Odds are it’s probably a virus
By Lori Goodwin, MD
Winter may be flu season, but many other contagious illnesses that can affect children are common year-round. Few are serious, but it helps to know the more common culprits and what to look for.
Roseola is a viral disease that begins with a temperature of 102-103 degrees for three to five days, followed by a pink, raised, lacy-looking rash around the time the temperature disappears. It is most common in children 6 months to 2 years of age. Symptoms may also include a runny nose, irritability, eyelid swelling and tiredness. Complications are rare. Roseola is not very contagious, but a child with a fever and a rash should be excluded from daycare until seen by a physician. You can control the fever with children’s acetaminophen and plenty of liquids to make the child more comfortable.
Fifth disease is a common illness caused by a mild parvovirus. The ill child typically has a “slapped-cheek” rash on the face and a lacy red rash on the torso and limbs. Occasionally, the rash may itch. The child may have a low-grade fever, malaise or a cold a few days before the rash breaks out. The child is usually not very ill, and the rash resolves in seven to 10 days. There is no specific treatment. However, children with sickle cell anemia, chronic anemia, or an impaired immune system may become seriously ill when infected by the virus and will require medical care. If a pregnant woman catches the virus, her baby may be at risk.
Fifth disease is believed to be spread through direct contact or by breathing in respiratory secretions from an infected person. The period of infectiousness is before the onset of the rash. Once the rash appears, a person is no longer contagious. Therefore, a child who has been diagnosed with fifth disease does not usually need to stay home from school or daycare after the fever is gone.
Coxsackie (also called “hand, foot and mouth disease”) can spread quickly, usually affecting small children, 6 months to 4 years of age. Coxsackie, which is more common in late summer and fall, begins with a mild fever, poor appetite, a general feeling of sickness, and frequently a sore throat. One or two days after the fever begins, sores develop in the mouth, beginning as small red spots that blister and turn into ulcers. Excessive drooling may be present. A non-itchy rash develops with flat or raised red spots, some with blisters, appearing on the palms of the hands, soles of the feet and sometimes the buttocks. The child may have only the rash or the mouth ulcers, not necessarily both. The illness is usually mild; most children recover with no treatment. Children’s acetaminophen can help when there is fever.
Coxsackie is very contagious, and your child’s playmates may develop it at the same time. The incubation period after contact is four to six days. Children who drool excessively with the illness are usually excluded from school and daycare until the drooling returns to normal.
Dr. Goodwin practices with CHKD Health System’s Newport News Pediatrics.