-6) or occasionally by human herpesvirus 7 (HHV-7). Roseola is also called roseola infantum (because it occurs mostly in infants), exanthem subitum (meaning “sudden rash”), and sixth disease (because it was the sixth of the similar childhood rash infections to be described). It is one of the classic childhood exanthems.
Who gets it?
Almost all cases of roseola occur in children before their third birthdays. The peak age is between 6 and 15 months. Fewer than half of children ever get roseola. Nevertheless, almost all children have had HHV-6 infections by age 3. For the majority, who never get the rash, the HHV-6 infection usually causes a fever, perhaps with other symptoms. It is a common cause of baby’s first fever.
What are the symptoms?
Classic roseola features a high fever (average 103°F) that lasts for 3 to 5 days (worse at night). Most children behave normally, even with the high fevers. In most, the fever ends abruptly, although it can disappear slowly over a day or so. A rash appears within hours of the fever subsiding. The rash is rose-colored, as the name roseola suggests. The rash may be present on the upper arms, legs, and face, but is most prominent on the neck and trunk, where it usually begins. It consists of numerous, small (2- to 5-mm), slightly raised patches that blanch when pressed. The rash does not itch and does not cause blisters. The rash typically lasts for 24 to 48 hours. Sometimes the patches coalesce before the rash disappears. In some children, the rash may be fleeting—gone in minutes or hours.
Is it contagious?
Once people have been infected with HHV-6 or HHV-7, the virus typically stays in their bodies for the rest of their lives. Antibodies prevent them from getting sick again themselves, but they can infect others. Most infected adults have the viruses in their saliva. Children typical get roseola from close exposure to caregivers who are themselves well—not from being around sick children or adults. Once exposed, the incubation period is 5 to 15 days.
How is it treated?
Antibiotics do not help. No treatment is needed in otherwise healthy children, except perhaps for acetaminophen or ibuprofen to lower the fever or increase comfort.
How can it be prevented?
There is no clear way to prevent roseola. There is no reason to exclude children with the roseola rash from daycare.
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