Roseola
Medical Author: John Mersch, MD, FAAP
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
What is roseola?
Roseola is a mild viral illness of sudden onset and short duration that most commonly affects young children. Roseola is most common in children 6 to 24 months of age. The average age is around 9 months. Less frequently, older children, teens, and adults may be infected.
What virus causes roseola?
Roseola is primarily caused by a virus called human herpesvirus 6 (HHV-6) and less commonly by human herpesvirus 7 (HHV-7).
How is roseola spread?
Roseola is spread from person to person, most likely by transfer of oral secretions. Roseola is not very contagious. The incubation period between exposure to the virus and onset of symptoms is
nine to 10 days.
What are the first signs and symptoms of roseola?
The signs and symptoms of HHV-6 (or HHV-7) infection vary depending upon the age of the patient. Infants and toddlers routinely will develop sudden symptoms with a sudden high fever that lasts for
three to five days, irritability, bulging "soft spot" on the head (fontanel), swollen glands in the front or back of the neck, runny nose, puffy eyelids (due to swelling with fluid), and mild diarrhea. Within 12-24 hours of the fever breaking, a rash rapidly appears. Older children who develop HHV-6 (or HHV-7) infection are more likely to have an illness characterized by several days of high fever and possibly a runny nose and/or diarrhea. Older children less commonly develop a rash as the fever abates.
How high can the fever go?
The fever can be quite high. The fever averages 103.5 F (39.7 C) but it can go up
as high as 103-106 F (39.4-41.2 C).
How should the fever be treated?
If the fever is not causing the child to be uncomfortable, the
fever need not be treated. It is not necessary to awaken the child to
treat a fever unless instructed to do so by a health-care
practitioner.
If you wish to treat the fever, acetaminophen (Tylenol and others)
can be used to lower a fever. Aspirin should never be used for fever
in children or adolescents.
A child with a fever should be kept comfortable and not be
overdressed. Overdressing can cause the temperature to go higher.
Bathing with tepid water (85 F or 29.5 C) may
help bring down a fever. Never sponge a child (or an adult) with
alcohol; the alcohol fumes may be inhaled causing many problems. If a child develops shivering during the bath, the temperature of the bath water should be raised.
Next: Can the fever cause a seizure? »
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