Dr. Komarovsky on roseola

Roseola, commonly referred to as the "sixth disease," is a common viral infection that many parents are unaware of how to treat in their young children. It can be concerning when a child has a sudden high fever and rash, particularly if this is their first illness. However, there’s no need to freak out, says renowned pediatrician Dr. Komarovsky.

According to his professional opinion, roseola typically resolves on its own without significant complications because it is mild and self-limiting. Knowing the symptoms and when, if at all, to seek medical attention are crucial.

Parents feel reassured by Dr. Komarovsky’s advice, which enables them to face the illness head-on and steer clear of pointless treatments. His useful advice can really help during this short but hectic period.

About the disease

Roseola is referred to by different names among doctors: pseudo-rubella, sudden exanthema, sixth disease, etc. Doctors always confuse roseola with either an allergic skin reaction or a viral infection, even though the disease is very common in children and is thought to be a unique childhood disease.

The herpes virus type 6 is the culprit behind the illness. Adult family members who do not even suspect it are typically its carriers.

Adults only experience chronic fatigue syndrome as a symptom. It is common for all members of the household to experience some degree of exhaustion after the birth of a child, and in Russia, visiting a doctor about such complaints is not customary.

The child initially exhibits classic ARVI symptoms, which include a fever that spikes above 39 degrees, a slight runny nose, and headaches. All the signs of intoxication are there, including body aches and occasionally vomiting or diarrhea in children who also have a high body temperature. The baby’s condition stabilizes and its temperature drops after three to five days. And just when the parents have calmed down and are celebrating the recovery, an odd pink rash covers the entire body, excluding the face and limbs.

The rash is three to five millimeters in diameter, does not itch, and occasionally has a white border around the pink center.

The rash typically appears one to three days following "recovery" from ARVI symptoms. Although the rash strongly resembles rubella, any qualified physician contacted by anxious parents would quickly rule out this serious illness because, aside from the rash, the clinical picture does not show any signs of rubella.

The baby’s back and stomach have the largest concentration of the rash, which only mysteriously goes away on the sixth day after it first appears. Since Rosoola produces a persistent, lifelong immunity, it is impossible to contract her again.

Three out of ten infants under the age of one and a half to two are sick, according to data compiled by the World Health Organization. 9–12 months is the most "dangerous" age range.

Roseola, also called "sixth disease," is a common viral infection in young children that typically results in a high fever and a pinkish rash, according to Dr. Komarovsky. He notes that although parents might be concerned, the condition is usually mild and goes away on its own with no major complications. In addition to making sure the child stays comfortable and hydrated, parents should concentrate on controlling the fever.

Than dangerous

According to Evgeny Komarovsky, there is no special risk in Rosoole. It goes away on its own, so no special medication is required. In most cases, sudden exanthema does not result in complications. Nonetheless, the disease’s early stages are hazardous when they coincide with intense heat. A temperature this high is extremely dangerous for infants, as it can result in convulsions, respiratory arrest, and irreversible damage to the crumbs’ nervous system. The baby poses a risk of dehydration very quickly if they vomit.

Treatment according to Komarovsky

The challenge of correctly diagnosing the illness lies in the prescription of the appropriate course of action. Upon observing the pink rash, the physician typically determines that the child suffers from a drug allergy (since the child’s parents have administered multiple medications to him when his fever spiked) and proceeds to prescribe antihistamines. And when the rash clears up (on the sixth day), parents can honestly say that the treatment they were prescribed was effective. Komarovsky claims that the rash would have disappeared on its own, even in the absence of anti-allergy medication, since it was past due.

In the worst situation, the physician will identify rubella and recommend the necessary course of action.

Parents should unquestionably insist on a clinical blood test if the doctor suspects their child has rubella. This test will identify whether the child’s blood contains antibodies to the herpes virus type 6 and the virus itself.

In the worst scenario, the district or local physician just writes an antibiotic prescription, an antiviral medication, and several vitamin complexes (just in case) without making any attempt to determine the cause of the child’s rash. Komarovsky claims that roseola is a virus, that antiviral medications have no demonstrated efficacy, and that treating roseola with them is essentially pointless.

According to Komarovsky, the best way to treat a child with the herpes virus type 6 is to set up the conditions necessary for a quick recovery rather than giving them the whole assortment of medications from the neighborhood pharmacy:

• Give antipyretics. For children, Ibuprofen or Paracetamol are best suited. It should be noted that the temperature with roseola is brought down very reluctantly and slowly, it may even seem that antipyretics did not work at all.

• Give the child plenty to drink at the initial acute stage of the disease. The drink should be at room temperature, so it will be absorbed faster. You should not give sweet or carbonated drinks, it is good if the mother cooks the child a compote of dried fruits, makes fruit drink, brews weak tea, gives ordinary non-carbonated drinking water. To understand how much liquid to give a baby with a fever, you need to multiply his weight by 30. This will be the amount of liquid in grams.
• The child"s room should not be hot, dry or dusty. Remove all carpets and soft toys, ventilate, humidify the air. The room temperature should be at 18-20 degrees, and the relative humidity should be 50-70%. If there is no humidifier, you can hang wet towels around the house.
• During illness, you should not overfeed the child. If there is no appetite, you cannot force-feed. All food should be easily digestible. If there is vomiting and diarrhea, be sure to give the child oral rehydration agents (for example, "Regidron").
• If the child is already actively moving and walking, during the initial stage, you need to provide him with rest, bed rest will reduce energy costs, and the baby will feel better.

Dr. Komarovsky stresses that most of the time, roseola is not a reason for alarm. Other than controlling the fever and making sure the child is comfortable, the condition usually goes away on its own without the need for special treatment.

It is important for parents to give their child lots of fluids, keep an eye on their temperature, and see a doctor if the fever doesn’t go down or if problems develop. Despite the high fever that initially raises concerns, Dr. Komarovsky reassures patients that roseola is usually a mild illness.

In general, most children recover from roseola without any long-term effects with the right care and attention, giving worried parents peace of mind.

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