What Is Roseola?
Roseola is a common viral infection that mainly affects children under age 2, usually between the ages of 6 and 12 months. It’s so common that almost all children in the U.S. have had it by the time they turn 2. Although it’s rare, older children and adults can also get it.
Doctors or other health care professionals might call it roseola infantum or exanthema subitum. You may also hear people calling roseola sixth disease. The simple explanation for that is that roseola was the sixth childhood rash (like measles) that scientists named.
Most of the time, roseola is nothing to worry about, and kids get better on their own.
Roseola Causes
Roseola is an infection caused by one of two viruses. Most often, it’s caused by human herpesvirus 6 (HHV-6). Occasionally, it’s caused by human herpesvirus 7 (HHV-7). When someone who has the virus talks, coughs, or sneezes, they spread infected droplets into the air, which your child can breathe in. These droplets can also land on surfaces, like a tabletop or a toy, contaminating them. If your child touches the contaminated area and then brings their hand to their nose or mouth, they can become infected too.
Unfortunately, it can take up to 15 days after getting infected to start showing symptoms -- and someone can be contagious before they are sick. That’s one reason why roseola can spread so easily.
Roseola in Adults
Older children and adults can get roseola, but it’s rare. This is probably because once you’ve had roseola, it’s unlikely that you will get it again. You’ll have some immunity against it. Since most children in the U.S. have roseola by the time they’re 2 years old, it’s likely you had also it and are now immune.
There is an exception to the immunity though. If you have a weakened immune system (are immunosuppressed or immunocompromised), you could get roseola again.
Roseola Symptoms
Your child might not have any symptoms for 5-15 days after getting the virus that causes roseola. When symptoms do appear, the first thing you’ll usually notice is a sudden, high fever (over 103 F) that lasts or can come and go for 3-7 days. Other symptoms can include:
- Vomiting
- Diarrhea
- Restlessness, irritability
- Loss of appetite
- Sore throat
- Cough
- Runny nose
- Pink eye (conjunctivitis)
- Swelling around their eyes or on the eyelids, droopy eyelids
- Swollen lymph nodes in their neck or back of the head
- Small red spots (can be pink) in the throat
Roseola rash
About one-quarter of people with roseola develop a flat, spotty, reddish rash after the fever goes away. It first appears on the chest, back, and belly, and then spreads to the neck and trunk. It doesn’t itch and may last just a few hours or a few days. Some people get the rash without having a fever.
Roseola vs. measles rash
There are several childhood infections that cause rashes, and it can be hard to tell them apart sometimes. Measles is a much more severe infection than roseola, and it’s much more contagious. If you’re not sure about what might be causing your child’s rash, speak with your doctor as soon as possible. There are differences between the two that you can look for:
Where the rash starts. If your child has roseola and develops a rash, it usually starts on the chest, back, and belly, and then it spreads. If your child has measles, the rash would start on their face and then spread downward.
Color of the rash. A roseola rash is red or pink. A measles rash is red or red-brown.
How the rash looks. If your child has a roseola rash, you’ll see that each spot is separate -- the spots don’t touch each other. The spots in a measles rash, however, join together.
Peeling. A roseola rash fades away while a measles rash gets flaky or peels.
Roseola Diagnosis
Most times, doctors can tell if your child has roseola by looking at them and reviewing their symptoms. If there’s a rash, the doctor will look at it to make sure it’s not caused by another virus, like measles. Blood tests aren’t usually done for a roseola diagnosis, but they can be, especially if your doctor wants to rule out another illness.
Roseola Treatment
There’s no treatment for roseola, and since it's caused by a virus, antibiotics won’t help (they’re only for bacterial infections). Your child’s doctor will likely recommend treating the symptoms to help make your child more comfortable. If your child has a health condition or takes medications that suppress their immune system, speak with your child’s doctor as soon as possible after they show signs of being ill because the doctor might recommend extra treatment.
If your child has a high fever or is uncomfortable, you can:
- Give them acetaminophen or ibuprofen. (Children under 6 months shouldn’t be given ibuprofen unless their doctor says it’s OK to do so. And don’t give aspirin to a child or teen under 18; it can cause a rare but serious condition called Reye’s syndrome.)
- Make sure they drink plenty of fluids so they don’t get dehydrated.
- Dress them in lightweight clothing so they don’t get too warm.
There really isn’t anything to do for the rash since it’s not itchy or painful.
