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Roseola

What is roseola?

  • Roseola, also called exanthema subitum or sixth disease, is a common contagious viral infection.
  • Roseola is caused by the herpes virus 6 and 7. This is not the same herpes virus that causes cold sores or genital infections.
  • Roseola occurs in children most likely 6 months to 2 years of age.
  • The large majority of otherwise healthy children with roseola recover quickly and completely.

How does a child get roseola?

  • Roseola is spread from person to person through secretions from the respiratory tract.
  • The droplets can spread through the air and be breathed in by a child, or may land or be placed on another surface such as a toy, which is then touched by a child. If that child then touches their eyes or mouth, they can become infected.
  • Roseola is contagious even if no rash is present. That means the condition can spread while an infected child has a fever but before its clear that the child has roseola.

How long will it take my child to become ill after being exposed to someone else with roseola?

  • Remember, just because your child is exposed to an ill person does not necessarily mean they too will become ill.
  • But if your child is to become ill, it usually takes 9 – 10 days after exposure for herpes virus 6.

What are the signs and symptoms of roseola in children?

  • Its possible to become infected with roseola but have symptoms too mild to be readily noticeable.

Signs and symptoms may include:

  1. The illness starts with a sudden, high fever (> 103 F) for 3 – 7 days.
  2. After the fever goes down, a rash appears on the back, chest, and abdomen and then spreads to the arms, legs and neck (see photo called Roseola).
  3. The rash consists of many small red or pink spots or patches. These spots may be flat or raised a little. The rash does not itch.
  4. The rash may last only a few hours or for a few days.
  • Other signs and symptoms of roseola may include:
    - Cough and runny nose
    - Tiredness
    - Irritability
    - Mild diarrhea
    - Decreased appetite
    - Swollen lymph nodes in the neck
    - A febrile seizure (a seizure with a fever) may result because of the high fever
  • People with weak immune systems who contract roseola may experience potentially serious complications from the infection, such as pneumonia or encephalitis — a potentially life-threatening inflammation of the brain.

How can roseola be diagnosed?

  • Roseola is generally a clinical diagnosis meaning that the diagnosis is based on the child’s symptoms and physical examination.
  • A blood test to check for antibodies to roseola is available but not routinely done.

What is the treatment for roseola?

  • Plenty of rest and fluids
  • Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) for fever and discomfort
  • For a child with a weak immune system your doctor may recommend a medication called ganciclovir.

How long will my child be sick with roseola?

  • Most children recover fully from roseola within a week of the onset of the fever.

When can my child return to daycare or school?

  • For roseola, it will depend on how quickly your child’s symptoms go away, especially their fever and rash.

When should I call my pediatrician concerning roseola in my child?

  • It is best to call for specific instructions when your child first develops a high fever or looks ill.
  • You should also call your doctor if your child has had fever for more than two to three days, has a febrile seizure, or poor fluid intake with signs of dehydration.

How can roseola be prevented?

  • Frequent hand washing is recommended to decrease the chance of becoming infected. Click on how to prevent infection for more details.