Roseola

Last update: June 10, 2025

Summary about Disease


Roseola, also known as sixth disease or exanthem subitum, is a mild viral infection common in young children, typically between 6 months and 3 years old. It's characterized by a high fever followed by a distinctive pink or red rash. It's usually a self-limiting illness and rarely causes serious complications.

Symptoms


High fever: Often the first symptom, typically ranging from 101°F to 104°F (38.3°C to 40°C). This fever can last for 3 to 7 days.

Rash: After the fever subsides, a pink or red, non-itchy rash appears. The rash usually starts on the trunk and spreads to the neck, face, arms, and legs. The rash consists of small, flat or slightly raised bumps.

Other possible symptoms: Irritability, mild diarrhea, decreased appetite, runny nose, cough, swollen eyelids. Sometimes, small pink spots on the soft palate (Nagayama spots) may be observed before the rash appears.

Causes


Roseola is caused by human herpesvirus 6 (HHV-6), and sometimes human herpesvirus 7 (HHV-7). The virus is spread through saliva or respiratory secretions, such as when an infected person coughs, sneezes, or talks.

Medicine Used


There is no specific antiviral medication to treat roseola. Treatment focuses on managing the symptoms:

Fever reducers: Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can be used to lower the fever. Aspirin should be avoided in children due to the risk of Reye's syndrome.

Plenty of fluids: To prevent dehydration.

Rest: To allow the body to recover.

Is Communicable


Yes, roseola is communicable. It's most contagious during the fever stage, before the rash appears. It's spread through respiratory droplets.

Precautions


Good hygiene: Frequent handwashing, especially after coughing or sneezing.

Avoid close contact: If possible, limit close contact with other children while the child has a fever.

No vaccine: Currently, there is no vaccine available to prevent roseola.

How long does an outbreak last?


The entire course of roseola, from the onset of fever to the resolution of the rash, typically lasts about one week. The fever usually lasts 3 to 7 days, and the rash typically lasts a few hours to several days.

How is it diagnosed?


Roseola is usually diagnosed based on the characteristic symptoms: a high fever followed by a rash. A doctor may perform a physical examination and ask about the child's medical history. Blood tests are usually not necessary, but can be performed to rule out other conditions.

Timeline of Symptoms


Incubation Period: 5-15 days after exposure

Phase 1 (Fever): 3-7 days of high fever (101°F to 104°F). Other symptoms may be present, such as irritability or runny nose.

Phase 2 (Rash): Fever subsides abruptly, followed by the appearance of a rash, which lasts from a few hours to several days.

Important Considerations


Febrile seizures: High fevers associated with roseola can sometimes trigger febrile seizures (convulsions) in young children. While frightening, these seizures are usually brief and don't cause long-term harm. Seek immediate medical attention if a child experiences a febrile seizure.

Complications: Roseola is generally a mild illness. Serious complications are rare but can include encephalitis (inflammation of the brain) or pneumonia, particularly in individuals with weakened immune systems.

Consult a doctor: If you suspect your child has roseola, it's always best to consult a doctor to confirm the diagnosis and rule out other potential causes of the fever and rash.