What is roseola?

Roseola (also termed sixth disease, roseola infantum, and exanthema subitum) is a common viral infection that occurs mainly in children between 6-24 months of age. The virus that causes roseola is usually relatively benign, because about two-thirds of children infected have no symptoms. When symptoms do occur, roseola begins with a high fever (102 F-105 F) that breaks in about three to seven days. When the fever breaks, a reddish or pinkish rash characteristic of roseola occurs all over the body (starting on the trunk and spreading to the arms, legs, and face) and lasts from a few hours to a few days. There is no specific treatment for roseola; however, the fever can be reduced with acetaminophen (Tylenol) and cool sponge baths.

Is roseola contagious? What is the incubation period for roseola?

Roseola is contagious. It has an incubation period (from time of exposure to the virus to symptom development) from about five to 14 days. The individual remains contagious until one or two days after the fever subsides. The roseola rash may still be present, but the child or individual is usually not contagious after the fever abates. Roseola is caused by a common virus (belonging to the family of herpesviruses and termed HHV-6). This virus does not cause cold sores or genital infections. Most pregnant females (about 96%) are immune to HHV-6 so there are only rare reports of a mother contracting roseola and transferring the virus to the fetus, in which HHV-6 may cause problems like miscarriage or birth defects.

How will I know if someone or my child has roseola?

If someone has roseola, usually they become infected from other individuals (for example, the children in a day-care center or siblings). The key to diagnosis of roseola is that when the fever stops, a non-itchy rash develops all over the body. The person, usually a child, has a decrease in appetite, mild diarrhea, or slight cough with runny nose but otherwise seems to be acting normal. This is not unusual for a child with roseola. However, if a child develops a high fever (102 F-105 F) and the fever does not go down, the child may develop more severe symptoms. Most individuals visit their physician/pediatrician to rule out other potential problems that may produce similar but more severe symptoms (for example, meningitis).

Child with roseola

Early Roseola Sign and Symptoms

The signs and symptoms of HHV-6 (or HHV-7) infection vary depending upon the age of the patient. Infants and toddlers routinely develop sudden symptoms with an abrupt onset of a high fever (103-104 degrees) that lasts for three to five days. The child may also develop irritability, swollen glands in the front or back of the neck, runny nose, puffy eyelids, 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.

How is roseola transmitted?

Roseola is easily spread from person to person in day-care centers, preschools, and among siblings by contact with a person's respiratory secretions and/or saliva. Sharing items like cups or utensils and even toys that are sometimes chewed on by a child can spread the virus to other children easily. For those adults who have never been infected with HHV-6, they too, may become infected, but the illness is not usually as severe in adults.

When will I know that someone or my child is cured of roseola?

In general, once the fever has abated for about a day or so, the person is usually cured and no longer contagious for roseola. The rash may linger on for a few days. Fortunately, most people are infected as a child and develop an immune response that renders them protected, usually for life, against roseola.

When should I contact a medical caregiver about roseola?

If you or your child has a rash that doesn't improve after a few days or, more importantly, the individual has fever of about 103 F, or fever less than 103 F that lasts for about one week, or if you or your child develops any seizures, slows or stops eating and drinking, or is not acting normal, the individual should be seen urgently by their physician or seen in a (pediatric) emergency department. If you aren't sure about what to do, contact your child's pediatrician or your physician immediately.


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American Academy of Pediatrics. "Roseola Infantum." HealthyChildren.org. Aug. 20, 2015. <https://www.healthychildren.org/English/health-issues/conditions/skin/Pages/Roseola-Infantum.aspx>.