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Overview of Viral Infections in Children

by Mary T. Caserta, MD

Viral infections are common among people of all ages but often seem to be concentrated in infants and children. Most childhood viral infections are not serious and include such diverse illnesses as colds with a sore throat, vomiting and diarrhea, and fever with a rash. Some viral illnesses that cause more serious disease, such as measles, are less common now due to widespread immunization. Several types of viral infections that children can acquire are discussed in the chapter on adult viral infections (see see Overview of Viral Infections).

Most children with viral infections get better without treatment, and many viral infections are so distinctive that a doctor can diagnose them based on their symptoms. A doctor usually does not need to have a laboratory identify the specific virus involved.

Many viral infections result in fever and body aches or discomfort. Doctors treat these symptoms with acetaminophen or ibuprofen. Aspirin is not given to children or adolescents with these symptoms, because it increases the risk of Reye's syndrome in those who have certain viral infections. Generally, parents can discern whether their child is ill with a potentially serious infection and needs immediate medical care. This is particularly true for children beyond infancy.

Some Viral Infections At a Glance


Period of Incubation

Period of Contagiousness

Site of Rash

Nature of Rash

Measles (rubeola)

7 to 14 days

From 2 to 4 days before the rash appears until 2 to 5 days after

In more severe cases, spreads over the trunk, arms, and legs

Starts around the ears and on the face and neck

Begins 3 to 5 days after the onset of symptoms and lasts 3 to 5 days

Irregular, flat, red areas that soon become raised

Rubella (German measles)

14 to 21 days

Infected newborns are usually contagious for many months

From shortly before the onset of symptoms until the rash disappears

Spreads to the trunk, arms, and legs

Starts on the face and neck

Begins 1 or 2 days after the onset of symptoms and lasts 3 to 5 days

Fine, pinkish, flat rash

Roseola infantum (exanthem subitum or pseudorubella)

About 5 to 15 days


Affects the chest and abdomen, with moderate involvement of the face, arms, and legs

Begins on about the 4th day, appearing as body temperature drops suddenly to normal, and lasts for a few hours to 2 days

Red and flat, possibly with raised areas

Erythema infectiosum (fifth disease or parvovirus B19 infection)

4 to 14 days

From before the onset of the rash until a few days after

Spreads to the arms, legs, and trunk

Starts on the cheeks

Begins shortly after the onset of symptoms and lasts 5 to 10 days

May recur for several weeks

Red and flat with raised areas, often blotchy and with lacy patterns

Chickenpox (varicella)

11 to 15 days

From a few days before the onset of symptoms until all spots have crusted

Appears later on the neck, arms, legs, and scalp and infrequently on the palms and soles

Usually appears first on the face and trunk

Appears in crops, so various stages are present simultaneously

Begins shortly after the onset of symptoms and lasts a few days to 2 weeks

Small, flat, red sores that become raised and form round, fluid-filled blisters against a red background before finally crusting

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