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Roseola in Children

What is roseola in children?

Roseola is a contagious viral illness. It causes a high fever and then a rash that develops as the fever goes away. The disease is also called roseola infantum or sixth disease.

What causes roseola in a child?

Roseola is caused by a type of herpes virus. The virus can enter the body through the nose and mouth. It is spread when a child breathes in droplets that contain the virus after an infected person coughs, sneezes, talks, or laughs.

Which children are at risk for roseola?

It most commonly affects children younger than age 2.

What are the symptoms of roseola in a child?

It may take 5 to 15 days for a child to have symptoms of roseola after being exposed to the virus. A high fever may start suddenly and may reach 105°F (40.5°C). A child is most contagious during the high fever, before the rash occurs. The fever lasts 3 to 5 days and then suddenly goes away.

As the fever goes away, a pink rash develops. The rash is either flat or raised lesions on the abdomen. It then spreads to the face, arms, and legs.

Your child may also have symptoms, such as:

  • Irritability

  • Swelling of the eyelids

  • Swollen glands

  • Ear pain

  • Decreased appetite

Febrile seizures are fairly common in children with roseola. Febrile seizures occur when a child's temperature rises quickly. Febrile seizures are generally not harmful. But they can be very scary. Not every child with a high temperature is at risk for a febrile seizure. Febrile seizures occur in about 3 in 100 children younger than age 5. This type of seizure may run in families.

The symptoms of roseola can be like other health conditions. Make sure your child sees their healthcare provider for a diagnosis.

How is roseola diagnosed in a child?

The healthcare provider will ask about your child’s symptoms and health history. They will give your child a physical exam. The physical exam will include inspecting the rash. The rash and high fever is usually enough to diagnose your child.

How is roseola treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. Antibiotics are not used to treat this illness.

The goal of treatment is to help reduce symptoms. Treatment may include:

  • Making sure your child drinks plenty of fluids

  • Giving acetaminophen or ibuprofen for fever and discomfort

  • Dressing your child in lightweight clothing during the fever

Talk with your child’s healthcare providers about the risks, benefits, and possible side effects of all medicines. Don't give ibuprofen to a child younger than 6 months old, unless your healthcare provider tells you to. Don't give aspirin to a child or teen. It could cause a rare but serious condition called Reye syndrome.

When should I call my child’s healthcare provider?

Call the healthcare provider if your child has:

  • Symptoms that don’t get better, or get worse

  • New symptoms

Key points about roseola in children

  • Roseola is a contagious viral illness. It causes a high fever and then a rash that develops as the fever goes away.

  • It most commonly affects children younger than age 2.

  • It may take 5 to 15 days for a child to have symptoms of roseola after being exposed to the virus. A high fever may start suddenly and may reach 105°F (40.5°C). The fever lasts 3 to 5 days and then suddenly goes away.

  • A child is most contagious during the high fever, before the rash occurs.

  • As the fever goes away, a pink rash develops. The rash is either flat or raised lesions on the abdomen. It then spreads to the face, arms, and legs.

  • The goal of treatment is to help reduce symptoms.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.

  • Before your visit, write down questions you want answered.

  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

  • Ask if your child’s condition can be treated in other ways.

  • Know why a test or procedure is recommended and what the results could mean.

  • Know what to expect if your child does not take the medicine or have the test or procedure.

  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

  • Know how you can contact your child’s healthcare provider after office hours, and on weekends and holidays. This is important if your child becomes ill and you have questions or need advice.

Medical Reviewers:

  • Barry Zingman MD
  • Dan Brennan MD
  • Stacey Wojcik MBA BSN RN