Daycare Outbreaks: Roseola

I’ve written before about Hand Foot and Mouth (actually more than once), which is a common often daycare-related illness, but have you heard of Roseola? Many haven’t, but it’s another common and thankfully very mild one your little might pick up. Let’s learn a bit more about it, its management and more.

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Disclaimer: this is not medical advice nor should it be interpreted as such. This blog is for informational purposes only. Please seek medical advice from your trusted healthcare provider.

What the heck is Roseola?

I think when people hear Roseola, fear sometimes sets in because it starts with an R and may be wrongly misinterpreted as Rubella.

Roseola is caused by a virus from a group known as herpesviruses and as I mentioned above, it is generally a mild illness. It is not related to cold sores.

It generally affects younger children – age 6 months to 2 years old.

It is contagious prior to symptoms generally, so an outbreak can be hard or nearly impossible to contain in a daycare or childcare setting. It is spread via both direct contact (with saliva) or droplets (sneeze/cough). Hand-washing is the best deterrent to spread.

Many children get it and don’t show symptoms, so the parents don’t even know!

What are the symptoms of Roseola?

Symptoms of the illness can include:

High fever for anywhere between 3-5 days (it is usually over 39 degrees Celsisus)
Fever may be accompanied by symptoms of discomfort, irritability
Post-fever, a rash may appear – pink/red spots – it is often on the arms or legs, sometimes on the neck or face
- They rash will “blanch” meaning when the spots are pressed on they turn white; there may be a lighter ring around them
- Not itchy generally
- Lasts a few hours to a few days
Sometimes there may also be cold symptoms or mild diarrhea
Fatigue

As you can see, it is mild and short-lived. With high fevers, there is a small risk for febrile seizure. Generally, febrile seizures are not harmful and general seizure precautions can be taken during the event. They can be very scary for us though. This is a topic I’ve been meaning to cover for awhile (and have it on my list!), but I have spoken about them briefly before here. Follow up is usually recommended with your family doctor/paediatrician after the occurrence of a febrile seizure. If the seizure lasts longer than 3 minutes, or baby is under 6 months then you should seek immediate care or call 911. Expect a dedicated resource on this soon.

Home Management

Barring the occurrence of a febrile seizure, roseola can generally be managed at home by you – the parents!

Tips for management at home include:

Offering supportive measures
- plenty of fluids
- rest
- and a healthy diet – but if appetite is decreased, focus on age appropriate fluids
Treat the fever if there are signs of discomfort or irritability – see my previous post on common misconceptions around fevers re: when treating a fever is recommended

In regards to return to daycare/childcare, please contact your provider. As mentioned, the disease is generally not contagious once symptoms present however, most sources recommend return to childcare after 24 hours post-fever resolution. Some want both fever and rash to be resolved. It is good to double check with your specific provider.

When and where to seek assistance:

Follow up with your child’s primary care provider:
- as soon as possible after a febrile seizure occurs
- if a fever lasts more than a few days or occurs in a baby under 6 months of age
- Note: AAP recommends calling your provider after 24 hours with a fever over 38.9 C/104 F
Call 911:
- if a seizure lasts more than 3 minutes or occurs in a baby under 6 months of age
If your child is dehydrated, depending on the degree of dehydration you may need different support – call Telehealth or your clinic’s nurse line for guidance if you’re unsure; or attend the emergency department if your child is showing signs of moderate dehydration or is lethargic (I talked about dehydration signs in my recent post on stomach viruses here)