Roseola
(Exanthem Subitum; Roseola Infantum)
Definition
Roseola is an infection caused by a virus. It is characterized by a sudden onset of high fever followed by a rash. This disorder usually resolves on its own with no complications. Roseola can occur year round, but it is most common in the spring and fall.
Roseola

Causes
Roseola is usually caused by a virus called human herpesvirus 6 (HHV-6). It can also be caused by human herpesvirus 7 (HHV-7). These viruses are not the same as the herpes viruses that cause cold sores or genital herpes .
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition. Risk factors for roseola include:
- Age: 6 months to 3 years; most common between 6 months and 15 months
- Contact with an infected child is rarely reported
Symptoms
Symptoms of roseola include the following:
-
Fever
- 103°F to 105°F
- Begins suddenly and is not associated with other symptoms
- Lasts 3 days, occasionally a day or two longer
- Convulsions may occur in association with high fever in up to 5% to 10% of children
-
Rash is characteristic in roseola and develops typically 12 to 24 hours after the fever
- Appears first on chest and abdomen
- Rose-colored
- May spread to arms, legs, neck, and face
- Lasts for a few hours to a few days and does not itch
-
Other symptoms or signs may include:
- Swelling of lymph nodes in the neck and behind the ears
- Irritability
- Poor appetite
- Upper respiratory tract infection symptoms may be present before onset of fever
The appearance of a rash after the fever disappears is the characteristic sign of roseola.
Diagnosis
The doctor will ask about symptoms and medical history and perform a physical exam. The symptoms and physical findings of roseola are so distinctive that no other tests are usually needed. Often, there is a history of other children with roseola in the community.
Treatment
No treatment is needed for roseola unless the child is immunocompromised. The most important treatment is to keep the fever down and maintain good hydration with fluids.
Discuss with your healthcare provider how best to bring the fever down including:
- Medications such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin)
- Lukewarm sponge baths
- Plenty of fluids
Aspirin is not recommended for children and teens with a current or recent viral infection. Therefore, do not give aspirin to your child with roseola.
Call your doctor if your child has a seizure and/or the fever persists.
Prevention
To help prevent the spread of roseola, avoid contact with an infected child when possible. The incubation period is 5 to 15 days. The virus is thought to be spread by contact with infected saliva, with adults forming the main reservoir. Carefully and frequently wash your hands to help prevent the spread of roseola.
RESOURCES:
American Academy of Family Physicians
http://www.aafp.org
American Academy of Pediatrics
http://www.aap.org
CANADIAN RESOURCES:
About Kids Health
http://www.aboutkidshealth.ca
Alberta Health and Wellness
http://www.health.gov.ab.ca/
References:
Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ .
Kleigman RM, Jensen HB, Behrman RE, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders Elsevier; 2007.
The Merck Manual of Diagnosis and Therapy . 17th ed. Simon and Shuster; 1999.
The National Library of Medicine website. Available at: http://www.nlm.nih.gov/ .
The Nemours Foundation website. Available at: http://www.nemours.org/index.html .
Last reviewed November 2008 by Kari Kassir, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.