A few weeks ago, my husband's five-month-old nephew was ill with a high fever (103 degrees). The doctor said it might be an ear infection. A day or so later, he broke out in a red, spotted rash from head to toe. About four to five days after this, my nine-year-old ran a temperature of 101 to 102. She had a headache but did not feel sick or show a rash. About a week after that, I had a temperature of 101 to 103 and felt tired but not really sick. Later I got achy joints and a severe headache. It hurt to move my neck and even to open or move my eyes. I had no rash. Now my husband has the same symptoms, but he developed a bit of a rash on his chest and abdomen. I am just wondering if you could tell me what this illness could have been. I am in an HMO, and it takes an act of Congress to get in to see the doctor.

G.J.

There are several interesting points to make about your question. First, all of you may or may not have had the same illness. It sounds possible, though, since each person became ill about a week after someone else. Most viral infections, such as influenza or the common cold, tend to have a fairly constant incubation period (the length of time from exposure to the first symptom). The chickenpox virus has an incubation period of about two weeks. Other viruses have incubation periods of five to seven days, which seems to fit your illness perfectly.

Interestingly, viruses may not affect each person in the same way. Your nephew may have a rash and an earache. With the same virus, you may have no rash at all. If I had to guess which virus infected your family, I would say an adenovirus. This type of virus causes conjunctivitis (red eyes), pharyngitis (sore throat) and rashes. The incubation period also seems about right.

My next point involves ear infections. While ear infections are quite common in childhood, they are overdiagnosed. It can be difficult to actually see the eardrum when examining a sick, crying baby. Also, the appearance of the eardrum alone is sometimes not enough to make the diagnosis. Sometimes, a doctor prescribes antibiotics for an ear infection just to be safe, when the diagnosis is not really certain.

My last point involves HMOs. An HMO (health maintenance organization) differs from other forms of health insurance in that it typically pays the doctor a set amount regardless of the amount of care that a patient receives. This can cause some problems, in that some doctors may be reluctant to perform expensive tests, because the HMO will not reimburse the doctor or medical group. However, it is far less expensive to see a patient in the doctor's office than in the emergency room. Therefore, it behooves most doctors to see patients promptly in the office. If you do not feel that you are getting good, prompt care from your HMO doctor, then you have two choices. The first and easiest choice is to change physicians. Most HMOs allow you to change your primary care provider as often as you like. The other option is to change HMOs. This can be more difficult or impossible if you get your medical coverage from your employer, but sometimes it can be done.