Roseola is a common infection that usually affects children by age 2. It's caused by a virus that spreads from person to person. It can cause a high fever followed by a rash that doesn't itch or hurt. About a quarter of the people with roseola get a rash.
Roseola, also known as sixth disease, usually isn't serious, and it goes away on its own in a week or so. Treatment of roseola includes cool cloths and medications to reduce fever.
If your child is exposed to someone with roseola and becomes infected with the virus, it will likely take 1 to 2 weeks for signs and symptoms of infection to appear. Or they may not appear at all. It's possible to become infected with roseola but not show any sign of it.
Roseola symptoms might include:
- Fever. Roseola often starts with a high fever — often higher than 103 F (39.4 C). It starts suddenly and lasts 3 to 5 days. Some children also may have a sore throat, runny nose or cough along with or before the fever. Your child may also develop swollen lymph nodes in the neck.
Rash. After the fever goes away, a rash often appears. A roseola rash is many small spots or patches. These spots tend to be flat.
The rash often starts on the chest, back and belly and then spreads to the neck and arms. It might reach the legs and face. The rash isn't likely to be itchy or painful. It can last hours or days. The rash might occur without a fever first.
Other signs and symptoms of roseola may include:
- Mild diarrhea
- Decreased appetite
- Swollen eyelids
When to see a doctor
Seek immediate medical care
Your child could have a convulsion (febrile seizure) if the fever becomes high or spikes quickly. If your child has an unexplained seizure, seek medical care immediately.
Call your child's health care provider
Call your child's health care provider if:
- Your child has a high fever, over 103 F (39.4 C)
- The rash doesn't improve after three days and the fever returns
Call your health care provider
Contact your health care provider if anyone in the household has a problem with their immune system and comes in contact with someone who has roseola. They may need monitoring for a possible infection that could be more severe than it is for someone with a strong immune system.
Roseola is caused by a virus, usually human herpes virus 6 or sometimes human herpes virus 7. It is spread by contact with an infected person's saliva, such as when sharing a cup, or through the air, such as when a person with roseola coughs or sneezes. It can take about 9 to 10 days for symptoms to develop after exposure to an infected person.
Roseola is no longer contagious after the fever has been gone for 24 hours.
Unlike chickenpox and other childhood viral illnesses that spread rapidly, roseola rarely results in a communitywide outbreak. The infection most often occurs in the spring and fall.
The risk of roseola is highest in older infants. It is most common between 6 and 15 months. Older infants are at greatest risk of acquiring roseola because they haven't had time yet to develop their own antibodies against many viruses. Newborns are protected by antibodies received from their mothers during pregnancy. But this immunity decreases with time.
Roseola is usually a mild disease, but it can cause complications.
Seizures in children
Occasionally a child with roseola experiences a seizure brought on by a sudden fever (febrile seizure). If this happens, your child might briefly lose consciousness, fall down, and have jerking arms and legs for several seconds to minutes.
If your child has a seizure, seek emergency care. Although frightening, febrile seizures in otherwise healthy children tend to be short-lived and are rarely harmful.
Concerns for people with weak immune systems
Roseola is of greater concern in people with a weak immune system. You might have a weak immune system, for example, if you've recently had bone marrow transplant. People with a weak immune system have less resistance to viruses. They tend to develop more-severe roseola or complications such as pneumonia or encephalitis. Encephalitis is a potentially life-threatening inflammation of the brain.
There is no vaccine to prevent roseola. You can protect others by keeping home a child with fever until the fever has been gone for 24 hours. Then, even if a roseola rash is present the disease isn't contagious.
Most people have antibodies to roseola by the time they're of school age, making them immune to a second infection. Even so, if one household member gets the virus, make sure that all family members wash their hands often to prevent spread of the virus to anyone who isn't immune.