What Parents Need to Know About Roseola

Roseola, also called sixth disease, is a common viral infection that typically affects young children under the age of 2 years. It is common during the spring and fall months in the United States. Please continue reading to learn more about this common contagious disease.

What is roseola or sixth disease?

Roseola is a viral infection caused by the human herpesvirus type 6 (HHV-6) and sometimes the human herpes virus type 7 (HHV-7). The virus causes a self-limited illness lasting three to seven days. The illness isn’t usually serious and gets better on its own in about a week’s time.

How common is roseola?

Most children (nearly 90%) have HHV-6 antibodies by the time they are 1 year old, indicating that they have been infected by the virus and have recovered. By age 4 years, almost every child has HHV-6 antibodies.

What are the symptoms of roseola?

Approximately 12-30% of children with roseola show symptoms. The most common symptoms of roseola are high fever, rash, mild diarrhea, swollen eyelids, swollen glands (swollen lymph nodes), decreased appetite, fussiness, and irritability.

A child with roseola will typically develop a high fever for 3-5 days. Then a rash will appear that is characteristic of roseola. However, not every child gets a roseola rash. The pink rash develops only in approximately 25% of infected children. The rash, when present, consists of flat spots or patches that do not typically itch or hurt.

Is roseola a contagious viral illness?

Yes, roseola is a contagious illness and can spread rapidly. However, widespread outbreaks of roseola are not common, unlike chickenpox or measles.

Roseola can spread through contact with an infected person’s saliva or respiratory droplets (coughing and sneezing). In other words, you can get the infection by sharing cups or utensils with an infected person or if an infected person coughs or sneezes near you.

Keep in mind that it can take up to 10 days from the time of exposure to the virus to the development of roseola symptoms in infected children.

At what stage is roseola contagious?

Roseola is contagious at the stage when there is a high temperature or fever. This stage usually lasts 3-5 days. It is no longer contagious after the fever has been absent for 24 hours.

You cannot do anything to prevent roseola. However, you should keep your child home until they have been fever-free for 24 hours. At this stage, the child is no longer contagious. This helps to prevent spreading of the infection to other children.

Is roseola contagious to parents? Can adults get roseola from a child?

Roseola can be contagious to parents. Adults can get roseola from children. However, the illness mostly affects children between the ages of 6 months and 3 years. Most adults have developed immunity after getting infected by the roseola virus during childhood.

How is roseola diagnosed?

Your child’s provider can diagnose roseola on the basis of their symptoms and a physical exam.

What should I do if my child has roseola?

If your child has symptoms of roseola, there is nothing specific you need to do to treat roseola. This disease is rarely harmful. The virus will go away and your child will recover in three to seven days without specific medical care.

You should make sure your child drinks plenty of water and stays well hydrated. Besides fluids, giving acetaminophen (Tylenol) or other over-the-counter pain relievers and fever reducers can help reduce symptoms and keep your child comfortable. However, you should not give aspirin to a child.

Loose, lightweight clothing can minimize any discomfort from the rash. Application of a cool sponge to the forehead may help reduce the fever.

When to have symptoms of roseola treated by a healthcare provider?

If you are not sure what is the cause of your child’s rash and high fever, get in touch with your child’s healthcare provider. It’s important to make sure your child’s condition is not something more serious. Also, high fever can sometimes cause a febrile seizure in children, which should be evaluated and treated by a healthcare provider.

You should get in touch with your child’s healthcare providers if your child’s symptoms are severe. Call his or her healthcare provider without delay in the following situations:

In a child younger than 6 months.
In children with poor general health or pre-existing health conditions.
If your child has a convulsion or febrile seizure (seek emergency care if febrile seizures occur).
If your child’s temperature rises quickly.
For a high temperature above 103F.
If the pink rash develops and does not improve after 3 days or the fever returns, make a follow-up appointment with the child’s healthcare provider.
If someone in your household has a health history of a weakened immune system. Roseola can develop into a serious health condition in such individuals.

What are some other types of children's viral rashes?

Some of the other common viral rashes in children are briefly described below.

Chickenpox (Varicella)

This is a highly contagious illness caused by a virus called varicella zoster. It spreads through direct contact or respiratory droplets in the air. Symptoms of chickenpox include fatigue, fever, muscle soreness, and loss of appetite. A red, itchy rash develops on the scalp, face, chest, and back and, less commonly, on the arms and legs. Chickenpox blisters are filled with clear fluid and crust over after rupturing.

Fifth disease

Also called slapped cheek disease or erythema infectiosum, fifth disease is a viral illness caused by human parvovirus B19. It spreads through direct contact and nose and mouth secretions. A child’s rash in fifth disease has the characteristic appearance of a slapped cheek. In addition, the rash occurs on the chest, back, arms, legs, and buttocks in some children. Other symptoms of fifth disease include a low-grade fever, headache, nausea, and vomiting.

Measles (Rubeola)

This is a highly contagious viral illness caused by the measles virus (Morbillivirus). It spreads through direct contact and airborne droplets when the child breathes, sneezes, or coughs. Measles is preventable with proper immunization. The measles rash consists of slightly raised lesions (red spots) that occur in tight clusters, appearing first on the face and then spreading to the rest of the body.

Rubella

Also called German measles or three-day measles, rubella is a contagious viral illness that causes a distinctive red rash on the face, arms and legs, and trunk. It is not a serious infection but can cause severe problems in unborn babies if a pregnant woman becomes infected. The measles-mumps-rubella (MMR) vaccine provides lifelong protection against this viral disease.

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