Introduction:

Roseola is a usually mild viral infection that is common among children. Most cases occur between the ages of 6 months and 3 years, and more than 75% of children have had roseola by the time they are 2. Roseola often starts with a high fever, usually followed by a distinctive rash just as the fever breaks. High fever can cause complications, so parents should watch their children' s temperatures carefully and keep in contact with their pediatrician. Treatment is usually aimed at bringing down the fever and making sure the child stays hydrated. Adults can sometimes get roseola, too.

Signs and Symptoms:

• Sudden high fever (103 - 106 °F), which usually lasts 3 - 4 days. Your child will most likely remain alert in spite of the fever.
• High fever can cause febrile seizures. Although you should take your child to the emergency room if he has a seizure, they usually are not harmful, and go away when the fever goes down.
• A rash appears as the fever goes away and lasts 3 - 4 days. It may look like measles or rubella, with small rose-colored bumps. The rash usually appears first on the trunk of the body. It may spread to the neck, arms, and legs but rarely to the face.
• Fatigue, irritability, decreased appetite, and swollen eyelids.
• Breathing problems, ear infections, and diarrhea can also occur.

What Causes It?:

Roseola is caused by the human herpes virus 6 (HHV-6) and, occasionally, human herpes virus 7. These are not the same herpes viruses that cause cold sores or genital herpes. Roseola is spread through saliva and respiratory secretions, so coughing and sneezing can spread the virus. The incubation period is 5 - 15 days. It is contagious, whether or not the child has a rash.

What to Expect at Your Provider's Office:

Your child's health care provider will look for the rash and may take blood to check for other conditions and complications. Your health care provider will take your child's temperature and talk to you about how to treat your child's roseola at home.

Treatment Options:

There is no cure for roseola. Most treatments reduce fever, letting the infection run its course. Most children get better within a week.

Drug Therapies

• Your doctor may suggest giving your child children' s acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to bring down the fever. Do not give your child aspirin. Children should never take aspirin because of the risk of Reye's syndrome, a potentially fatal condition.
• Make sure your child drinks a lot of fluids to prevent dehydration. Water and other clear fluids are fine. You may want to use drinks that contain electrolytes, such as Pedialyte.
• Phenobarbital is sometimes given for seizures.
• For people with weakened immune systems, a doctor may prescribe the antiviral medication ganciclovir (Cytovene).

Complementary and Alternative Therapies

Herbal teas can help reduce fever. Always ask your pediatrician before giving any herb or supplement to a child. Adult doses are listed, unless otherwise specified. To determine a child' s dose for herb teas, ask your pediatrician. For some herb teas, adult doses may be given to the mother to treat breastfeeding babies. Be sure to check with your pediatrician before using herbs while breastfeeding or before giving herbs to your child.

Nutrition and Supplements

Your child should get plenty of rest and fluids.

Always ask your doctor before giving any vitamin or supplement to a child.

• Vitamin C (200 mg two times per day for children ages 1 -3 ; 325 mg two times per day for ages 4 - 8) may help fight a viral infection.
• Zinc (2 mg per day for children ages birth to 6 months; 3 mg per day for children 7 - 12 months; 3 mg per day for children 1 - 3 years; 5 mg per day for children 4 - 8 years) may increase immune system activity.
• Selenium (10 mcg per day for children ages birth to 6 months; 15 mcg for children 7 - 12 months; 20 mcg for children 1 - 6 years) may help children recover more quickly from viral infections.
• Vitamin E (9 IU per day for children ages 7 - 12 months; 10 IU mg for children 1 - 3 years; 16 IU for children 4 - 8 years) helps support the immune system.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to diagnose your problem before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts).

To determine the right dose for a child, ask your pediatrician -- and always ask your doctor before giving herbs to a child.

These herbs are often used to reduce fever:

• Lemon balm (Melissa officinalis)
• Peppermint (Mentha piperita)
• Elder (Sambucus nigra)
• Chamomile (Matricaria recutita)

Use equal parts of the above herbs to brew a tea. If you are breastfeeding, you can drink 1 cup three to four times per day to pass the benefits along to your baby.

Garlic and ginger tea with one to three cloves garlic (Allium sativum) and one to three slices of fresh ginger (Zingiber officinale) may help stimulate the immune system and prevent upper respiratory infections. You can add lemon and a sweetener for flavor. Do not give honey to children under 2 years old.

Homeopathy

Few studies have examined the effectiveness of specific homeopathic remedies. Professional homeopaths, however, may recommend one or more of the following treatments for roseola based on their knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.

• Aconitum -- for children who have a sudden high fever, especially when the fever is accompanied by restless anxiety. This remedy is best when used very early in disease, before a rash appears.
• Belladonna -- for children who have a sudden high fever that rises during the night and is accompanied by flushed face and red lips. The skin tends to be hot to the touch, but extremities feel cold. Children for whom this remedy is appropriate tend to be very agitated and may even be delirious.
• Arsenicum album -- for children whose fever increases between midnight and 2 a.m., and who are fidgety and have pain in their legs.
• Pulsatilla -- for children who have fever and chills that are worse in warm rooms but better in fresh air. Symptoms tend to be less intense than for the other remedies listed.

Acupuncture

Acupressure for children may be calming and help reduce the fever.

Massage

Gentle massage may help your child feel better. A foot massage may help; however, some children will not want to be touched.

Following Up:

Most children get well within about a week with no problems. If your child has a seizure, call your doctor or go to the emergency room immediately.

Special Considerations:

Avoiding infected children is the only way to prevent roseola. There is no vaccine.