Roseola is a common childhood illness caused by a viral infection. It typically triggers a high fever that usually lasts for about a week. Once the fever breaks, a child is likely to develop a distinctive skin rash that can last from a few hours to several days. Children from the ages of 6 months to 3 years are most likely to contract roseola, although it can occur rarely in older children and adults.

Two closely related viruses – human herpesvirus type 6 and type 7 – cause roseola, which is also known as roseola infantum when it occurs in children. Patients who develop roseola are contagious and may spread the virus through expelling drops of fluid into the air while talking, laughing, sneezing or coughing.

In diagnosing roseola, a physician will perform a complete physical examination and compile a thorough medical history. A blood test may be performed to confirm the presence of antibodies associated with roseola.

Roseola typically does not require special treatment, and will pass on its own. Adults rarely contract the disease and, if they do, usually develop a mild form of the illness. However, adults may transmit the virus to children.

Roseola is typically mild and most children make a quick and full recovery. Parents can help reduce the child’s fever and related symptoms by using certain physician-approved medications. Parents also can keep the child cool by applying a sponge or towel soaked in lukewarm water to the child’s body. Dehydration can be avoided by encouraging consumption of clear liquids.

However, treatment may be more difficult in children with compromised immune systems who may be at greater risk of developing severe infections.

Roseola is a contagious disease caused by a virus that initially causes a high fever in children who are infected. Once the fever breaks, a skin rash develops first on the trunk and then it spreads over the body.

Children from the ages of 6 months to 3 years are most vulnerable to roseola, although the most common time for it to occur is from 6 to 12 months of age. Also known as exanthem subitum, the illness is typically mild after the initial high fever and most children make a quick and full recovery. In some cases, the high fever associated with the condition triggers seizures. Adults rarely develop the disease but may transmit the infection to children. 
 

Roseola is extremely common. After a child is exposed to the virus that causes roseola, it may take about five to 15 days before symptoms appear. In some cases, children who contract the virus never display any symptoms.

Drops of fluid from the nose and throat of infected adults or children can transmit roseola to others when the person talks, laughs, sneezes or coughs. Transmission occurs through breathing in germs or touching the nose or mouth after a finger has been exposed to a germ. Although roseola is contagious, it rarely causes the kind of widespread outbreaks associated with conditions such chickenpox. It appears that children who have symptoms of roseola no longer are contagious.

Roseola occurs year-round but most cases develop in the spring and fall. Children who recover from roseola appear to develop some immunity to the disease, and it is rare for a child to develop roseola more than once. By the time most people are of school age, they have developed antibodies to roseola and are immune to infection. However, adults occasionally do become infected. In such cases, the disease tends to be milder than it is in children.

Two closely related viruses cause roseola – human herpesvirus type 6 and type 7. The herpesvirus family consists of a large number of viruses, including the one that causes chickenpox and shingles (varicella zoster virus). These viruses are also related to herpes simplex viruses, but do not cause the cold sores or genital sores common to those forms of virus. Human herpesvirus type 6 is the most common cause of roseola. 

Roseola is most likely to strike older infants because they have not yet developed antibodies against many types of viruses, and have lost the antibodies they received from their mother while in the womb.

In addition, patients with weakened immune systems, such as those who have received a recent bone marrow or organ transplant, are more likely to develop roseola and to have a previous infection return. They are also more likely to develop a serious case of roseola, have a more difficult time fighting the condition, and are more likely to develop complications (e.g., pneumonia, encephalitis).

Children who develop roseola usually do so after having a minor upper respiratory illness. Although the condition typically causes symptoms, children with a very mild case may show no symptoms at all.

Initially, the primary symptom is a substantial fever. It is not uncommon for the child’s temperature to rise to over 103 degrees Fahrenheit (39.5 degrees Celsius) and even up to 105 degrees Fahrenheit (40.6 degrees Celsius). This fever usually lasts about three days but may last for as long as a week to 10 days, causing the child to become fussy and irritable. Lack of appetite, a sore throat, a runny nose and swollen lymph nodes in the neck are also common with this fever. Other symptoms may include fatigue, mild diarrhea and swelling of the eyelids.

In a minority of cases, the fever may trigger convulsions known as febrile seizures. These can cause the child to lose consciousness while the arms, legs or face jerk and twist for several minutes. The child may also lose bladder or bowel control.

After the fever has continued for a few days, it typically breaks suddenly. When this happens, a raised rash usually begins to appear on the child’s trunk and spreads across the body, especially to the neck, face, arms and legs. This rash is usually pinkish-red and individual spots may turn white when touched. Spots often have what appears to be a halo surrounding them. The rash does not itch or cause discomfort. It may last from anywhere from a few hours to several days.

Symptoms in adults tend to be milder than those in children and often resemble those of mononucleosis, a disease involving excess numbers of white blood cells that is characterized by fever and swollen lymph nodes.

Parents are urged to seek medical care if their child has a fever that lasts more than a week, or a rash that remains after three days. Anytime a child has a fever over 103 degrees Fahrenheit (39.5 degrees Celsius) parents should consult a physician.

In diagnosing roseola, a physician will perform a complete physical examination and compile a thorough medical history. In rare cases, a blood test may be performed to confirm the presence of antibodies associated with roseola. This may be necessary, as many other childhood illnesses (e.g., ear infection, common cold) can mimic the initial symptoms of roseola. This is particularly true in instances when the child does not develop the rash typically associated with roseola.

Roseola typically does not require special treatment. The condition will pass on its own over time. The chief aim of treatment is to reduce the child’s fever. Parents can keep the child cool by applying a sponge or towel soaked in lukewarm water to the child’s body. Ice, cold water, alcohol rubs, fans and cold baths should not be used, as they are likely to produce chills in the child.

Certain medications (e.g., acetaminophen, ibuprofen) can help reduce fever. Patients should consult with a physician before giving their child any medications. It is particularly crucial for parents to avoid giving aspirin to their child. The use of aspirin in a child who has a viral illness has been linked to Reye syndrome, a potentially fatal condition that can cause liver failure.

Encouraging a child to drink clear fluids such as water can help prevent dehydration that may occur as a result of the fever. Other fluids that may be used include children's electrolyte solutions (or sports drinks), clear broth or sodas like ginger ale that have been stirred at room-temperature until the fizz is eliminated. It is also important that children with roseola get plenty of rest.

Parents should contact a physician if their child becomes lethargic, stops drinking or has an inability to keep fluids down. In addition, any seizures require immediate emergency care.

Children who have compromised immune systems may be at greater risk of health problems from roseola. This includes children who have had bone marrow or organ transplants. Such patients may experience multiple bouts of roseola, or may develop particularly severe cases that are more difficult to treat. Physicians may prescribe antiviral medication for patients that are considered immunocompromised.

Preparing questions in advance can help parents to have more meaningful discussions with their child’s physicians. Parents of children with roseola may wish to ask their doctor the following questions:

1. What are the symptoms that might indicate that my child has roseola?
   
   
2. How will you diagnose my child’s condition?
   
   
3. Does roseola pose a danger to my child’s overall health?
   
   
4. What medications can I use to lower my child’s fever?
   
   
5. What steps can I take to prevent my child from dehydrating?
   
   
6. How long will it take for my child’s condition to improve?
   
   
7. How long will my child need to be kept out of school?
   
   
8. Should I isolate my child from his or her siblings to prevent spread of the condition? If so, for how long?
   
   
9. Is it possible for my child to develop roseola again?
   
   
10. I’ve heard adults sometimes get roseola. How can I reduce my risk of getting it from my child?