If your child develops other symptoms or becomes very sick, their doctor might recommend an antiviral medication -- either foscarnet or ganciclovir.
Is roseola contagious?
Roseola is contagious, so you should keep your child away from others, at least until the fever goes away. Once it’s been gone for at least 24 hours, they can play with other kids, even if they still have a rash.
Roseola Home Remedies
There’s no medical treatment for roseola, but there are some things you can do at home to help keep your child more comfortable.
Keep your child hydrated. Here are some helpful tips:
- If your child is breastfeeding or bottle feeding, try nursing or offering the bottle more often, for shorter periods if needed.
- Use a syringe or spoon to offer fluids.
- Offer drinks in small cups so the amount doesn’t seem overwhelming.
- Offer rehydration solutions, like Pedialyte, that come in frozen pops as well as liquid.
- Dilute apple juice or a sports drink.
- Some kids love to eat flavored gelatin, which is hydrating.
Make sure they get plenty of rest. Resting is the best way to wait out a virus. If your child has a fever, cover them lightly -- don’t pile on the blankets.
Keep them comfortable. A cool cloth on the forehead can help your child feel less feverish and more comfortable. It used to be advised to give kids a cold bath if they had a fever, but that’s not a good idea and isn’t recommended anymore. Instead, you can give your child a sponge bath with a lukewarm cloth.
How Long Does Roseola Last?
Most children recover from roseola in about a week. The fever can last from 3 to 5 days. If they get a rash, this can last anywhere from a few hours to a few days.
If your child seems to be getting worse or has a seizure, take your child to an emergency department or call 911. If your child isn’t better after a week, contact your doctor.
What Problems Can It Cause?
Most children recover from roseola infection within a week without any complications. But, as with all illnesses, there can be some complications.
Febrile seizures
About 10% to 15% of young children who have roseola have febrile seizures. These are seizures that are caused by the high fever. They usually last from a few seconds to 15 minutes. Some may last longer. During one of these seizures, your child may:
- Lose consciousness
- Jerk or twitch their arms, legs, and/or face
- Lose control of their bladder or bowels
Febrile seizures can be frightening, but they are typically harmless. But if the seizure lasts longer than 5 minutes, you should call emergency medical services. In either case, contact your doctor right away, even if the seizure is short.
Rare roseola complications
More serious complications are rare. If they do happen, it's usually among children who have problems with their immune system, such as those with cancer or who have had an organ transplant. These include:
- Encephalitis (including cerebellitis), inflammation of the brain including in the cerebellum
- Meningoencephalitis, inflammation or infection of the layers protecting the brain and spinal cord (meninges)
- Rhombencephalitis, inflammation of the brainstem and cerebellum
- Myocarditis inflammation of the heart muscle
- Pneumonitis, inflammation of the lung tissue
- Rhabdomyolysis, muscle breakdown
- Thrombocytopenia, low levels of platelets in the blood
- Guillain-Barre syndrome, an autoimmune disorder that affects the nervous system
- Hepatitis, inflammation of the liver tissue
- Bone marrow failure, which means the bone marrow can’t make enough platelets, red blood cells, or white blood cells
Can You Prevent Roseola?
Unlike some other childhood diseases like measles or chickenpox that have vaccines, there is no roseola vaccine. The only way you can try to prevent roseola is by good and regular hand washing and avoiding people who are infected with the virus.
Takeaways
Roseola is such a common childhood viral infection that almost all children in the U.S. have had it by the time they turn 2 years old. There is no roseola treatment and most children recover from the virus quickly. Although complications are rare, around 10% to 15% of children who have high fevers from roseola have febrile seizures. If you are worried about your child or they have seizures with fever, contact your doctor as soon as possible or go to the emergency room.
FAQs
What can roseola be mistaken for?
Because of the rash and fever, some people might mistake roseola for measles. However, the rash is different and measles is a much more serious infection.
Can adults get roseola from a child?
It is possible for an adult to get roseola from a child, but it’s rare. Most adults had roseola when they were young, and this makes them immune to getting it again. However, if the adult has a suppressed immune system, they could get it a second time.
Can kids go to school with roseola?
Children with roseola shouldn’t go to school because they can spread the infection. Once the fever is gone, they should be OK to go back to school.
Is it OK to bathe a baby if they have roseola?
It’s best to give a sponge bath with lukewarm water to help your baby be more comfortable if they have roseola.
How do you soothe roseola rash?
Roseola rashes aren’t itchy or sore, so there is no need to soothe them.
