What You Need To Know About Roseola

Pediatric Basics

Baby boy (9-12 months) crying
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Roseola is a common viral infection of early childhood, mostly infecting children between the ages of 6 months and 3 years.

How common? It is thought that up to 25% of ER visits for fever in young children are because of roseola.

Roseola Symptoms

Children with roseola usually just have a high fever, often up to 104°F (40°C). About three to seven days later, once the fever breaks, kids with roseola get a red or pink raised rash all over their body.

This rash usually lasts a few hours to a few days. Unlike many other rashes that kids get, the rash of roseola is not itchy.

Some children infected with the virus that causes roseola do have other typical viral symptoms, such as a runny nose, cough, swollen glands, irritibility, and diarrhea. Other signs and symptoms might include febrile seizures or a bulging fontanel (soft spot).

Some children with roseola also have Nagayama's spots or red papules on their soft palate or base of the uvula in their mouth.

Even more common is to become infected with the roseola virus and not have any symptoms at all. The AMA reports that 'in about two thirds of these children the infection is asymptomatic.'

Roseola Rash

Besides the fact that the roseola rash typically starts after the fever breaks, there are some other things to look for to help you figure out if the rash is really from rosela.

The roseola rash usually starts on a child's trunk and back and then spreads to his face, arms, and legs.

The rash is often described as looking like small pink to red spots that sometimes come together to form larger patches.

Roseola Diagnosis

When a child with the roseola virus just has a fever, the diagnosis is difficult to make. It is not until the classic pattern of the rash starting after the fever has stopped that you can make the diagnosis, and by then, the child is already better.

Although it is easy to suspect roseola when a younger child has a fever, keep in mind that other infections can also cause just a fever. To rule out these more serious infections, including blood and urinary tract infections, a blood and urine culture may need to be done, especially in younger infants, even if your pediatrician suspects roseola.

No specific testing is usually required to diagnosis roseola, but a complete blood count might show a low white blood count (leukopenia).

Roseola Treatments

There is no specific treatment for roseola and most kids recover without problems.

Fever reducers, such as acetaminophen or ibuprofen, are helpful while your child has a fever.

What You Need To Know About Roseola

Other things to know about roseola include that:

  • You should usually call your pediatrician when your younger child has a fever, especially when they have no other symptoms.
  • Roseola is also called exanthem subitem (sixth disease) and it is caused by the HHV-6 virus (human herpesvirus 6). It is also thought that the HHV-7 virus might also be able to cause roseola.
  • The roseola rash was classically described as the "rash of roses" because it seemed to suddenly bloom on a child's body.
  • Unlike many other childhood infections, there is no seasonal pattern to getting roseola, so children may become infected year round. And it is not necessarily contagious, although some people believe that children transmit the virus through respiratory secretions and saliva while they have a fever. Others think that most kids become infected from people (usually family members) who have no symptoms. Either way, outbreaks are uncommon.
  • Although your child won't be able to attend daycare while he has a fever, according to the CDC, 'a child with rash and no fever may return to child care.'
  • About 1/3 of febrile seizures in younger children are thought to be caused by the roseola virus.
  • Children under 6 months are usually protected from getting roseola though maternal antibodies and children older than 2-3 years are usually immune. The biggest danger is to people with immune system disorders.

Has your child had roseola yet?


Principles and Practice of Pediatric Infectious Diseases (Fourth Edition)

Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases (Eighth Edition),

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