Roseola

What Is Roseola?

Roseola is a contagious viral infection most common in infants and young children. It’s known for a sudden high fever lasting several days, followed by a pink or red rash that appears as the fever subsides.

While the rash may look alarming, roseola is typically mild and short-lived. Most children recover quickly with supportive care. Adults can occasionally get roseola, but it’s rare and usually less severe.
The illness spreads easily, especially in childcare settings, but once children recover, they develop lifelong immunity to the virus.

What Causes Roseola?

Roseola is caused by human herpesvirus type 6 (HHV-6) or type 7 (HHV-7). Despite the name, these viruses are different from the herpes viruses that cause cold sores or shingles.

The infection spreads through:

• Respiratory droplets from coughing, sneezing or talking
• Saliva, for example from sharing utensils or cups
• Close contact with someone who’s infected, even if they don’t have visible symptoms
  
  

Roseola can be contagious even before the rash appears, during the fever stage. Once the rash develops, the risk of spreading the virus drops significantly.

Signs and Symptoms of Roseola

 Symptoms usually appear 5–15 days after exposure and often follow a predictable pattern:

1. High Fever (First Stage)

• Sudden fever, often between 102–105°F
• Irritability or fussiness
• Runny nose or mild cough
• Swollen eyelids or lymph nodes
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2. Rash (Second Stage)

• As the fever breaks, a rash of small pink or red spots appears, starting on the chest and spreading to the neck, arms and face.
• The rash is not itchy or painful and may fade within 1–3 days.
  
  

Some children may experience mild diarrhea or decreased appetite during the illness. In rare cases, a rapid rise in temperature can trigger a febrile seizure, which requires medical attention.

How Is Roseola Diagnosed?

Because roseola symptoms can resemble other childhood illnesses, a physical exam is often needed to confirm the diagnosis.

A health care provider will usually:

• Review the child’s fever history and rash pattern
• Examine the skin and throat
• Rule out other causes of rash such as measles, rubella or allergies
  
  

Blood tests or viral swabs are rarely needed unless symptoms are unusual or severe.

How to Treat Roseola

There is no specific antiviral medication for roseola. Treatment focuses on relieving symptoms and keeping the child comfortable.

At-Home Care

• Keep your child well-hydrated with water, electrolyte drinks or clear fluids.
• Use acetaminophen (Tylenol) or ibuprofen (Motrin) to reduce fever, but avoid aspirin in children.
• Offer light, easy-to-digest foods and plenty of rest.
• Use cool compresses to help lower body temperature during fever.
  
  

Medical Treatment

Most cases resolve at home within a few days. However, contact a health care provider if your child:

• Has a fever lasting longer than four days
• Experiences a seizure, breathing problems or persistent vomiting
• Appears unusually lethargic or unresponsive
  
  

Rarely, children with weakened immune systems may need hospital care to manage complications.

How to Prevent Roseola

Since roseola spreads through saliva and respiratory droplets, good hygiene practices are the best defense.

Prevention Tips

• Wash hands frequently with soap and water.
• Avoid sharing cups, utensils or towels.
• Teach children to cover coughs and sneezes with a tissue or elbow.
• Keep sick children home until they are fever-free for at least 24 hours.
  
  

There is no vaccine for roseola, but once a child has been infected, they are generally immune to future infections.

If your child develops a sudden high fever or rash, contact your pediatrician or primary care provider for guidance. While roseola is usually mild, professional advice can help ensure comfort and rule out other conditions.

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